Statistics Canada - Government of Canada
Accessibility: General informationSkip all menus and go to content.Home - Statistics Canada logo Skip main menu and go to secondary menu. Français 1 of 5 Contact Us 2 of 5 Help 3 of 5 Search the website 4 of 5 Canada Site 5 of 5
Skip secondary menu and go to the module menu. The Daily 1 of 7
Census 2 of 7
Canadian Statistics 3 of 7 Community Profiles 4 of 7 Our Products and Services 5 of 7 Home 6 of 7
Other Links 7 of 7

Warning View the most recent version.

Archived Content

Information identified as archived is provided for reference, research or recordkeeping purposes. It is not subject to the Government of Canada Web Standards and has not been altered or updated since it was archived. Please "contact us" to request a format other than those available.

Skip module menu and go to content.

Health State Descriptions for Canadians
82-619-MIE

Diabetes

Context

Introduction

Summary table

Health states for diabetes

Sequelae of diabetes

References

Download chapter (PDF)

More information

Sequelae of diabetes

Diabetic retinopathy, chronic, proliferative and non-proliferative
ICD-9 250.5, 362.0

Description Diabetic retinopathy is a disease of the microvasculature of the retina and is caused by high blood sugar. In the early (“non-proliferative” or “background”) stages, the blood vessels in the eye weaken and leak tiny amounts of blood or fluid, causing swelling of the retina. Most often vision remains normal, but there is potential for it to become blurred. In the more advanced (“proliferative”) stage, the blood vessels are blocked or closed and parts of the retina die. New blood vessels form to replace the dead ones, but are fragile and often bleed into the eye, blocking vision. Scar tissue then forms, shrinking or tearing the retina or even detaching it from the back of the eye, often leading to severe visual loss or blindness. The incidence and severity of retinopathy increases with the duration of diabetes, and is likely to be worse if control of the diabetes is poor. Both type 1 and type 2 diabetes present this risk.

Almost all people who have had diabetes for more than 30 years will have retinopathy in various stages of progression.17-20 It is the leading cause of adult blindness in Canada21 affecting approximately 400 Canadians every year.22 Adequate control of diabetes and control of high blood pressure will slow the progression of the disease, and is thus the aim of treatment. Other treatment
modalities include laser surgery to seal leaking vessels and vitrectomy (a surgical procedure) for cases of hemorrhage into the eye. Treatment can prevent blindness in most cases.

Diabetic retinopathy affects numerous aspects of a person’s quality of life. Usually individuals with diabetes present with both non-proliferative and proliferative retinopathy, and these are considered together here. Moderate limitations in physical functioning are present. For example, if blindness should occur, as in the proliferative stage, the patient will require a caregiver’s help for special needs that include meal planning and preparation, activities of daily living, urine testing, insulin administration, and foot care.

Blindness can also affect the emotional state, as it can contribute to self-esteem problems related to a loss of independence. Loss of vision can also lead to mild limitations in the capacity to sustain social relationships. Vision loss, change in health status and lack of independence due to blindness can also create anxiety. The risk of blindness is 25 times greater among individuals with diabetes than among those without.23,24

Classification Core Supplementary
 

2 3 3 2 1 2

3 1 1 3 1

Diabetic neuropathy, chronic
ICD-9 250.6, 713.5

Description Diabetic neuropathy is a disorder that affects nerve tissue in the body. Exact causes are likely different for different varieties of neuropathy, but high blood glucose is a key factor as high blood sugar levels cause chemical changes in nerves, impairing the nerves’ ability to transmit signals. Diabetic neuropathy is the most common complication of diabetes, with a prevalence rate of approximately 50% in the diabetic population.

Symptoms occur, on average, 10 to 20 years after diagnosis. Numbness and tingling in the feet is often the first sign, though symptoms vary depending on the nerve(s) and part of the body affected. Keeping tight control over glucose levels is important in preventing progression of tissue damage and the onset of further problems. Treatment is aimed at reducing the symptoms using a topical treatment such as Capsaicin, or anti-depressant/anti-epileptic drugs (i.e. Amitriptyline/Gabapentin) to control nerve pain.

Limitations are experienced in many attributes of functional health. This description is based on individuals with chronic, medication-controlled diabetic neuropathy. Moderate levels of pain and discomfort are experienced. Severe nerve damage results in a loss of feeling (e.g., pain and temperature) in the area where the neuropathy is present; individuals may experience minor cuts, scrapes, blisters, or pressure sores that they may not be aware of due to the insensitivity. Painful diabetic neuropathy can become physically disabling, resulting in moderate limitations in physical functioning.

Emotional state is affected, and symptoms of weakness, particularly in the muscles, can be experienced. There are also mild limitations in the capacity to sustain social relationships. This is mainly due to sexual dysfunction; approximately 50% of males with diabetes experience impotence,25-27 and 35% of females with diabetes experience some form of sexual difficulties.28 Symptoms in the hands (and lower extremities) that include numbness, tingling, burning, or pain provide potential for limitations in the use of hands and fingers.

Classification Core Supplementary
 

3 3 2 2 1 2

2 1 1 1 2

Diabetic foot, chronic
ICD-9 250.7

Description

Diabetic foot is a complication of diabetes that results in infection in the skin, muscles, or bones of the foot. This is a result of the nerve damage and poor circulation associated with diabetes. Because diabetes also alters the immune system, decreasing the body’s ability to fight infection, even small infections can lead to death of the skin and other tissues, leading to deformities and potentially amputation. Foot infections occur most frequently when the foot is exposed to extreme temperatures or dryness, or when corns and calluses are not well maintained. In this case, ulcerations and sores will often develop. Approximately 15% of individuals with diabetes will develop a foot ulceration at some point in their life.29-31 Over half of all leg amputations occur in people with diabetes.31

Diabetic foot is not a curable condition. However, preventive measures can be taken to reduce the risk of diabetic foot and its effects: inspecting feet every day; wearing shoes and socks at all times; and not smoking. Blood sugar levels, blood pressure and cholesterol should be kept under control; individuals should regularly visit a physician. If infection is present, antibiotics are prescribed to control it.

Diabetic foot has many implications for an individual’s health state. In particular, pain and discomfort are experienced at moderate levels, mostly associated with infection or trauma to the foot, although some individuals may not feel pain or discomfort at all. Bed rest is necessary to treat an infected foot, causing moderate limitations in physical functioning, and contributing to mild limitations in the capacity to sustain social relationships. Moderate levels of anxiety are also experienced due to fear of amputation.

Classification Core Supplementary
 

3 3 1 2 1 2

3 1 1 1 1


Home | Search | Contact Us | Français Top of page
Date modified: 2005-09-30 Important Notices
Online catalogue