Glossary: Diabetes in Canada: Facts and figures from a public health perspective

Glossary

A

Aboriginal: Descendants of the first inhabitants of North America. Indians (First Nations), Métis and Inuit are the three groups of Aboriginal people recognized in the Canadian Constitution.

Age-standardized: Rates are adjusted for changes in the age structure of the population over time, or for differences in age structure across different populations (for example, by provinces, territories, or ethnicity).

Asymptomatic: When an individual has a disease or condition but does not experience or present with any symptoms.

B

Bipolar disorder: A mood disorder sometimes called manic-depressive illness or manic-depression that is characterized by altering episodes of depression and mania.

Body mass index (BMI): A measure of human body size and proportion. It is defined as the weight in kilograms divided by the square of height in meters (see Obesity). Various levels of BMI are used as guidelines for healthy targets.

C

Cardiovascular disease: All diseases of the circulatory system including congenital and acquired diseases such as acute myocardial infarction (heart attack), ischemic heart disease, valvular heart disease, peripheral vascular disease, arrhythmias, hypertension, and stroke.

Cataracts: A gradual clouding of the natural lens of the eye that prevents light from reaching the retina.

Canadian Chronic Disease Surveillance System (CCDSS): A national surveillance system that uses population-based administrative data from provinces/territories to provide comparative information for assessing the scope, use of health services and health outcomes of chronic diseases in Canada.

Celiac disease: A disease of the small intestine. It is caused by an immunological (allergic) reaction to gluten in the diet that inflames and destroys the inner lining of the small intestine.

Chronic obstructive pulmonary disease (COPD): A disorder where the bronchial airflow is persistently obstructed.

Co-morbidity: When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as co-morbid. Co-morbidity also implies interactions between the illnesses that affect the course and prognosis of both.

Confidence interval (CI): An interval provided around an estimate to indicate its reliability. In this report, the 95% confidence intervals show an estimated range of values which is likely to include the true rate 19 times out of 20.

Congenital malformation: A physical defect present in a newborn, irrespective of whether the defect is caused by a genetic factor or by prenatal events that are not genetic.

Costs due to premature mortality: The economic burden of premature mortality refers to the foregone future economic production that otherwise could have been realized by society had death not occurred prematurely.

D

Diabetes mellitus: A chronic disease that occurs when the body is unable to sufficiently produce or properly use insulin. Diabetes mellitus occurs in several forms – type 1, type 2 and gestational are the most common.

Diabetic ketoacidosis (DKA): Often referred to as diabetic coma, DKA results from high levels of blood sugar due to a relative lack of insulin.

Diabetic nephropathy: Results when high blood sugar levels damage the blood vessels that filter blood in the kidneys.

Diabetic retinopathy: Results when high blood sugar levels damage the tiny blood vessels in the retina of the eye.

Dialysis: A procedure that is a substitute for many of the normal duties of the kidneys, such as filtering waste products from the blood.

Diagnosed diabetes: The Canadian Chronic Disease Surveillance System summarized data about Canadian residents who have used the Canadian health care system. If there was sufficient evidence of use attributed to diabetes, it was assumed that a person had diagnosed diabetes. The minimum requirement was at least one hospitalization or two physician claims, with a diabetes specific code(s), over a two-year period. Cases of gestational diabetes are excluded.

Direct costs: Direct costs refer to the value of those goods and services for which a payment was made or resources were used in the treatment, care, or rehabilitation related to illness or injury. Direct costs are comprised of expenditures for hospital care, physician care, and medication, as well as expenditures for care in other institutions and additional direct health expenditures (such as other professionals, other health spending, capital, and public health and administration).

Depression: A mood disorder characterized by sadness, inactivity, difficulty with thinking and concentration, significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and, sometimes, suicidal thoughts or an attempt to commit suicide.

E

Ethnicity: Ethnicity in the 2009-2010 CCHS was based on the question, "People living in Canada come from many different cultural and racial backgrounds. Are you: 1. White?" 2. Chinese?" 3. South Asian (e.g., East Indian, Pakistani, Sri Lankan)?" 4. Black?" 5. Filipino?" 6. Latin American?" 7. Southeast Asian (e.g., Cambodian, Indonesian, Laotian, Vietnamese, etc.)?" 8. Arab?" 9. West Asian (e.g., Afghan, Iranian)?" 10. Japanese?" 11. Korean?" 12. Other – specify."

F

Fasting plasma glucose (FPG): A test that measures blood glucose after a fast of eight hours minimum. See also oral glucose tolerance test.

G

Gestational diabetes: Occurs when elevated blood sugar levels develop during pregnancy, but normally ends following childbirth.

Gingivitis: An inflammatory condition of the gums surrounding the teeth.

Glaucoma: An eye problem that develops when the increased pressure within the eye starts destroying the nerves within the retina. Without early treatment, glaucoma can cause vision loss and blindness.

Glucagon: A medication for treating severe hypoglycemic reactions.

H

HbA1c levels: Glycohemoglobin – often referred to as HbA1c or A1c – is a hemoglobin molecule bound with glucose. HbA1c levels are determined by a blood test that determines the proportion of glycohemoglobin in the blood. Typically, approximately 4% to 6% of hemoglobin in the blood has glucose bound to it, but individuals with diabetes usually have higher blood levels of glycohemoglobin.

Health literacy: A person's ability to find, understand and use written information to promote, maintain and improve their health.

Hospital separation: The number of in-patients who leave hospital through discharge or death.

Hyperglycemia: Elevated blood sugar levels.

Hypertension: High blood pressure is generally defined as a systolic blood pressure equal to or greater than 140 mmHg and/or a diastolic blood pressure equal to or greater than 90 mmHg. In people with diabetes, however, hypertension is defined as a systolic blood pressure equal to or greater than 130 mmHg and/or a diastolic blood pressure equal to or greater than 80 mmHg.

Hypoglycemia: Blood sugar levels that are lower than normal. Occurs when excess insulin in the blood leads to low blood sugar levels.

I

Incidence: The number of newly diagnosed cases during a given period in a specified population.

Incidence rate: The rate of individuals newly diagnosed with a disease among those at risk during a specified time period.

Indirect costs: Indirect costs refer to the value of economic output lost as a result of illness, injury or premature death. Indirect costs are comprised of short-term and long-term disability (morbidity costs), and premature death (mortality). They are measured in terms of the value of decreased productivity attributable to restricted activity days due to morbidity, and lost years due to premature mortality.

Insulin: A hormone secreted by beta cells in the pancreas that enables the cells of the body to absorb sugar from the bloodstream and use it as an energy source.

Insulin pump: A programmable medical device worn outside the body 24 hours a day that aims to mimic the natural insulin delivery of the pancreas. It continuously infuses insulin based on the individual's corporal needs over the course of a 24-hour cycle.

L

Laser photocoagulation: A technique to seal off bleeding blood vessels. Tissue is coagulated using a laser which produces light in the visible green wavelength that is selectively absorbed by the pigment in red blood cells.

Life expectancy: A summary measure of the health status of a population. It is defined as the average number of years an individual of a given age is expected to live if current mortality rates continue to apply.

M

Mania: A mood disorder characterized by symptoms such as inappropriate elation, increased irritability, severe insomnia, grandiose notions, increased speed and/or volume of speech, disconnected and racing thoughts, increased sexual desire, markedly increased energy and activity level, poor judgment, and inappropriate social behaviour.

Morbidity: Any departure, subjective or objective, from a state of physiological or psychological wellbeing.

Morbidity costs due to long term disability: The economic burden of long-term disability refers to lost economic production due to restricted activity days caused by long-term disability. Long-term disability refers to periods of restricted activity lasting six months or greater.

Morbidity costs due to short term disability: The economic burden of short-term disability refers to the lost economic production due to restricted activity days caused by short-term disability. Short term disability refers to periods of restricted activity of less than six months.

Mortality rate: An estimate of the proportion of a population that dies during a specified period.

Mortality data: Mortality or death data are collected by the provincial or territorial registrar of vital statistics for residents of that province or territory at the time of death and sent to Statistics Canada for final editing. The death registration covers all deaths of Canadians occurring in Canada and to some extent in the United States. Deaths occurring in countries other than Canada and the United States are not included.

N

Neuropathy: A group of nerve diseases that affect the peripheral nerves. Can cause numbness, and sometimes pain and weakness, in the hands, arms, feet, and legs.

O

Obesity: A relative term for excessive accumulation of fat in the body; defined in several ways. This report uses the World Health Organization definition: individuals are considered obese if they have a Body Mass Index (BMI) equal to or greater than 30 kg/m2 (see Body Mass Index, Waist-to-hip ratio).

Obesogenic: That promotes high-energy diets and sedentary lifestyles, that increases risk factors associated with obesity.

Oral glucose tolerance test (OGTT): A test that measures blood glucose after a fast of eight hours minimum and two hours after administration of 75 grams of glucose. See also Fasting plasma glucose (FPG).

Osteoarthritis: A common form of arthritis that causes pain, stiffness and swelling around one or more joints that lasts longer than two weeks. It can involve any joint, but usually occurs in hands and in weight-bearing joints such as the hips, knees, feet and spine.

Overweight: Individuals are considered overweight if they have a Body Mass Index (BMI) equal to or greater than 25 kg/m².

P

Periodontitis: The destruction of the ligament, bone, and soft tissues that support the teeth.

Physical inactivity: A relative term, which refers to the lack of exercise, the definition of which varies among researchers.

Population attributable risk (PAR): The proportion of the deaths or disease cases that may be preventable in the whole population if a cause of mortality or a risk factor were totally eliminated.

Pre-diabetes: A state in which affected persons have fasting blood sugar levels or a response to a fasting glucose tolerance test that is higher than normal, but not high enough for a diagnosis of diabetes.

Prevalence: The number of individuals affected by a disease or a risk factor at a given point in time.

Prevalence rate: The proportion of individuals that are affected by a disease or a risk factor at a given point in time.

S

Sleep apnea: A sleep-related breathing disorder. The word apnea means "no breathing", and sleep apnea refers to pauses in breathing that occur during sleep. On average, these pauses last for ten to 30 seconds, until the brain reacts to overcome the problem.

Standard population: A population structure that is used to provide a constant age distribution, so that the rates of different study populations can be adjusted for comparison (see Age-standardized rates).

T

Thyroid disease: An over- or under-functionning of the thyroid gland. The thyroid gland is an essential organ for producing thyroid hormones, which maintain body metabolism.

Type 1 diabetes: An autoimmune disease in which the body's immune system attacks and destroys the insulin-producing cells of the pancreas.

Type 2 diabetes: A metabolic disorder that occurs when the pancreas does not produce enough insulin and/or when the body does not properly use the insulin it makes.

W

Waist-to-hip ratio: The ratio of waist circumference to hip circumference. It is used as a measurement of obesity (see Obesity).