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ADSS Update for Steering Committee June 24, 2008 Jeff Johnson PhD. Stephanie Vermeulen MSc.

ADSS Update for Steering Committee June 24, 2008 Jeff Johnson PhD. Stephanie Vermeulen MSc. ADSS Deliverables. AHW & IHE/ACHORD partnership Deliverables Alberta Diabetes Atlas 2007, 2009, 2011 ADSS Newsletter Regular updates and issue-specific focus ADSS Website

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ADSS Update for Steering Committee June 24, 2008 Jeff Johnson PhD. Stephanie Vermeulen MSc.

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  1. ADSS Update for Steering Committee June 24, 2008 Jeff Johnson PhD. Stephanie Vermeulen MSc.

  2. ADSS Deliverables • AHW & IHE/ACHORD partnership • Deliverables • Alberta Diabetes Atlas • 2007, 2009, 2011 • ADSS Newsletter • Regular updates and issue-specific focus • ADSS Website • Timely, region-specific information

  3. Alberta Diabetes Atlas 2007 Debut: June 2007

  4. Alberta Diabetes Atlas 2007 Acknowledgments 1. Background & Methods 2. Epidemiologic Trends, 1995-2005 3. DM & Health Care Utilization 4. DM & Cardiovascular Disease 5. DM & Lower Limb Amputations 6. DM & Kidney Disease 7. DM & Eye Disease 8. DM & Mental Health 9. DM & First Nations People 10. Key Findings & Policy Options Glossary

  5. ADSS Newsletters • January 2007 “What is the ADSS?” • August 2007 “Diabetes and Eye Disease” • Fall 2007 “Diabetes and the Under 20” • February 2008 “Diabetes and First Nations” • June 2008 “Active Dissemination of the ADSS”

  6. Future ADSS Newsletters • Healthcare Utilization and Costs • Health Region/Community- Specific Profiling • Diabetes and Pregnancy

  7. ADSS Fact Sheet 2008

  8. www.albertadiabetes.ca

  9. ADSS Website- Interactive Aspect All of Alberta Regional Health Authority Sub-Region Community Rates/Cases from 1995-2005 DM alone or DM & Disease First Nations Status All Ages 20-34 years 35-49 years 50-64 years 65-74 years 75 + years Both Sexes Male Female FIGURES FROM DATABASE

  10. Active Dissemination Efforts • Answered an RFP from the Public Health Agency of Canada: “Local Community Dissemination for the ADSS” • On January 15th, MP Laurie Hawn announced funding for this initiative ~$150,000 and presented Jeff and IHE with a “large cheque”.

  11. Active Dissemination Efforts • Lethbridge (Chinook Region) was our first stop in August 07. • Presented to: • Building Healthy Lifestyles Team (DEC) • RHA and PCN Leadership • The public • Hospital Health Care Providers (including a group of internists)

  12. Active Dissemination Efforts • Brooks and Medicine Hat (Palliser Region) was our second stop in January 08. • Brooks: • Living Healthy Team (DEC) • The public and diabetes association board members • Medicine Hat: • Seniors/the Public • Health Care Providers • Physicians

  13. Active Dissemination Efforts • Second visit to Medicine Hat (Palliser Region) February 08. • Committee of the Board for Palliser Health (including the Director of CDM, CEO and VP of the region) • Health Care Professionals- from Medicine Hat and Oyen and Bow Island were telehealthed in. • Third visit to Medicine Hat April 08. • Diabetes Collaborative Workshop (PCN Staff)

  14. Active Dissemination Efforts • Red Deer (David Thompson Health Region) March 08 • HC Professionals, Regional folks and the public • Fort McMurray (Municipality of Wood Buffalo/ Northern Lights Region) April 08 • HC Professionals, PCN folks, MOH, the public • Westlock (Aspen) June 23.08 • PCN staff and Primary Health Care Committee • Grande Prairie (Peace Country) TBA • Camrose (East Central) TBA

  15. Diabetes Prevalence in Palliser(Case Counts)

  16. Prevalence Rates by Community(Age-Adjusted, 2006)

  17. Diabetes Prevalence Rates for Oyen(Age-Adjusted, 1995-2006)

  18. Incidence Rates by Community(Age-Adjusted, 2006)

  19. Diabetes and Eye DiseaseCrudeLaser Photocoagulation, 2006

  20. Crude Rates of Laser Photocoagulation(1995-2006) Chinook rate in 2006: 99/10,000 Palliser rate in 2006: 558/10,000

  21. Local Information for Local Planning • ADSS can be used by the Regions to more accurately assess what the burden of DM and it’s comorbidities are. • ADSS provides important information and specific numbers that can be included in Regional Health Authority business plans/performance reports. • Diabetes is one of the conditions expected in performance reports for all health regions in Alberta. • ADSS can help regions plan and evaluate new programs.

  22. Calgary Health Region, 2006(Age/Sex Adjusted)

  23. Capital Health Region, 2006(Age/Sex Adjusted)

  24. ADSS: Capital and Calgary • Sub-region prevalence • PCNs • St. Albert/Sturgeon • Southside • Quality indicators…. • Dashboard reporting • How ADSS can supplement this

  25. St. Albert – Sturgeon PCN Age-Adjusted Prevalence (St. Albert)

  26. St. Albert – Sturgeon PCN Age-Adjusted Prevalence (Morinville)

  27. ADSS Dissemination 1. Active dissemination to Regions: • Local presentations • Regional Administration • MOH/PCNs/DECs • Public 2. Ongoing Newsletters 3. ADSS Website (www.albertadiabetes.ca) *ADSS Dissemination Sub-Committee: J. Johnson, C. Andres, A. Edwards, K.McLaughlin, R. Lewanczuk

  28. ADSS Outputs • Abstracts • CAPT Conference Halifax and CSEB Conference Calgary (May 07): • Epidemiological Trends • DM & Kidney Disease • EASD Conference Amsterdam (Sept 07): • DM & Mental Health • CDA Vancouver (Oct 07): • DM and Eye Disease (oral) • DM and Mental Health (oral) • DM and First Nations • DM and Kidney Disease

  29. ADSS Outputs • Abstracts con’t • SPH Symposium (Nov 07) • DM and Mental Health (oral) • DM & Eye Disease • Epidemiological Trends • AMHB Banff (Nov 07) • DM & Mental Health (oral) • ADA San Francisco (June 08) • DM & the Under 20 years (oral)

  30. ADSS Outputs • Submitted Abstracts • CDPAC Ottawa (Nov 08) • Active Dissemination of the ADSS • CDA Montreal (Oct 08) • Increasing Inc and Prev of DM in First Nations • Urban and Rural differences of DM (non-FN) • ADSS vs. Denmark DM registry • Active Dissemination of the ADSS • Introduction of Teleophthalmology in N. AB • Epi trends in the Under 20 population.

  31. ADSS Outputs • Manuscripts • Submitted • Increasing Inc & Prev of DM among Status Aboriginal Men in Urban and Rural Alberta (submitted to CJPH) • In Progress • Non-FN Urban-Rural trends • U20 epi trends • Teleophthalmology in N. AB • Active Dissemination of the ADSS (case study) • ADSS vs. Danish NDR

  32. ADSS Ethics Considerations • November 06 • Request for Ethics submitted (Panel B) • Reply indicated that the surveillance that we were about to complete did not constitute research and therefore did not require an ethics review or approval. • Necessary to submit subsequent individual research projects for consideration by the HREB (i.e. amendment to the ADSS ethics application) • May 08 • Letter submitted to HREB to obtain approval to move ahead with GDM project. • Outcome???

  33. Diabetes and First Nations • The incidence and prevalence of diabetes is more than twice as high among First Nations people, for both males and females, compared to non-First Nations people. • The increased incidence and prevalence of diabetes for First Nations compared to non-First Nations has remained constant from 1995 to 2005. • Among First Nations people, the incidence and prevalence of diabetes are higher among females compared to males.

  34. Diabetes Prevalenceby First Nations Statusby Urban-Rural

  35. Diabetes Prevalence, 1995-2006 FN vs Non-FN, Rural & Urban

  36. Diabetes Prevalence 1995-2006FN People by Sex, Rural and Urban

  37. Diabetes Incidence, 1995-2006 FN vs Non-FN, Rural & Urban

  38. Diabetes Incidence 1995-2006FN People by Sex, Rural and Urban

  39. Key Messages… First Nations • In rural areas DM is more prevalent for FN, and incidence is increasing faster; • FN women in rural areas have the highest prevalence of DM; • FN men have had greatest increases in incidence. Non-First Nations • Among non-FN, prevalence is similar between urban and rural; • Men in rural settings have had greatest increase in incidence and prevalence (~60%).

  40. DM in the Under 20 year old Population Objectives • Evaluate epi trends for diabetes among the under 20 population in Alberta, Canada; • Incidence • Prevalence • Compare age-specific trends over past 10 yrs; • Further assessment of validity of NDSS/ADSS case definition in under 20 population.

  41. Prevalent Cases, 2006 2,301 cases (28 per 10,000)

  42. Diabetes Prevalence, 1995-2005 Under 20 30% 42% 51%* 93%* *p=0.005

  43. Diabetes Incidence, 1995-2006 Under 20 ICD9  ICD10CA ARP (shadow billing)

  44. Diabetes Incidence, 1995-2006 U20 by Age Category *p=0.034

  45. ADSS Accomplishments (07- 08) • Deliverables • Alberta Diabetes Atlas 2007 • ADSS Newsletter • ADSS Website • Active Dissemination • PHAC funded • Local presentations • Research outputs • Presentations at scientific meetings • Manuscripts

  46. Questions…??? stephanie.vermeulen@ualberta.ca jeff.johnson@ualberta.ca www.ACHORD.ca

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