Are You At Risk? A Diabetes Risk Assessment Tool

Organization Sponsor: Canadian Diabetes Association (CDA)

URLs: 

Program Description

Right now, one million Canadians are living with Type 2 diabetes and don’t know it. Are you one of them? What are the risk factors?
• Are you 40 years of age or older?
• Do you have a close relative (parent or sibling) who has Type 2 diabetes?
• Are you a member of a high-risk population, such as those of Aboriginal, Hispanic, Asian, South Asian, or African descent?
• Do you have a history of gestational diabetes or pre-diabetes or some evidence of the complications of diabetes (such as eye, nerve or kidney problems)?
• Do you have heart disease, high blood pressure, or high cholesterol?
• Are you overweight (especially around your abdomen)?

If you answered “yes” to any of these questions, you should contact your healthcare provider and get checked for diabetes right away. If left untreated or improperly managed, diabetes can result in a variety of complications:
• heart disease
• kidney disease
• eye disease
• problems with erection (impotence)
• nerve damage (Diabetic Peripheral Neuropathy)

What are the signs and symptoms?
There are many signs and symptoms that can indicate Type 2 diabetes. Some of these are unusual thirst, frequent urination, weight change (gain or loss), extreme fatigue, blurred vision, cuts and bruises that are slow to heal, and tingling or numbness in the hands or feet.

If you have any of these symptoms, it is important to contact your healthcare provider right away. Even if you don’t have symptoms, if you are 40 or older, you should still get checked.

Diagnosis of diabetes
Your healthcare provider will have to test your blood to determine if you have diabetes. There are three different tests that can measure the amount of glucose (sugar) in your blood.
1. Fasting blood glucose (FPG): You must not eat or drink anything except water for at least eight hours before this test. A test result of 7.0 mmol/L or greater indicates diabetes.
2. Casual blood glucose: This test may be done at any time, regardless of when you last ate. A test result of 11.0 mmol/L or greater, plus symptoms of diabetes, indicates diabetes.
3. Oral glucose tolerance test: You will be given a special sweetened drink prior to this blood test. A test result of 11.1 mmol/L or greater, taken two hours after having the sweet drink, indicates diabetes.

A second test must be done in all cases (except if you have acute signs and symptoms). Once you’ve been diagnosed with diabetes, ask your healthcare provider to refer you for diabetes education.

Program Approximate Cost: 

free

Funding Sources: 

Canadian Diabetes Association

Strategies For Sustainability: 

The prevalence of Type 2 diabetes in Canada and worldwide has risen more quickly during the last two decades than originally forecast. Emphasis has been placed on the prevention of Type 2 diabetes among high-risk groups with impaired fasting glucose and/or impaired glucose tolerance (also referred to as pre-diabetes) as growing evidence demonstrates that Type 2 diabetes can be prevented or delayed through lifestyle or pharmacological interventions.

Impact Of Program: 

This new implementation research will help inform Canadian efforts aimed at preventing Type 2 diabetes. Simple, cost-effective early detection programs are an essential first step toward reducing the serious healthcare burden posed by the unprecedented rise in diabetes and pre-diabetes in Canada.

Evaluation Tools: 

Seven provincial pilots are currently underway to field test and validate this screening approach, while also assessing effectiveness and user satisfaction. The PHAC is currently developing and validating a “made-in- Canada,” self-administered questionnaire with high diagnostic accuracy to detect prevalent undiagnosed Type 2 diabetes.

Key Elements Towards Success: 

PHAC is developing a “made-in-Canada,” non laboratory-based screening questionnaire, validated against the diagnostic gold standard, to identify pre-diabetes and undiagnosed diabetes among middle-aged adults. This 2-stage screening approach is based on an effective Finnish model (the Finnish Diabetes Risk Score [FINDRISC]), which is being adapted to reflect Canada’s multi-ethnic population

Challenges To Meet Them: 

Adapting the test to the Canadian multicultural population.

Length and Stage of Project: 

This began in 2009 and is ongoing.

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