Report summary – Diabetes in Canada: facts and figures from a public health perspective

Pelletier, Catherine; Dai, Shaotao; Kc, Roberts; Bienek, Asako; Onysko, Jay; Pelletier, Louise

doi:10.24095/hpcdp.33.1.07

Cited by 84 publications

(33 citation statements)

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“…This is significant, as diabetes is closely associated with cardiovascular disease, retinopathy, neuropathy, and kidney disease. In turn, this places increasing stress on the health care system, and these patients utilize medical resources three to four times the amount of those without diabetes[ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study

Arnason

Bowen

Mansell

2017

WJD

101

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AIMTo determine the short-term biochemical effects and clinical tolerability of intermittent fasting (IF) in adults with type 2 diabetes mellitus (T2DM).METHODSWe describe a three-phase observational study (baseline 2 wk, intervention 2 wk, follow-up 2 wk) designed to determine the clinical, biochemical, and tolerability of IF in community-dwelling volunteer adults with T2DM. Biochemical, anthropometric, and physical activity measurements (using the Yale Physical Activity Survey) were taken at the end of each phase. Participants reported morning, afternoon and evening self-monitored blood glucose (SMBG) and fasting duration on a daily basis throughout all study stages, in addition to completing a remote food photography diary three times within each study phase. Fasting blood samples were collected on the final days of each study phase.RESULTSAt baseline, the ten participants had a confirmed diagnosis of T2DM and were all taking metformin, and on average were obese [mean body mass index (BMI) 36.90 kg/m2]. We report here that a short-term period of IF in a small group of individuals with T2DM led to significant group decreases in weight (-1.395 kg, P = 0.009), BMI (-0.517, P = 0.013), and at-target morning glucose (SMBG). Although not a study requirement, all participants preferentially chose eating hours starting in the midafternoon. There was a significant increase (P < 0.001) in daily hours fasted in the IF phase (+5.22 h), although few attained the 18-20 h fasting goal (mean 16.82 ± 1.18). The increased fasting duration improved at-goal (< 7.0 mmol/L) morning SMBG to 34.1%, from a baseline of 13.8%. Ordinal Logistic Regression models revealed a positive relationship between the increase in hours fasted and fasting glucose reaching target values (χ2 likelihood ratio = 8.36, P = 0.004) but not for afternoon or evening SMBG (all P > 0.1). Postprandial SMBGs were also improved during the IF phase, with 60.5% readings below 9.05 mmol/L, compared to 52.6% at baseline, and with less glucose variation. Neither insulin resistance (HOMA-IR), nor inflammatory markers (C-reactive protein) normalized during the IF phase. IF led to an overall spontaneous decrease in caloric intake as measured by food photography (Remote Food Photography Method). The data demonstrated discernable trends during IF for lower energy, carbohydrate, and fat intake when compared to baseline. Physical activity, collected by a standardized measurement tool (Yale Physical Activity Survey), increased during the intervention phase and subsequently decreased in the follow-up phase. IF was well tolerated in the majority of individuals with 6/10 participants stating they would continue with the IF regimen after the completion of the study, in a full or modified capacity (i.e., every other day or reduced fasting hours).CONCLUSIONThe results from this pilot study indicate that short-term daily IF may be a safe, tolerable, dietary intervention in T2DM patients that may improve key outcomes including body weight, fasting glucose and postprandial variability....

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Section: Introductionmentioning

confidence: 99%

Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study

Arnason

Bowen

Mansell

2017

WJD

101

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“…FN people continue to experience shorter life expectancy and higher rates of mortality and chronic conditions including obesity, type 2 diabetes and CVD ( 4 ) . In BC, the general population has the lowest prevalence of chronic diseases among the Canadian provinces ( 5 , 6 ) ; however, FN in BC experience poorer health status and a greater burden from chronic conditions compared with the general population in BC ( 7 ) . Recent statistics show some improvements, including a slowdown in the diabetes prevalence rate lately ( 8 , 9 ) .…”

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confidence: 99%

Seafood consumption patterns, their nutritional benefits and associated sociodemographic and lifestyle factors among First Nations in British Columbia, Canada

Marushka¹,

Batal²,

Sadik³

et al. 2018

Public Health Nutr.

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“…We estimated these probabilities from published data on incidence rates of chronic diseases ( S6 Table ) [ 31 , 40 – 45 ], the effects of weight status on incidence of these chronic diseases from a meta-analysis by Guh et al ( S7 Table ) [ 27 ] and weight status distribution ( S4 Table )[ 36 ]. We considered only chronic diseases for which the meta-analysis found a significant effect including Diabetes, Hypertension, Stroke, Coronary artery disease, Asthma, Osteoarthritis and 7 cancers (Kidney, Pancreatic, Colorectal, Breast, Endometrial, Ovarian and Gallbladder) ( S7 Table ) [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach

et al. 2017

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BackgroundThe Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools) has been recognized as a “best practice” in preventing childhood obesity. To inform decision making on the economic implications of APPLE Schools and to justify investment, we evaluated the project’s cost-effectiveness following a life-course approach.MethodsWe developed a state transition model for the lifetime progression of body weight status comparing elementary school students attending APPLE Schools and control schools. This model quantified the lifetime impact of APPLE Schools in terms of prevention of excess body weight, chronic disease and improved quality-adjusted life years (QALY), from a school system’s cost perspective. Both costs and health outcomes were discounted to their present value using 3% discount rate.ResultsThe incremental cost-effectiveness ratio(ICER) of APPLE schools was CA$33,421 per QALY gained, and CA$1,555, CA$1,709 and CA$14,218 per prevented person years of excess weight, obesity and chronic disease, respectively. These estimates show that APPLE Schools is cost effective at a threshold of ICER < CA$50,000.In probabilistic sensitivity analysis, APPLE Schools was cost effective more than 64% of the time per QALY gained, when using a threshold of ICER

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Report summary – Diabetes in Canada: facts and figures from a public health perspective

Cited by 84 publications

References 0 publications

Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study

Effects of intermittent fasting on health markers in those with type 2 diabetes: A pilot study

Seafood consumption patterns, their nutritional benefits and associated sociodemographic and lifestyle factors among First Nations in British Columbia, Canada

Cost-effectiveness of a school-based health promotion program in Canada: A life-course modeling approach

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