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More than 2/3 of all Ontarians with diabetes live in major urban centres


More than two-thirds of all Ontarians with diabetes live in major urban centres, with approximately one half of all cases in the Greater Toronto Area (GTA) alone; however acute complication rates are lowest in urban centres, according to researchers at the Institute for Clinical Evaluative Sciences (ICES).

“Currently, more than one million Ontarians live with diabetes. In this report, we were able to examine diabetes at the community level and found enormous variation across the province in terms of complication rates,” says Gillian Booth, lead author and Adjunct Scientist with ICES.

Access to diabetes programs and services was greatest in Ontario’s urban areas with diabetes education programs, including those at satellite and outreach locations distributed fairly extensively throughout the province. But the numbers of endocrinologists and ophthalmologists were fairly sparse outside of major centres. Optometrists were more equitably distributed throughout the province than other specialists who treat people with diabetes.

“Fortunately there are a variety of treatments available that can delay or prevent serious complications of diabetes, so access to care is critical for people with diabetes. Although the number of diabetes programs and services was greatest in urban centres, the existing service capacity in these regions may still be insufficient – and the rising numbers of people living with diabetes in these areas will create an ongoing demand for more services,” says Booth.

Diabetes prevalence rates were high in the GTA, affecting as much as 13 per cent of the adult population in some centres; but in some northern and rural communities the prevalence rate was as high as 32 per cent.

The study found:

  • Nearly one out of every 10 Ontarians has been diagnosed with diabetes.
  • Acute complication rates varied four-fold across the province.
  • Acute complication rates were highest in smaller, predominantly rural communities in both northern and southern Ontario.
  • Acute complication rates were lowest in urban centres.
  • In some communities, as many as three out of every 10 adults with diabetes had a potentially preventable diabetes-related hospitalization or emergency department visit between 2006/07 and 2010/11.
  • Chronic complication rates were highest in northern Ontario and in predominantly rural areas in southern Ontario.
  • In some of these communities, as many as two of every 10 adults with diabetes had one or more chronic complication (e.g., cardiovascular hospitalization, amputation or end-stage kidney disease) between 2006/07 and 2010/11.
  • There was relatively little variation across the province with respect to the prevalence of medical comorbidities, but mental health physician visits were significantly more common in Toronto and surrounding areas.

In 2008, the Ontario Ministry of Health and Long-Term Care launched the Ontario Diabetes Strategy (ODS), a comprehensive initiative that builds on internationally accepted best practices and the growing body of evidence supporting the organization of healthcare around chronic disease management.

The report “Regional Measures of Diabetes Burden in Ontario,” is being published by ICES on April 24, 2012.  

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.


Read the Journal Article