# Temporal and Regional Trends in the Crude Prevalence of Diabetes in Canada From 2000 to 2022: An Ecological Study Using Aggregated Surveillance Data

## TL;DR

This study tracks diabetes prevalence in Canada from 2000 to 2022, showing rising rates with regional and demographic differences.

## Contribution

The study provides new insights into regional and sociodemographic disparities in diabetes prevalence trends across Canadian health zones.

## Key findings

- Diabetes prevalence increased steadily across all Canadian health zones from 2000 to 2022.
- Zone 3 (Eastern) had the highest diabetes prevalence, while Zone 4 (Central) had the lowest by 2022.
- Males had higher diabetes prevalence than females, and older age groups were more affected.

## Abstract

Background

Diabetes remains a significant public health concern in Canada, with rising prevalence rates observed over recent decades. Understanding geographic and demographic patterns is essential for informing targeted prevention and resource allocation strategies. This study aims to examine trends in crude diabetes prevalence across four Canadian health zones from 2000 to 2022, using aggregated, age- and sex-stratified surveillance data, and with a focus on regional and sociodemographic disparities.

Methods

Data were obtained from the Canadian Chronic Disease Surveillance System (CCDSS), comprising annual counts of diabetes cases and population estimates stratified by age group, sex, and health zone. Crude prevalence rates were calculated and analyzed over time. A Poisson regression model with a log link and population offset was used to quantify temporal trends and assess differences by region, sex, and age group. Interaction terms were included to explore variation in trends across zones.

Results

Between 2000 and 2022, crude diabetes prevalence rose steadily across all regions, although the pace of increase varied. Zone 3 (Eastern) consistently showed the highest prevalence, whereas Zone 4 (Central) recorded the lowest levels by 2022. The Poisson regression model confirmed a significant annual rise in prevalence (β = 0.016, p < 0.001). Males had a significantly higher prevalence than females (β = -0.225, p < 0.001), and advancing age was strongly associated with a greater diabetes burden. Interaction terms between year and health zone indicated that temporal trends were not uniform across regions.

Conclusion

Diabetes prevalence in Canada has increased markedly over the past two decades, with substantial disparities across regions, age groups, and sexes. These findings underscore the need for region-specific diabetes prevention and control strategies, especially in high-burden zones. Continued surveillance and disaggregated analyses will be vital for addressing the evolving epidemiology of diabetes across the country.