A new diabetes screening program in Edmonton goes further than any other in North America, effectively making diabetes a reportable disease.

Under the program, whenever someone in the city visits a doctor, hospital or walk-in clinic, their blood-sugar information is recorded in a central database. Edmonton's Capital Health Region plans to use the information to identify and treat anyone with diabetes or at risk for the disease.

The goal of the program is to help people manage their diabetes through lifestyle changes, said Dr. Richard Lewanczuk.
(CBC)

Left untreated or unmanaged, diabetes can have devastating results, such as blindness, loss of limbs, kidney failure and even death.

By 2010, the cost of treating diabetes in Canada is expected to rise to $15.6 billion. The program's directors hope that the costs will be reduced dramatically through early screening and proper management.

Blood test results showing high glucose levels would flag the risk for diabetes. Pharmacists, doctors and nurses would encourage anyone who appeared to be at risk due to excess weight or inactivity to get the voluntary blood test.

Participants would also be offered the opportunity to enter a Type 2 diabetes management program that includes diet and exercise advice.

Registered patients would be contacted every three months by their family doctor to ensure they are in good health. Those without family doctors would receive the same treatment from public health services.

"We're moving from this acute-care system of get sick, then we do something, then we wait until you get sick again, to a system where we are being really proactive and following up with patients," said Dr. Richard Lewanczuk, director of chronic disease management for the region.

Costly testing

Full screening is a laudable goal, but health ethicist Arthur Schafer of the Centre for Professional and Applied Ethics in Winnipeg has some reservations.

"Even the blood strips, the glucose strips that diabetics use to test themselves, cost our health-care system $300 million a year," said Schafer, who referred to a debate over the point at which diabetes patients should be medicated.

Nancy Thompson changed her diet but has to take some drugs to control her diabetes.
(CBC)

Lewanczuk countered that the goal is to catch the signs of Type 2 diabetes early, so people can make lifestyle changes and avoid the need for medication. But he acknowledged that some people will still need drugs to control their blood sugar levels.

Nancy Thompson of Edmonton had her diabetes noted during a routine scan 18 months ago. Thompson attended courses to learn how to eat properly and monitor her blood glucose levels, and said it is working.

"I started out just with diet alone, but my morning glucose was gradually creeping up," said Thompson. "So now I take two very mild pills a day."

So far, two people have asked to be excluded from the registry and 76,000 people are included — 90 per cent of the estimated number of people with diabetes in Edmonton, Lewanczuk said.

The drug company Pfizer helped start the program.