However with the introduction of an integrated chronic disease prevention and management framework into the current health care system, governments must support the needs of health care professionals, but also the needs of the patients. Canadians living with a chronic disease like diabetes will be confronted with some challenges. They will need to take an active role in their own health care, and in order to fulfill that expanded role, they must become fully informed participants able to work in partnership with health care professionals. Without their active and informed participation, provincial governments will not realize the outcomes that research indicates may be possible with the implementation of a chronic disease management model.

The current health care delivery system was designed to mitigate acute medical conditions. Canadians with a chronic disease are the heaviest users of today’s health care system. Yet diabetes is just one of a number of chronic diseases that can be self-managed effectively by a patient who receives the appropriate education and support. And in future with the implementation of a chronic disease management framework, all patients living with diabetes will be asked to understand their disease, to know what they need to do on a daily basis to self-manage, to monitor certain results from testing blood glucose levels for example and to adapt their medication or diet and exercise accordingly, and finally to recognize when they need to seek health professional advice and care. Unfortunately not all Canadians and their families living with a chronic disease like diabetes are getting the support and education they need today to be active partners. In fact, a recent report by the Health Council of Canada indicated that while 98 percent of Canadians with a chronic health condition agreed to take on the responsibility for their health care, just under half received the education or support to carry out a treatment plan effectively. Only about 15 percent reported that their doctor referred them to exercise classes, education programs or other supportive services.^[1]

The Canadian Diabetes Association believes that provincial governments have a responsibility to ensure that patients and their families are prepared and supported to take on this critically important new role during the transition to a chronic disease management framework. And we fear that far too many Canadians do not know enough about what they should expect or do about effective disease management. For example, we know that the majority of Canadians living with diabetes – 55 percent according to a recent poll^[2] – do not know what the recommended targets are for blood glucose levels. Given the importance of this measurement to avoid the onset of serious complications ranging from heart and kidney disease to blindness and amputation, this lack of knowledge is a serious concern. And more importantly, if you don’t know what the target blood glucose levels should be, how can the person with diabetes know whether to adjust their medications, diet or physical activity levels?

For this reason, the Canadian Diabetes Association supports government investment in educating Canadians how to be fully informed partners in their health. We also encourage government to ask Canadians living with diabetes or any chronic disease what they see as the barriers to their active participation in an integrated chronic disease management framework, as well as to invite people to identify what tools and information they require.

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