Dylan Youngstrom was just 27 when he was diagnosed with Type 2 diabetes.
The young man from Saskatoon went to the doctor to have a persistent pain checked out. While his pain turned out to be nothing, the blood test he did during his exam showed very high levels of blood sugar.
“For me, it was completely out of the blue,” he said.
“I hadn’t been diagnosed with prediabetes or anything like that. Not really a major history of it in my family or anything either.”
He thought of himself as relatively healthy. Although he was “a little overweight,” he wasn’t obese, and played sports occasionally. His friends had similar habits too, and didn’t suddenly develop diabetes. “Surprise would be the word.”
He went on metformin, a drug commonly used to treat diabetes, but more recently, he’s been able to control his blood sugar with a strict ketogenic diet and exercise. He’s been able to come off the medication. Now 34 and working at SaskTel, he has learned to change his lifestyle to keep himself healthy.
He says he’s gotten good at adjusting menu options when dining out — getting a bunless burger or a side salad — but it’s not always easy keeping up. “The level of control that I think is required for me to stay on track I think is quite high, and I think that’s the challenging part.”
“There is definitely a mental fatigue to it.”
Once a relatively rare event, there are many more young people like Youngstrom being diagnosed with this chronic condition.
The lifetime risk of diabetes for Canadians at 20 years old is about 50 per cent, according to a 2016 study of 2.8 million Albertans. Advocates say this points to the need for a comprehensive national strategy to deal with the disease.
The study, published in the Canadian Medical Association Journal, also found that around eight in 10 First Nations people who are 20 will eventually develop the disease.
“It really is a striking statistic,” said Dr. Jan Hux, president and CEO of Diabetes Canada.
Although similar figures aren’t available for previous generations, researchers know that people are being diagnosed with Type 2 diabetes at younger and younger ages. A recent Lancet review found that the prevalence of Type 2 diabetes among people under 40 has been “dramatically increasing” worldwide. A 2007 paper also published in the Lancet found that the prevalence of diabetes increased by about 31 per cent more in younger Ontarians between 1995 and 2005 than in people over 50.
“The most rapid growth is in women under the age of 50,” Hux said.
“It’s increasing in all age segments but it’s really pushing down into the younger ages.”
Being diagnosed younger can have serious health implications. “When you’re diagnosed at 70 and it takes 20 years of diabetes for you to really have the risk of complications, it’s not the same as getting it at 25 and knowing that by your productive years you’re going to be at high risk of things like heart attack, stroke, amputation, blindness.”
Youngstrom said he doesn’t worry too much about the risk of complications down the road. “Once in a while, it’ll pang me. I’m a person who doesn’t like to worry about something until it’s there to be worried about. It doesn’t mean that I’m not aware of it. It kind of makes a person look at mortality a bit more closely.”
“I’ve known people that have passed away because of diabetes complications under the age of 60, so all of a sudden I go, ‘Well, there’s a chance my life is half over.'”
But, he said, if his blood sugar is properly controlled, that lessens his risk of complications. “That’s the battle.”
Hux blames two factors for the increasing prevalence of diabetes in younger Canadians. First, people of South Asian, East Asian, Afro-Caribbean, and Hispanic heritage tend to have a higher genetic risk of developing diabetes, and immigration from those regions has increased.
But she also points to changes in how we live over the last few decades. “Now our environments are full of cheaply available, low-nutrient, high-calorie food offerings. We live in environments that discourage active lifestyles and I don’t mean heavy fitness programs, but even just walking.”
Being active is no longer part of our daily routines, she said, which means a higher risk of developing diabetes.
Still diabetes risk is complicated, she said, making it hard to point to any specific factor. “You can see somebody who’s thin and fit and highly active and gets Type 2 diabetes simply because their genetic risk is so high. And then there are lots of people who are obese and don’t have diabetes.”
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With an estimated 9.9 per cent of Canadians being diagnosed with diabetes by 2020, and at younger and younger ages, this means a huge cost economically and personally to those with the disease. That’s why Diabetes Canada is asking for a comprehensive strategy to be included in the 2019 federal budget.
Their plan, modelled after a similar strategy to fight HIV, is based on specific goals:
- 90 per cent of Canadians living in an environment that prevents the development of diabetes
- 90 per cent of Canadians to be aware of their diabetes status
- 90 per cent of Canadians with prediabetes or diabetes to be engaged in medical interventions to prevent the disease from progressing
- 90 per cent of Canadians who are having medical interventions to have improved health outcomes
“Diabetes has been described as one of the greatest public health challenges of the 21st century, and Canada has no active diabetes strategy,” said Hux.
Prevention should be a huge focus of any strategy, she said. “Once you have it, it’s the rest of your life.”