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NL Gets D-Minus On Health Performance - Diabetes To Blame

Uncategorized Aug 19, 2015

The Conference Board of Canada is the latest to score our health performance as both a province and a country. NL failed again, with a D minus, as a result of our high diabetes rates. Sadly, being at the bottom of the country health-wise is not news.

The amount of money diabetes costing us is ALARMING.

When I read the diabetes stats, and I crunched some of the numbers, I was just shocked! For a cash conscious "have-not mentality" province, we are certainly throwing a lot of money away.

First, Let's Address The D-Minus Rating

My first reaction to the CBC headline that we were the lowest graded province in terms of health status was to think... yeah, so we are the sweetest and fattest in the country again. This has been the case for the last several years according to various reports and while providing us NLers with an ongoing sense of guilt and embarrassment, it is not news. All the same, being a doctor, I went to the original report and read up.

What stunned me was this: "Newfoundland and Labrador, the worst-ranked province, scores a “D-” for placing just below the worst-ranking peer country, the United States."

Wait! What?!?!? We are WORSE than the US and they don't have free healthcare! Those are the breaks. The US ranked at a D, we ranked a D minus. Canada as a country ranked better at a B grade overall. Yip, apparently NLers are worse off, the rating is a direct result of our high incidence of Type 2 (Adult-Onset) Diabetes.

Diagnosis rates are as follows:

  • Canada: 5.3%
  • US: 6.7%
  • NL: 6.8% of the population. This is almost 36 thousand NLers!
    • And these are the rates of full blown diabetes, it also doesn't include the people diagnosed with pre-diabetes. Which btw, the Canadian Diabetes Association estimates is about 25% of the NL population: add another 132,000 NLers.
    • That is a whopping total of 168,000 NLers with diabetes or pre-diabetes. It is well known that many people will live with diabetes for years before anyone catches on and that astronomically high number still doesn't include them! That's the entire population of St. John's CMA!

Christ... we are a pretty sweet bunch. So what?

How much it's costing us is what.

Try millions out-of-pocket?

For arguments sake, let's assume you are okay with the obvious long-term health risks of diabetes:

  • Taking pills and/or sticking a needle in your own gut or butt for the rest of your life;
  • Not being able to see (diabetic retinopathy);
  • Amputated limbs (complications as a result of infected ulcers in the feet and extremities);
  • Not getting to hang out and play with your grand kids for very long due to early death;
  • Among a laundry list of other terrible complications that are possible...

Assuming you are okay with taking those kind of risks (which I doubt), let's follow the money. Diabetes is expensive. "A person with diabetes can face medication and supply costs in the range of $1,000 to $15,000 a year", according the to study report. The Canadian Diabetes Association also estimates that the annual out-of-pocket (i.e. you pay not medi-care) cost for individuals with Type 2 Diabetes is $3396.04. Multiply that by the 168,000 NLers with diabetes/pre-diabetes and you get a budget of about $570 million dollars!

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Let's put that number into context:

  • $3396 per year per person is about half the cost of groceries for the year for a small family.
  • The NL Government is reported to be looking at a $916 million dollar budget deficit as a result of falling oil prices. $570 million is over half that deficit.
  • The annual snow clearing budget for St. John's is just under 18 million. This is a fraction of what we spend on diabetes.
  • What would you do if you won 570 MILLION DOLLARS?!!

I get that health care costs are a fact of life for those with a diagnosed illness. If you are sick and need care or medication, I would be the first to tell you to go get it. If you need it, you need it.

So what's the rub?! Press us and every doctor will tell you, Type 2 (Adult-Onset) Diabetes is a chronic disease that results from long-term bad dietary and lifestyle choices. Read that in another way and you are hearing that it is a largely preventable disease! For want of some better choices, we could be saving ourselves hundreds of millions of dollars!

Let that sink in....

There are so many studies out there proving that diet and exercise interventions drastically improve the risk, incidence and severity of diabetes that it's common sense. The report itself quotes one study which showed that people at risk of type 2 diabetes (i.e. pre-diabetics) were able to reduce their risk by 58 per cent by exercising moderately for 30 minutes a day and by losing 5–7 per cent of their body weight. That's why primary care standard has doc's sending you home to work on it with diet and lifestyle first whenever possible, before they give out the medications. Diet and lifestyle works when it's implemented. Every -- single -- time.

Actions You Can Take Today

According to my research and clinical experience, the crux of implementing it right means this:

  1. Learn about the impact food and sugar has on blood sugar.
  2. Find and cut the sugar out of your diet.
  3. Move around a bit, 30 minutes per day is all ya need.

Seriously! That's it! Three Steps! You can do that! Especially if it means $570 million dollars back into our pockets. Heck, most of us would do it for the $3396 to put towards the groceries each year!

As a doctor, I want to see this province get healthier. As a tax-burdened citizen, I want to see  you to keep more of your hard earned cash too.

So, I created the 30 Day ZERO Sugar Challenge to help you with the first two bullet points. It's only $30 bucks and is meant to help anyone interested in making the one change that will make the most difference in your health if you haven't already made it, i.e. finding and cutting the sugar out of your diet. (I'd exercise for you too if I could, but that's not how it works.)

Look, my philosophy is always to take the next most important baby step in the right direction and then building on that with the next step. You see, anything more than one little change, and it's too overwhelming for most of us. Compliance goes down, and so do the results. I truly believe that reducing sugar intake is where to start for Newfoundlanders and Labradorians.

Once we have a bit of momentum going, we'll talk about the exercise. By that time, it won't be so daunting, I promise.

You didn't read to the end for nothing. Get more details and sign up for the ZERO Sugar Challenge here. It starts whenever you are ready.




Other episodes you might enjoy : 

How To Fill Your Plate With Confidence (And Control Your Blood Sugar)

8 Foods To Help You Balance Blood Sugar All Day

TYPE II's: What To Do When You Feel Fed Up With Your Sugars

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