March 29, 2019 New Brunswickers with diabetes still waiting for renewal of provincial diabetes strategy

Following New Brunswick’s provincial budget speech, those living with diabetes are unsure if the Progressive Conservative government plan to renew the Provincial Comprehensive Diabetes Strategy. This is a key priority for Diabetes Canada and people living with diabetes. No mention was made of the diabetes strategy in the budget speech, although Diabetes Canada has been working with the Department of Health and health officials on renewal of the strategy, which has not seen action since representatives from all provincial political parties agreed to renewing it during the lead up to the 2018 provincial election.

In New Brunswick today approximately 96,000 people, or 12.5 per cent of the provincial population, are living with diabetes and those numbers are expected to rise to 126,000 (15.7 per cent) by 2029. In fact, when including the rate of prediabetes in this province, 1 in 3 people are already living with either diabetes or prediabetes. Treating diabetes and its complications is currently estimated to cost the N.B. health-care system $100 million in direct costs, which is estimated to rise to $127 million by 2029 if more is not done to address the diabetes burden. 

To help mitigate the alarming impact of diabetes on families, employers, health-care and the economy, Diabetes Canada has strongly recommended the renewal of the provincial Comprehensive Diabetes Strategy. Beginning in 2011, this strategy laid the ground work to help tackle the impact of the disease in the province. Many key initiatives were developed, but continuation of these plans is left in doubt unless the diabetes strategy is continued. People living with diabetes are concerned about the lack of much needed discussion to renew the strategy.

“Keeping a provincial strategy focused on enabling individuals to self-manage, supported by a health-care system and policies geared toward better management of diabetes, will help to combat the diabetes epidemic, allocate scarce resources and prioritize investments in health that are sorely needed," says Lisa Matte, regional director for Diabetes Canada.

The Comprehensive Diabetes Strategy was responsible for the creation of several successful government programs, services and patient management practices, that had not previously existed. Some highlights include: 

• Province wide adoption of standard clinical order sets for hospitalized patients on insulin management for diabetes. 
• The first provincial diabetes registry, for data collection and to assist with investments in top diabetes priorities for the province. 
• The Pink Sheet Initiative was created as a tool for primary care physicians to monitor health trends in their diabetes patient population and enhance care delivery. 
• The implementation of high-risk foot care clinics and several Health Care Provider foot care tools. 
• The pediatric insulin pump program and the eventual expansion to create greater access to this medical device for those who would benefit. 
• The Diabetes Outreach Case Manager program, which saw the hiring of a dozen new diabetes case managers to assist with the clinical management of patients with complex needs and poorly controlled diabetes, as well as a fundamental resource for family practices to create increased diabetes management capacity. 
• The Chronic Disease Billing Incentive for doctors to help improve the quality of care for patients living with diabetes.  
• An annual bursary for Certified Diabetes Educators (CDE) for health-care providers to receive this certification, which has resulted in dozens of new CDE trained professionals. 
• The Live Well/Bien Vivre health coaching program to support lifestyle changes, in partnership with Medavie Health Foundation and Diabetes Canada. 
• A fulsome evaluation, report and key recommendations regarding Diabetes Education Centres in New Brunswick. 

Diabetes Canada will continue to advocate for a new strategy, and re-establishing an advisory group to oversee the strategy, with the Minister and health officials.