“We’re now in a very exciting time where we have treatments with previously unseen capacity to improve the control of type 2 diabetes and help our patients manage weight,” said Dr. Sue Pedersen, a specialist in endocrinology and metabolism from Calgary, during a webinar hosted by Benefits Canada and sponsored by Eli Lilly Canada in September.
More than two million Canadian adults currently have type 2 diabetes and the prevalence is increasing over time, she said, noting the subsequent burden on Canadian workplaces is very significant. While those who experience low blood sugar may find it difficult to be productive or require absence from work, there’s also increased disability due to complications such as heart attacks strokes, eye problems, neuropathy, depression and kidney failure.
“A patient who is carrying a heavy burden of these complications is going to have more difficulty being productive or even present at work.”
During the webinar, Pedersen cited research that found reduced productivity and missed work costs employers about $1,500 per year for each employee living with type 2 diabetes and those living with type 2 diabetes are absent two to 10 days more per year from work.
She also noted challenges in good control over blood sugar results in a higher risk of developing complications over time. Indeed, blood sugar control is measured by the A1C blood test that reflects blood sugar over the past three months. The goal is seven per cent, she said, though only about half of Canadians with type 2 diabetes are at this target.
The higher the A1C, the higher the risk of developing diabetes complications, said Pedersen. Conversely, if A1C can be reduced and get closer to target, it lowers the risk of complications. If A1C is reduced by one per cent, the risk of overall complications is reduced by about 20 per cent and generates a 13 per cent reduction in diabetes-related costs.
In addition, she discussed the clear links between type 2 diabetes and obesity and how they impact employee health and productivity. For example, 90 per cent of people with type 2 diabetes also have elevated weight and people with higher weight are likely to have higher uncontrolled A1C, resulting in a 23 per cent higher risk of microvascular complications and a 56 per cent high risk of cardiovascular disease, congestive heart failure, heart attack or stroke.
Reducing weight, even a little, can improve blood sugar control and generate overall health improvements, said Pedersen, noting Diabetes Canada guidelines for weight management in people with type 2 diabetes recommends a five to 10 per cent weight loss. “We’re really seeing a movement globally towards recognizing the importance that we must treat type 2 diabetes and obesity together.”
Diabetes Canada guidelines have a three-pronged approach to diabetes management — heart and kidney protection, blood sugar control and weight loss. Many existing treatments for type 2 diabetes are effective, she said, but may cause weight gain, which doesn’t benefit those living with type 2 diabetes and obesity.
In terms of treatment, new classes of type 2 diabetes medications are revolutionary because they treat both type 2 diabetes and obesity, noted Pedersen. “It helps [people] manage their weight and improve their diabetes control to prevent health issues from progressing.”
She encouraged benefits plan sponsors to cover these new treatments. “Managing type 2 diabetes and obesity holistically and together are essential to improve our patient’s health, to reduce complications, to improve their quality of life, to help them to be able to be at work and productive at work. I ask you to please consider making these medications available.”