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1 in 4 Ontarians do not report having diabetes


Chronic disease care self-management can improve the health of patients, especially those with diabetes. A new report from Ontario’s Institute for Clinical Evaluative Sciences (ICES) says many people with physician diagnosed diabetes do not report having the disease, suggesting their self management of the disease is inadequate.

The ICES study looked at a registry of physician-diagnosed diabetes and studied the respondents to a 2000/01 population-based health survey. Self reported diabetes was defined based on the answer to the question, “Do you have diabetes?” Lead investigator and senior ICES scientist Dr. Baiju Shah notes, “Self-care is the cornerstone of diabetes management and a substantial portion of the diabetic population may be inadequately managed. The lack of self identification may happen for many reasons, because physicians simply did not inform their patients of the diagnosis or used other euphemisms rather than the word diabetes. Individuals who do not self-identify as having diabetes may not be aware of the risks to their health. They may also be less likely to respond to public education messages about the disease and if they do not report having the disease to their physicians and other healthcare providers, diabetes may not be taken into account in treatment plans for their other health conditions.”

The results:

  • The sample size in the population health survey was 39,278 respondents in Ontario, aged 20 years or older.
  • Of them, there were 1,812 people with physician-diagnosed diabetes in the registry. 1,356 (75%) self reported having diabetes in survey while 456 (25%) did not.
  • People who were male, lived in rural areas with longer diabetes duration and who saw diabetes specialists were more likely to report the disease. People who did not report having diabetes were less likely to perform glucose blood monitoring and less likely to have specialist physician care, than those who did.
  • More than one in four people with physician-diagnosed diabetes did not self-report having the disease.

“Our findings suggest that patients may need to advocate on their own behalf for referral to diabetes specialists, which those not reporting diabetes may be less likely to do. And it is far more likely primary care physicians have to identify people who do not report having diabetes and to overcome this potential barrier to care,” says Dr. Shah.

The study, “Self-reported diabetes is associated with self-management behaviour: a cohort study,” is in BMC Health Services Research.

Author Affiliations: ICES (Drs. Shah, Manuel); Departments of Medicine and Health Policy, Management and Evaluation, University of Toronto (Dr. Shah); Department of Medicine, Sunnybrook Health Sciences Centre, Toronto (Dr. Shah); Department of Public Health Sciences, University of Toronto (Dr. Manuel) – ONT.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.



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