Diabetes surge has become 'epidemic' in northeast Calgary, ophthalmologist warns

Diabetes, and complications from diabetes, seem to be surging among people in northeast Calgary, especially in certain communities — with one ophthalmologist warning it has reached "epidemic" proportions.

Dr. Jag Anand says diabetes is what brings most people into his northeast Calgary retina clinic.

"I'm seeing more patients and they are coming with more complications. It is a big problem," Anand said, calling it an "epidemic."

"And if you are a South Asian or East Indian, you have five to six times higher risk of getting diabetes as compared to your other compatriots. And, of course, it's very high in the Indigenous population as well." 

Many of those complications go beyond retinopathy. He is hearing from patients with kidney and heart problems, diabetic feet, and numbness in their lower extremities — all conditions he says should have been diagnosed earlier. 

Anand said many of his patients put off seeking medical attention until the disease has progressed further than it needs to.

"Most of my patients do sometimes two jobs and they are so busy working so hard trying to pay off their mortgage and other bills that they neglect their health," he said.

He said knowledge of the risks and complications of diabetes remains very low in many northeast communities.

"If we make people aware that they have to take that seriously, it is a disease which can kill you and it can blind you."

'It's like a common thing now'

Buela David, who came to Canada from India as a child, is one of Anand's patients — and wishes she had taken diabetes more seriously when she developed it 28 years ago. 

She tried to regulate her blood sugar levels with diet and medication — but as life got busier and she started working two jobs, her health deteriorated.

"Just like everybody else, I thought I could control it," said David.

"And just on the pills, then gradually went to insulin. Then it started affecting my eyes." 

David experiences swelling at the back of one eye that affects her vision. She sees Anand every four to six weeks to get an intravitreal injection into the eye — but even though she's been getting the treatment for four years, she doesn't look forward to it.

"I just go into panic mode every time I have to go," she said.

She agrees with Anand that diabetes is alarmingly common in the city's South Asian community. 

"The friends and families that I know, every family has somebody [who] is diabetic, so it's like a common thing now," she said.

Confirmed cases on the rise

Alberta Health Services doesn't collect specific data to show whether a chronic disease is more prevalent in one part of the city over another.

However, AHS groups its health statistics into five geographic zones — and the latest data shows the number of confirmed diabetes cases in the Calgary zone has almost doubled over 15 years.

Overall, about one in four Albertans — 1,207,000 Albertans — are affected by the disease, because they've been diagnosed with Type 1 or Type 2 diabetes, are pre-diabetic, or have the disease but aren't aware of it, according to a Diabetes Canada report in 2021. 

Diabetes is the leading cause of blindness. It causes 30 per cent of strokes, 40 per cent of heart attacks and can affect kidney function.

Adults in the lowest income groups are 3.9 times more likely to have the disease than adults in the highest income group.

And certain populations face a higher risk of developing Type 2 diabetes, according to the Diabetes Canada report:

• South Asian.
• Asian.
• Indigenous.
• African.
• Arab.
• Hispanic.

These populations make up 42.4 per cent of Calgary's population, and many lower-income groups are concentrated in the city's northeast, according to the 2016 Canadian census.

Dialysis use increasing

Dr. Stuart Ross, an endocrinologist and clinical professor of medicine at the University of Calgary, isn't prepared to call diabetes an "epidemic" in northeast Calgary — but says there's no question it's on the rise.

"Is it increasing? Probably, yes," Ross said. "We have data to prove that. And so it's still, whether you use the word 'epidemic' or not, the issue is that it's a major health concern."

It's part of a larger trend, not just in Calgary but in Canada and many other countries, he said.

"Over the years I've watched the numbers of people with dialysis increase dramatically and we've had to open up more dialysis clinics right across, for example, across southern Alberta to deal with the number of people," Ross said.

"That's an indication that those people have not had the proper assessments because we do have the means to prevent it from progressing." 

He pointed out that many of the most serious complications of diabetes are preventable with proper diet, exercise and a healthy lifestyle.

Diabetes strategy needed

Anand is a strong advocate for a national diabetes strategy like those already found in several Commonwealth countries. 

The strategy would include a national program to help prevent the rising cases. It would include a pharmacare program for diabetes medication — something Anand calls "the missing piece" in the diabetes jigsaw puzzle.

"Every country like Australia, England, New Zealand, they all have national diabetic eyecare programs," Anand said. "If we had that, that itself will help reduce the impairment of vision from diabetes by at least 80 to 90 per cent."

As for David, she wishes she had realized earlier how serious diabetes complications can be — and feels people in her community need more education about the disease.

"Especially people who don't speak English," David said  "[They] still don't understand the seriousness of this disease kind of thing. So they need to know more."