Diabetes is spreading among Quebec teenagers

The proportion of young Quebecers with diabetes has increased since the early 2000s, confirms a study by the National Institute of Public Health of Quebec (INSPQ) published Thursday. And the frequency of this chronic disease is still underestimated.

Ariane Kroll
The Press

“Diabetes has become more prevalent among young people (1 to 19 years old and especially among 12-19 year olds), who constitute the only group for which the incidence increased between 2001 and 2019”, underlines the INSPQ.

The prevalence of diabetes in people under 20 fell from 0.14% in 2001 to 0.19% in 2019, specifies the Institute in its Portrait of diabetes in the Quebec population. The number of new cases recorded thus rose from 340 to 420 per year during this period. Thus, in the year preceding the pandemic, in 2019, Quebec had 3,265 young diabetics.

At the population level, this remains a small number, since less than 1% of Quebec diabetics are under 20 years of age. The trend is no less worrying.

The data used by the INSPQ does not indicate how much of the rise comes from cases of type 2 diabetes, widely associated with obesity and considered by the World Health Organization (WHO) to be a “largely preventable” problem. “. These data show, however, that the prevalence of diabetes has remained “fairly stable” among primary and preschool children, while it has increased among adolescents (up 48% among 12 to 15 year olds, and 54% % among 16-19 year olds).

And as type 2 diabetes occurs more in adolescents than in children, the increase observed in older people could “indicate indirectly an increase in type 2 diabetes in adolescents, as observed elsewhere”, notes the INSPQ.

In addition, changes to the Régie de l’assurance maladie du Québec (RAMQ) billing system in effect since 2016, with which doctors enter fewer diagnoses “probably contributed to reducing the incidence” of diabetes in the data. available, for young people as well as for the rest of the population, notes the Institute.

Pre-diabetes

It is not only the cases of diabetes that are underestimated in young people, but also the cases of pre-diabetes, detectable by the insulin resistance of the patients, testifies the D^D Julie St-Pierre, Professor of Pediatrics at the Faculty of Medicine of McGill University and Director of the Maison de Santé Prévention (MSP) in Montreal.

A study she conducted on 133 young obese Quebec patients showed that 68% of them (91 patients) had hyperinsulinism. However, 70% of these (64 patients) had not been tested for hyperinsulinism when they consulted first line.

The D^D St-Pierre is working with other physicians in Quebec and the rest of Canada to develop a practice guide for the management of children suffering from obesity. This guide would include markers to detect warning signs earlier, to prevent patients from going to type 2 diabetes, which causes “a huge loss of quality of life”.

If not well treated, the disease can lead to multiple health problems over the next 15 to 20 years, including erectile dysfunction, blindness, heart attack, stroke, amputation or the need for a kidney transplant, lists the D^D St Pierre.

More and more diabetics in Quebec

At least 8.1% of the Quebec population suffered from diabetes in 2019, a proportion which has almost doubled in less than 10 years (4.3% in 2001), show data from the INSPQ. This increase is explained by a positive factor (the decrease in the mortality of people with diabetes) and by a demographic factor (the aging of the population), shows the study.

“At 50, there is something to do among Quebecers to get them to move more, eat fruits and vegetables, take public transit,” said one of the co-authors, Claudia Blais, in a telephone interview.

Indeed, of the hundred new cases diagnosed every day in Quebec, 80% are detected in people aged 50 and over. “And we are sure that at this age, it is type 2”, argues M^me Blais, who is a professor at the Faculty of Pharmacy at Laval University.

“Enormous gains are still possible”, underlines the INSPQ study, recalling that people with diabetes “are 2.7 times more likely to be hospitalized than people without diabetes of equivalent age”.