Diabetes is one of the fastest growing health challenges of the 21st century. In 2018, 4.3 million Ontarians were living with diabetes or pre-diabetes, and by 2028, that number is estimated to grow to 5.3 million.

As home to Ontario’s largest regional nephrology program, which treats the highest volume of kidney patients in the province, Scarborough Health Network (SHN) is opening the Diabetes Kidney Disease clinic to support the management of CKD by managing diabetes, in early 2021.

The collaborative partnership with diabetes services enables patients to access a designated nephrologist and endocrinologist as part of their clinic visit. The team will create timely and seamless patient care plans together with the patient, freeing the patient from attending two independent visits and supporting faster access to care. SHN nephrologists will refer patients who require this support directly to the program.

SHN serves a “diabetes hotspot” in Scarborough, which has the highest prevalence of diabetes from east of the Greater Toronto Area to Algonquin Park.

“There are different determinants of health that can lead to higher incidences of CKD; here in Scarborough we have a lot of those factors in one community,” explained Ethel Macatangay, Director, Nephrology and Chronic Disease Management.

“These factors that put our population at risk of CKD include ethnicity, low socio-economic status, and age. With these determinants combined, the Scarborough population is at higher risk of diabetes and CKD than in other areas of the province.”

The diabetes epidemic has led to an increase in diabetes-associated complications worldwide, including chronic kidney disease (CKD). In Canada, about 50 per cent of people with diabetes will develop signs of kidney damage in their lifetime.

CKD is progressive, irreversible, and often goes undetected. It increases the risk of cardiovascular events such as heart attack, stroke, and cardiovascular death. CKD also puts people on a path towards dialysis (a treatment that cleans your blood and removes excess fluid from your body when your kidneys are no longer healthy enough to do so) or kidney transplant. This risk grows as kidney functions worsen.

Advanced kidney disease has significant impact to an individual’s quality of life. Symptoms such as tiredness, loss of appetite, difficulty sleeping, swollen hands and feet, shortness of breath, and more may affect how one feels and carries out their lifestyle activities.

A broad array of evidence-based treatments and new technologies are now available to facilitate early control of the disease. The purpose of launching the Diabetes Kidney Disease Clinic is to apply these principles to help CKD patients improve their quality of life, reduce the progression of kidney disease, and to prevent other complications.