National Framework for Diabetes Act

An Act to establish a national framework for diabetes

This bill was last introduced in the 43rd Parliament, 2nd Session, which ended in August 2021.

This bill was previously introduced in the 43rd Parliament, 1st Session.


Sonia Sidhu  Liberal

Introduced as a private member’s bill.


This bill has received Royal Assent and is now law.


This is from the published bill. The Library of Parliament often publishes better independent summaries.

This enactment provides for the development of a national framework designed to support improved access for Canadians to diabetes prevention and treatment.


All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.


June 2, 2021 Passed 3rd reading and adoption of Bill C-237, An Act to establish a national framework for diabetes
March 10, 2021 Passed 2nd reading of Bill C-237, An Act to establish a national framework for diabetes

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:30 p.m.
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Sonia Sidhu Liberal Brampton South, ON

moved that Bill C-237, An Act to establish a national framework for diabetes, be read the second time and referred to a committee.

Madam Speaker, it is an honour to speak to my private member's bill, Bill C-237, an act to establish a national framework for diabetes in Canada. I would also like to thank the member for Winnipeg North for seconding the motion to introduce my bill.

I could not be happier to be debating my bill during November, which, as many may know, is Diabetes Awareness Month.

Over 11 million Canadians live with diabetes or prediabetes. A new case is diagnosed every three minutes and 90% of these cases are type 2, which means they can be prevented through better awareness, education and lifestyle changes. This disease is the cause of 30% of strokes, 40% of heart attacks, 50% of kidney failure requiring dialysis and 70% of non-traumatic low-limb amputations. This is the harsh reality. In the Peel Region alone, which I am proud to call home, the rate of diabetes more than doubled between 1996 and 2015.

Some Canadians are at increased risk of diabetes, including South Asians, the indigenous population and Métis people. We also know that diabetes disproportionately affects Canadians with low incomes and education.

Complex public health challenges, such as chronic diseases like diabetes, cannot be addressed with a single-solution approach. No organization, institution or sector of society acting alone can solve this challenge. All segments of society, including communities, academia, government, the charitable and not-for-profit sectors, and the private sector must work together if we are to be successful. That is why the bill mandates that the Minister of Health work in collaboration with provincial health leaders, indigenous communities and other stakeholders to develop a national framework designed to support improved access to diabetes prevention and treatment to ensure better health outcomes for Canadians.

In many cases, diabetes is preventable. We know that individuals who have a moderate to high level of physical activity, who eat a healthy diet and who do not smoke are 82% less likely to be diagnosed with diabetes. Having been a health care professional for over 18 years, I have seen first-hand how a healthy diet, staying active and exercising can all contribute to the prevention of this disease. Let us combat diabetes and its life-threatening complications by making Canadians familiar with diabetes warning signs, encouraging healthy lifestyle choices and making it possible to access the best possible care.

It is estimated that this year the cost of hospital care and drugs for diabetes will amount to approximately $30 billion. This is a massive burden on our public health care system, but the costs do not end there. Whenever a Canadian suffers a stroke or a heart attack, that is an additional cost to our health system that may result in long-term costs. When a Canadian experiences kidney failure that requires dialysis, there is a cost. When a Canadian tragically has to undergo amputation, there is a cost. The secondary costs that diabetes has on our public budget cannot be calculated, but every dollar spent preventing it means greater savings down the line. So many of these complications are preventable with the proper care.

When I was first elected in 2015, it was a goal of mine to bring the issues of Canadians living with diabetes to Ottawa and to elevate the issue of diabetes as a whole. I have been honoured to serve as the chair of the all-party diabetes caucus, where we have heard from diabetes advocates, stakeholders and organizations to gain a better understanding of how the federal government can support Canadians living with diabetes.

In 2017, I travelled extensively to consult with medical professionals and stakeholders about how best to meet the needs of those suffering from diabetes. This gave me even greater insight into how diabetes impacted communities in different regions of Canada. The result of this was the publication of the report, “Defeating Diabetes”, which promotes healthy eating as a prevention method.

That same year, I represented Canada at the Global Diabetes Policy Summit in Rome, Italy, where 38 countries were represented. We spoke about the best way to tackle this growing issue. I also attended the World Congress of Diabetes in Calcutta, where, through engagement with international leaders, we were able to compare research and assess our commitment to the fight against diabetes.

One other important aspect of diabetes I learned on these international travels was how well-respected Canada is on the world stage when it comes to diabetes, especially on the insulin invention. I hope that Canada will continue to be a global leader in the fight to defeat diabetes for years to come.

Locally, I successfully advocated for the City of Brampton to proclaim November as Diabetes Awareness Month and the 14th as Diabetes Day. In 2018, the all-party diabetes caucus engaged fellow parliamentarians to participate in Diabetes Day on the Hill to raise awareness of diabetic risks to Canadians and to build support for an updated comprehensive national diabetes strategy. Our diabetes mobile screening unit was brought in to emphasize prevention and encourage testing. This was an opportunity for all members of Parliament to get first-hand experience in understanding the aspects of diabetes. Nearly a hundred of us accepted the challenge to wear a step counter and log our efforts for 10 days to raise awareness around our health.

This spring, I was able to virtually participate in several meetings and town halls with Diabetes Canada about how Canadians living with diabetes have been affected by COVID-19. While people with diabetes are not more likely to catch COVID-19, if they do get it, adults living with diabetes are at greater risk of developing serious symptoms and complications. More recent data from Alberta shows that 42% of Albertans who have died of COVID-19 also had diabetes. Those who are infected with the virus are more likely to suffer serious cardiac and respiratory complications. They face mortality four times that of those without diabetes.

As many members of the House know, back in the spring of 2019 I was proud to bring forward the unanimously supported motion to declare November as Diabetes Awareness Month in Canada, but there is so much more to do than raise awareness. The World Health Organization recommends that every country implement a national framework for diabetes. Last April, the Standing Committee on Health tabled a report that gave multiple recommendations. Among them the committee asked that the government consider a framework for a diabetes strategy for Canada. This comprehensive report already outlined the steps that the government should take in the fight against diabetes.

When we were undergoing this study, we heard a great deal about the mental health issues that are common among people living with diabetes. Those living with type 2 diabetes are more at risk of depression. We have heard examples of their being stigmatized and bullied. There are overall signs of greater risk of mental health issues, including anxiety and depression. At the health committee, we heard from one individual living with diabetes who spoke openly about the anxiety and the stigma she felt around the disease in her family. She said:

In my family, there are 35 diabetics and we don't talk about it. I have to do my blood sugar under the table when I visit my mother. We don't discuss it, and they don't treat.

Last year, I lost my uncle to it because they just won't treat. They won't admit to it. They don't want to deal with it because the stigma is so bad.

There is a strong need to reduce the stigma associated with diabetes. Reducing messaging that blames patients for their diabetes is an important first step to take. Early detection of diabetes can prevent complications and reduce the strain on the health care system.

The health committee also heard some shocking stats about diabetes and indigenous communities. Diabetes rates are three to four times higher among first nations than among the general Canadian population, and many indigenous people are at increased risk of developing diabetes. Furthermore, indigenous individuals are diagnosed with type 2 diabetes at a younger age than other individuals. Those living in a first nation community who are in their twenties have an 80% chance of developing the disease during their lifetimes, compared with 50% among the rest of the population of the same age.

The Canadian Indigenous Nurses Association identified several factors as to why this is the case. Geographical isolation, lack of health care services, poor Internet connectivity to facilitate distance care, and reduced access to nutritious food all contribute to the prevalence of diabetes in indigenous communities.

The health committee also recommended the federal government hold discussions with the provinces to explore possible approaches to providing uniform coverage of diabetes-related medications, supplies and equipment, such as lancets, across Canada. As it stands now, each province provides different coverage for different aspects of diabetes treatment, meaning those living with diabetes receive uneven support depending on where they live. All levels of government must work together to find a solution to improve access to a family physician and other health services for people living with diabetes in rural, remote and northern communities.

As I mentioned previously, my community in Brampton and the Peel Region faces a high rate of diabetes compared with the rest of the country. However, locally, we have some true diabetes champions working to reverse this course. I appreciate all of the private sector stakeholders based in Brampton that do phenomenal work helping those with diabetes, such as Medtronic and Dynacare, which provide testing services and advice to help people manage their illness.

The #Dynacare4Diabetes wellness campaign just launched in our city. The goal of this campaign is to encourage Bramptonians to assess their risk and get tested to see if they are at risk of diabetes by providing the A1 test free of charge.

Medtronic is doing commendable work in providing compassionate care for our residents living with diabetes.

I would like to thank Laura Syron, the president of Diabetes Canada, and its federal affairs director, Kimberley Hanson. I have been proud to work alongside them to raise awareness, including helping them with multilingual communications materials for multicultural communities.

I would also like to thank JDRF, Canada's leading type 1 diabetes advocacy organization, for all the support and advice it has provided over the years. It also endorsed my bill.

I am so proud to have support on this bill from organizations and individuals such as the CNIB Foundation, Peel's medical officer of health, Dr. Lawrence Loh, Dr. Naveed Mohammad of William Osler Health System and many more.

I thank the Brampton City Council, which has officially endorsed this bill.

Canada has repeatedly been the home of some of the biggest breakthroughs in diabetes care and research. Twenty years ago, Dr. Shapiro at the University of Alberta was on the team of researchers that developed the Edmonton protocol and islet transplant procedure, which temporarily reversed diabetes and allowed patients to be insulin independent. Just last week, it was reported that his team may be on its way to finding an actual cure for diabetes. This work is in its early stages.

In 1961, Canadian scientists discovered stem cells, and of course next year will mark the 100th anniversary of Sir Frederick Banting's historic discovery of insulin right here in Canada. Two weeks ago, on World Diabetes Day, I was in London, Ontario to participate in the ceremony to rekindle the Flame of Hope. This flame has been burning brightly and will continue to do so until we find a cure for diabetes. It stands as a symbol of Canadian innovation. I hope it will be a Canadian team of researchers that will one day be able to extinguish this flame.

Bill C-237 would change the lives of the 11 million Canadians living with diabetes from coast to coast to coast. By working together, I am confident that one day we will extinguish the torch at Banting House. Together, I know we will find a way to defeat diabetes.

I encourage all members in the House to join me in supporting the improvement of the lives of millions of Canadians across our country.

Canada gave insulin to the world. There is no reason why we cannot lead the way to defeat diabetes.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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Winnipeg North Manitoba


Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons

Madam Speaker, if I may, I would like to express my appreciation to the mover of the bill. She has been an incredible advocate on the diabetes file. Over the years, I have seen her advocate very passionately here in the House, as well as in caucus and on the side with many people.

Obviously, she is very passionate about the issue. I wanted to give her my personal thanks for being such a strong advocate on such an important health issue that all Canadians need to have a better understanding of.

I wanted to make that comment and compliment my colleague.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I would like to thank my hon. colleague for his great passion for diabetes. We need diabetes advocates on all sides of the House.

The member is right that the bill is rooted in the community I represent in the Peel region. I am passionate because I know that diabetes is a big burden on the health care system. I have heard from so many constituents who have diabetes or whose family members do, and they need more support. One in six people in Peel is affected by diabetes. This is so—

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Liberal Alexandra Mendes

Questions and comments, the hon. member for Shefford.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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Andréanne Larouche Bloc Shefford, QC

Madam Speaker, I thank my colleague from Brampton South for her excellent speech. She and I are both members of the Standing Committee on the Status of Women.

In her speech, she talked a lot about the skyrocketing health care costs associated with diabetes.

How will she ensure that this bill respects the jurisdiction of Quebec and the provinces, say by boosting health transfers to 35%, and that the federal government attends to its own affairs?

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I recognize my colleague's interest in increasing health transfers to the provinces. During the pandemic, the federal government has been there to support the provinces, including with $19 billion in the safe restart program.

The bill follows up the report from the health committee, and the framework includes measures to identify the training needs of health care professionals related to prevention and treatment. It promotes research, data collection and information sharing and takes into consideration existing strategies and best practices, such as those in the committee report, including—

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Liberal Alexandra Mendes

Questions and comments, the hon. member for South Okanagan—West Kootenay.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:45 p.m.
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Richard Cannings NDP South Okanagan—West Kootenay, BC

Madam Speaker, I thank the member for the important bill before us. I fully support it.

She has pointed that from the start, Canada has been a world leader in the technology of treating diabetes. However, we are really near the bottom of the pack when it comes to access to treatments, needless hospitalizations and needless deaths. That is because half of the diabetics in Canada cannot afford to pay for their insulin and the devices they use to monitor it.

I am wondering if the member and her Liberal colleagues will be supporting Bill C-213, the NDP bill on a publicly paid universal pharmacare plan, which would solve this problem once and for all.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:50 p.m.
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Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I thank the hon. member for supporting the bill.

The bill is important because the framework will include everything for prevention and treatment. I am proud to sit on the Standing Committee on Health, which got the great work done for national pharmacare. Some of that work included the report on the national pharmacare plan. The health committee heard from witnesses that 22% of Canadians are not getting their prescription medications. We need to include our provincial partners and territories as well.

The bill is important because it would help 11 million Canadians living with diabetes or prediabetes. It is one of the most prevalent diseases in the country. As I said, it is a very good bill for helping all 11 million Canadians with diabetes or prediabetes.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 1:50 p.m.
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Chris d'Entremont Conservative West Nova, NS

Madam Speaker, I am very pleased to speak today on second reading of Bill C-237, an act to establish a national framework for diabetes, which would require the Minister of Health to develop a national framework to support diabetes prevention and, of course, treatment.

It is important for me to participate in the second reading of this bill given that my family is touched by this disease. My son, André was diagnosed with type 1 diabetes at the age of 17. He, my wife and I had to adapt to his disease and help him understand his new limitations, but celebrate, of course, his strengths.

We were lucky, if that is the right word, in that we came into this at a later age, where André was more than capable of taking over his care and express how he was feeling.

I can only imagine what it would be like with a toddler or a younger child. A friend of mine used to tell me what it was like 30 years ago without modern strip testing, trying to get a ketone reading from her toddler's diaper. How far we have come, considering a lot of diabetics now use continuous testing, where we can just swipe our smart phones near to get a reading. However, we still have a long ways to go.

Due to this disease connection, I am involved with various organizations that support patients with diabetes, such as the JDRF, one of the many organizations that work tirelessly to support people living with diabetes and their families until a cure is finally found.

November is Diabetes Awareness Month. This year, I should add that next year, 2021, will mark the 100th anniversary of the discovery of insulin by Dr. Charles Best and Dr. Frederick Banting.

In Canada, diabetes affects more than three million people, or 8% of the total population, and is considered a national epidemic. When pre-diabetic people, caregivers and families of people with diabetes are considered, this number rises to 11 million Canadians, or about 30% of the total population.

It is important to note that these numbers are increasing year after year. Even if people with diabetes manage to live what they call a normal life, we must continue to work for the prevention of diabetes and its consequences until a cure is found. Since diabetes affects so many people in Canada, we need to be in a better position and have legislation that responds adequately to the needs of people living with diabetes and pre-diabetes with the development of a national framework.

Bill C-237 seeks to respond to diabetes in Canada by improving awareness, prevention, treatment, research, data collection and training. It also wants to follow up on the Canadian diabetes strategy that was created in 1999, which aimed to prevent, detect early and self-manage diabetes and its complications, as well as national surveillance. This has, since 2005, integrated the healthy living and chronic disease strategy to promote the health of all Canadians, reduce the risk of chronic disease related to high-risk individuals, and support detection and early management of chronic diseases.

According to a 2013 report by the Office of the Auditor General, despite numerous efforts to better manage diabetes, the Public Health Agency of Canada, Health Canada and the Canadian Institutes of Health Research believed that, although diabetes prevention and control activities existed, they were not coordinated well enough to ensure the success of the Canadian diabetes strategy.

This report led to studies at the health committee and, following the last study in 2019, a report was tabled. Entitled, “A Diabetes Strategy for Canada“, it strongly recommended that the government proceed with the development of a national strategy on prevention and management of diabetes.

Having spoken with many representatives of various organizations supporting people living with diabetes and those who support research, I know that this bill has been expected for some time now, and I do see it as a positive step forward.

However, I have some concerns with the bill in its current form, which gives the Minister of Health the authority to prepare a report on establishing a national diabetes framework without parliamentarians being made aware. This is concerning, since there will be many financial implications related to the collection of data and the research that the bill will require, which we will not know before voting for it.

It is important to remember that during the first reading of the bill last February, before the beginning of the COVID-19 pandemic, we already knew that the Liberal government had reached record deficits and debts.

We on this side of the House were very much looking forward to the tabling of the Liberal budget in March, which of course never happened. The Liberals' lack of transparency left all Canadians in the dark regarding their country's public finances. It is concerning knowing that two years will have passed before the government finally tables its budget in March 2021.

Government spending has hit record highs. Yes, money had to be spent to fight the pandemic, but we also know that some of that spending was not in Canadians' best interest. Some of it reeks of scandal.

Having said this, despite the good intention of the bill, it is difficult for me to vote in favour of it without knowing all the financial implications that go along with it. I find it unacceptable and irresponsible for the government to continue to lack transparency when it comes to our country's finances.

The establishment of a national framework for diabetes is without a doubt very important, but I wonder about the other diseases that also deserve to benefit from such a national framework. I think of people who suffer from cystic fibrosis, multiple sclerosis or Parkinson's. Which of these diseases also deserve a national framework?

Unfortunately there is a weakness in the bill that I must highlight. As drafted, Bill C-237 does not clearly demonstrate, even though the Minister of Health would be responsible for establishing a framework and implementing it at the national level, who would respond to the problems and expectations, or even how, of diabetics in Canada.

We have to take into account the fact that health programs are essentially the responsibility of the provinces and that approaches to health care vary from one province to the next.

For example, for people with type 1 diabetes, Ontario has the assistive devices program, the ADP, which helps diabetics pay for their insulin pumps, while elsewhere in the country, financial support at the provincial level is less generous or non-existent. Accordingly, a consultation with the provinces and territories is needed.

The Conservatives have always respected provincial jurisdictions and we will always continue to do so. I want to ensure that the bill does not interfere with how each province and territory manages their health care system. The Conservatives have always given priority to working collaboratively with the provinces and territories and we are convinced that this fundamental value of our party would allow us to develop strong national objectives in terms of the quality of the desired framework.

It would be better to adopt a national framework to measurably improve the prevention and treatment of diabetes and thereby reduce the burden of this disease on the Canadian public and the health care system, which is already strained.

As a country that has the health Canadians at heart in all its forms, we should allow Canadians living with type I diabetes to benefit from an equal basis from the disability tax credit as well as those who access the registered disability savings plan, which would be an important and significant step forward. This would be a concrete measure to reduce the amount of expenses incurred by people living with diabetes and would significantly help them improve their health.

In September 2019, the Conservative Party announced that it wanted to broaden the eligibility criteria for the disability tax credit. This announcement was specifically intended for type I diabetics. Diabetes Canada supported it and asked the other parties to support it as well. We believe diabetics should have access to the DTC and call on all federal parties to include it.

As our family lives with it, I support it in a way—

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 2 p.m.
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The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Liberal Alexandra Mendes

The member is out of time.

The hon. member for Shefford.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 2 p.m.
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Andréanne Larouche Bloc Shefford, QC

Madam Speaker I rise today to speak in the House of Commons about Bill C-237, an act to establish a national framework for diabetes, a disease that affects members of my family.

I first heard about this disease when I was a child. I was told that my father's half-sister had diabetes and that she had problems with the sugar levels in her blood. Then, when I was a teenager, a cousin who is my age was diagnosed with this disease. My mother was her godmother, so together with her mother, we supported her during months of treatment at Hôpital Sainte-Justin.

It was a great shock for her because she had to get used to a new diet, pricking herself several times a day and avoiding the complications that can be associated with diabetes. She rebelled because she was tired of having to follow so many rules to control her blood sugar levels.

In recent months, I have been the Bloc Québécois critic for seniors, and naturally I have been dealing with this issue. In my speech, I will remind members of the elements of this bill that my party supports and explain the effects of the pandemic on those with this disease. Finally, I will call for better investments in research, which is the key to a cure.

The enactment provides for the development of a national framework designed to support improved access to diabetes prevention and treatment. It asks that the Parliament of Canada recognize the need to be proactive in the fight against diabetes and that the Government of Canada develop and implement a national framework for diabetes.

The bill provides for the strategy to be designed in consultation with the provincial governments and Quebec. If the bill moves forward, the Bloc Québécois must ensure that the national framework reflects the demands of Quebec and respects its jurisdiction. The bill invites stakeholders to a conference for the purpose of developing a national framework and determining the main focuses that should be included: explanations on diabetes, identification of needs, promotion of research, promotion of knowledge sharing, analysis of what is already being done to achieve health care equality and so forth. The bill gives the government one year to develop the strategic framework and five years to report on its effectiveness.

It is important to note that this disease is on the rise in Canada, and that it entails significant expenses for patients and for the system. On behalf of myself and the Bloc, I would like to take this opportunity to remind everyone that Canadian health transfers must be increased to 35% right away, no strings attached. The same thing is happening in Quebec, where cases have been rising steadily since 2000.

At this point, I would like to go over a brief history of the fight against diabetes in Canada. It began between 1999 and 2005, when the first Canadian diabetes strategy was developed. The Canadian diabetes strategy was launched in 2005, and it was then incorporated into the integrated strategy on healthy living and chronic diseases.

In 2006, the strategy began funding multi-sectoral organizations dedicated to fighting chronic disease. A number of advances came about during that period, including self-management of the disease, thanks to the development of guides for people with diabetes; the dissemination of information about the disease, thanks to data collected by the Public Health Agency of Canada; and the Canadian Best Practices Portal.

In 2009, the Public Health Agency of Canada, Health Canada and the Canadian Institutes of Health Research established a partnership with Diabetes Canada, Diabetes Québec and the Juvenile Diabetes Research Foundation. From then on, funding of research projects and public awareness were part of the fight against diabetes.

Since 2016, the Canadian diabetes strategy has been part of Health Canada's Centre for Chronic Disease Prevention and the strategic plan 2016-2019. This plan is very general and contains more statements of principle than meaningful measures. The main elements are practically the same as in previous plans: support research, collect and share data and mobilize various stakeholders.

Since 2019, Diabetes Canada has been promoting Diabetes 360o, a framework calling on the federal government to create and fund a national strategy.

Although health care is a provincial jurisdiction, the federal government must play a role, especially when it comes to prevention. Because obesity and diabetes are so closely linked, governments must develop strategies to promote awareness and healthy living habits. Over time, several measures have been designed to do just that. I will give an overview.

With regard to labelling, although there have been many changes in this area, the government systematically runs into problems with lobby groups representing beverage companies and producers, for instance. This idea comes up regularly in discussions. The objective would be to change labels to make them easier for consumers to read or to make space on soft drink labels to inform the public about the harmful effects of obesity.

The government also promotes physical activity, which we care a lot about. Ongoing measures include awareness campaigns, the promotion of physical activity and tax credits for sports activities.

In addition, the government promotes healthy eating, or maintaining a healthy body weight. That is an important part of preventing and controlling diabetes.

Although it is sometimes difficult to strike a balance between economic interests and promoting healthy eating, as the debate surrounding Canada's food guide showed, the public still needs to be informed and needs to develop healthy eating habits.

I would now like to talk briefly about diabetes among indigenous people. For many reasons, the prevalence of type 2 diabetes is four to five times higher in certain indigenous communities than in the general population.

The Government of Canada is aware of the problem and is investing an average of $50 million per year through the aboriginal diabetes initiative, a Health Canada program that involves working with indigenous people to reduce health inequalities.

For indigenous communities, there are three components to the fight against diabetes. First, there is prevention, in the form of awareness campaigns on healthy lifestyle habits that can prevent obesity and the risks related to diabetes. Then there are annual screening tests for high-risk individuals, so they can be treated as soon as possible and avoid complications. Finally, there is treatment, which ensures that people from indigenous communities who have diabetes get treated in accordance with the guidelines, in order to reduce morbidity and mortality.

As for the cause, or should I say causes, of this major disparity, might the government's inaction to improve the situation on indigenous reserves have something to do with it? The answer is in the question. An ounce of prevention is worth a pound of cure.

Third, I would like to remind hon. members of the consequences that the pandemic is having on diabetics. Given their condition, they are being asked to self-isolate to avoid COVID-19 and the resulting complications. They are also experiencing economic repercussions.

I would like to note that back home in Shefford, the diabetes health forum, which had been organized by Les Diabétiques de la Haute-Yamaska to raise awareness of this disease, unfortunately had to be cancelled last March.

However, over Zoom, I was able to meet with Juliette, from the Kids for a Cure Lobby Day organized by JDRF. I salute her for her courage. She and her organization made three recommendations.

The first recommendation is that the Government of Canada should mark the 100th anniversary of the discovery of insulin by making a new $15-million investment in partnerships to cure diabetes between JDRF and the Canadian Institutes of Health Research.

The second recommendation is that, as recommended in the first annual report of the disability advisory committee, Canadians who receive a life-sustaining therapy, such as insulin therapy, should be eligible for the disability tax credit.

The third recommendation is that, as recommended by the Standing Committee on Health in its report entitled “A Diabetes Strategy for Canada”, the Government of Canada should invest in the implementation of a national diabetes strategy, Diabetes 360o, designed to achieve different results depending on the type of diabetes.

We are therefore in favour of the development of a strategy for Canada, on condition that it respects the requests of the provinces and Quebec and areas of shared jurisdiction. It should be noted that Diabetes Canada and Diabetes Québec already hold an annual conference. We are wondering what this additional conference might be and what benefit it could have on the community.

In closing, for all these reasons, I decided to accept the invitation and light up my office with beautiful blue lights as a sign of solidarity on World Diabetes Day, which was November 14. Let us take action.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 2:05 p.m.
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Richard Cannings NDP South Okanagan—West Kootenay, BC

Madam Speaker, these days the world is focused on a pandemic, but that does not mean we have to forget about the myriad of other illnesses suffered by humanity. That is why I am happy to voice my support for Bill C-237, which would require the Minister of Health to develop a national framework for diabetes prevention and treatment in consultation with the provinces, indigenous groups and relevant stakeholders.

I support the bill because I believe we truly need a new national diabetes strategy. That strategy should be based on the diabetes 360° framework developed in 2018 by Diabetes Canada and dozens of other stakeholder groups. I also believe that the Government of Canada must support indigenous-led diabetes programs, services and research; prioritize food sovereignty; provide access to appropriate care and treatment options; and raise awareness about gestational diabetes and the increase in diabetes among young indigenous women.

I also strongly believe that there is an urgent need for a national approach to pharmacare that would ensure all Canadians living with diabetes have access to the medications they need when they need them. This must include coverage for diabetes devices and supplies, such as test strips, syringes, insulin pumps and continuous glucose monitors.

We all know the story of Frederick Banting and Charles Best, who, with their colleagues James Collip and John Macleod, discovered insulin in a University of Toronto lab in 1921. This discovery revolutionized the treatment of diabetes worldwide and remains among the most celebrated medical discoveries in Canadian and even world history. Diabetes was formerly a death sentence for young people who developed the disease, but now they could look forward to long and productive lives.

We are on the eve of the centenary of that discovery, and one would think that we could celebrate that centenary with pride. Unfortunately, the scourge of diabetes is, in many ways, far worse than it was 100 years ago. Canada has one of the poorest records in the world, and it is getting worse.

Every three minutes a Canadian is diagnosed with diabetes. The number of Canadians with diabetes has doubled in the last 20 years. Right now, one in three Canadians either have diabetes or have a high risk of developing it. It is an epidemic. People who are 20 years old in Canada have a 50% chance of developing diabetes in their lifetime. For first nations people, that risk is 80%.

The health care costs of diabetes will top $40 billion by 2029. Diabetes causes 30% of strokes, and it is the leading cause of blindness. It causes 40% of heart attacks, 50% of cases of kidney failure, and 70% of leg and foot amputations. It reduces lifespans by five to 15 years, and about 7,000 Canadians die each year as a direct result of diabetes.

Thankfully, there is a plan for how to fight this scourge. Diabetes Canada has developed a detailed plan called diabetes 360°, which could dramatically improve our rate of diabetes and reduce the significant impacts it has on the health of Canadians. It will cost money, but that investment will repay itself a hundred times over in savings to our health care system.

The goal of diabetes 360° is to have 90% of Canadians living in an environment that preserves wellness and prevents the development of diabetes, 90% of Canadians aware of their diabetes status, 90% of Canadians living with diabetes engaged in appropriate interventions, and 90% of Canadians engaged in interventions achieving improved health conditions. Diabetes 360° must be the basis for any national strategy.

When Dr. Banting discovered insulin, he gave the rights to that discovery to the University of Toronto, so that diabetics around the world could have affordable access to this life-saving drug. However, times have changed, and many of the monitoring and injection devices are very expensive. Many Canadians living with diabetes are unable to afford the medications, devices and supplies they need.

This cost related non-adherence can lead to avoidable complications and mortality, and that is why there is an urgent need for a universal, comprehensive and public pharmacare plan to ensure all Canadians have access to the medications they need when they need them. As I mentioned, this must include coverage for devices, such as test strips, syringes, insulin pumps and continuous glucose monitors.

The Canadian Federation of Nurses Unions produced a report that found that 57%, over half, of diabetics in Canada reported failing to adhere to their prescribed therapies due to affordability issues related to those medications.

According to the Juvenile Diabetes Research Foundation Canada, 830 young and middle-aged diabetics in Ontario die each year because of poor access to insulin. That could dramatically change if all Canadians had access to the medicines they need, but they do not.

Canada is the only country with a universal health care plan that does not include free access to prescribed medications. Some 10% to 20% of Canadians report not filling their prescriptions because they simply cannot afford the cost. That non-adherence costs all of us in added hospital stays and extra pressure on our health care system.

A universal, single-payer public pharmacare plan would save over $4 billion per year because we could get better deals on our drug costs. Right now, we pay more for drugs than almost any other country in the world.

All Canadians would benefit from a public pharmacare system, but diabetics would benefit more than most, because they would be assured of access to insulin and the monitoring equipment they need to manage their disease to stay alive.

Canada should be proud of its history in the treatment of diabetes and the discovery of insulin, but right now, we are at the bottom of the list when it comes to treatment, hospitalizations and needless deaths. We need to turn this trend around.

Bill C-237 would go a long way to achieve this turnaround by mandating the creation of a national framework. However, for rapid and lasting success we need real government leadership and investment in community health programs and public pharmacare to make a real difference in the health of Canadians.

I call on all members here to support Bill C-237, and even more importantly, Bill C-213, the bill calling for a universal, publicly funded pharmacare program tabled by my colleague the member for New Westminster—Burnaby. That program would save billions of dollars in public expenditure and most of all, would save thousands of lives of people, young and old, who suffer from diabetes and other ailments across the country.

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 2:15 p.m.
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Ruby Sahota Liberal Brampton North, ON

Madam Speaker, it is an honour to rise today to support my colleague from Brampton South on her private member's bill, Bill C-237, an act to establish a national framework for diabetes. She has done incredible work on the issue of diabetes and my fellow Brampton colleagues and I fully support and endorse her work.

This is a critical issue for the residents in my constituency, and had I been selected in the private member's lottery process, it is something I would have loved to bring forward myself. Therefore, I am extremely pleased to see the bill before the House at second reading.

The issue of diabetes is very near and dear to my heart. I make it a point to meet with JDRF's Kids for a Cure each year to listen to their suggestions and to advocate for what the Government of Canada can do better to help.

I have seen the issue first-hand, as my childhood best friend suffered from type 1 diabetes. Throughout his childhood, he had many struggles, and I could not understand at the time why he had to take them on. Into his adult years, many more obstacles faced him. This story did not end well: We lost him all too soon a few years back because of complications from this terrible disease.

My maternal grandmother also passed because of complications from diabetes, and my mother suffers from type 2 diabetes. Thus, I am predisposed to becoming the next victim of this terrible disease. I already had gestational diabetes during my pregnancy with my son, something I find very hard to talk about since I feel there is a stigma attached to having diabetes. People feel it is somehow their fault. As a mother, I know mothers do not want to do anything to affect the health and well-being of their children.

Canada has accomplished many incredible things in the medical field, and by far our most successful is the discovery of insulin. This breakthrough was a tremendous step forward in diabetes treatment and helping to improve the quality of life of diabetics in Canada and around the world. As we get closer to the 100-year anniversary of its discovery, Canada should once again choose to be a leader in diabetes treatment and invest more in research and countermeasures to help keep our cities stronger and healthier.

Over one million people living in Ontario suffer from type 2 diabetes. The GTA alone has half of Ontario's cases, with my home city of Brampton being known as the diabetes capital of Canada. Brampton has one of the highest rates of diabetes in Ontario, with the exception of only select indigenous communities, where as many as one-third of residents suffer from this terrible disease.

It is my hope that the House will support the bill and support the call for a national framework for diabetes on behalf of my constituents of Brampton North and everyone affected by this disease.

In the last 12 years, the prevalence of diabetes in Ontario has doubled, which to most people means suffering with the disease itself and a list of complications, such as increased heart attacks, strokes, requiring dialysis and undergoing amputations. Diabetes can affect every aspect of a person's life and makes day-to-day activities more challenging. Brampton must deal with all of these complications with only one fully functional hospital and suffers from underfunding of health care from the province as compared with other cities in the province of Ontario.

It is unfortunate, but I have been witnessing my own mother's struggles with this disease for many years now, and as she suffered a heart attack recently, I know how serious the complications can become. My husband, who is a podiatrist, shares many stories of patients who must undergo amputations. I never knew how common amputations due to diabetes were.

What is even more concerning is that despite well-tested methods of prevention and management, diabetes is becoming increasingly more common in Canadian society. New data from the 2019 Diabetes Canada cost model finds that currently one-third of Canadians have either diabetes or pre-diabetes. Worse still, it found that less than 50% of all Canadians can identify less than half of the early warning signs of diabetes, and even less were able to list the health complications diabetes can cause.

This is a worrying trend, which highlights the urgency for creating a strategy to help combat the disease. The need for proper educational tools to teach people about the disease, its causes, symptoms and treatments is absolutely clear. If we can push through the right policies and programs, we can reduce the prevalence of diabetes in our communities and keep higher-risk individuals healthy. Canada needs a national framework for diabetes and it needs one now.

Here are the facts. We already know the risk factors that increase the likelihood of developing diabetes.

Obesity, spurred on by unhealthy eating habits and a sedentary lifestyle, plays a significant part in diabetes onset. The likelihood for developing diabetes is more than seven times higher among obese individuals and three times higher among overweight individuals, as determined by a person's BMI.

We also know that socio-economic factors play a big part in the lived experience of having diabetes. Individuals with lower incomes are more likely to suffer complications from the disease and are less likely to regularly see their doctors, compared to those with higher incomes.

We know that pregnant women with diabetes are more likely to have suffered a number of complications with their pregnancies, such as high blood pressure or obstructed births and stillbirths. More pregnant women should be making use of specialist prenatal and obstetrical care, but do not know. There is not enough research and I do not know why.

We also know that ethnic background plays a role, which we just cannot ignore, in determining which communities are more likely to develop this disease. Diabetes is more common in certain ethnic groups, including people of indigenous, South Asian, African and Hispanic descent. When we look at patterns of diabetes in Ontario, the data fit with where these higher-risk communities live.

The GTA and particularly Brampton have high rates of ethnic diversity and we are also seeing higher rates of diabetes. This genetic susceptibility increases the risk of diabetes onset, even for those at a younger age and at lower BMIs, meaning one could be a skinny diabetic. Making the need for community-tailored educational campaigns is that much more important. People might be at higher risk and never even know it, let alone know what steps to take to mitigate these risks.

I would like to take a moment to recognize the great work done by a local community advocate Dr. Bajaj and the Stop Diabetes Foundation. The organization has taken on two main objectives: one, to decrease the burden of diabetes afflicting our society, through community-based education on preventative lifestyle; and, two, to increase the longevity of patients living with diabetes, by using a combination of medically proven treatments and lifestyle regimen.

Education and awareness must be done with social and cultural context taken into consideration. By keeping the status quo and not investing in creating a national framework, we are allowing incident rates to rise for a disease that is proven to be preventable in certain circumstances with the proper educational campaigns, tools and policies.

The bill has many recommendations. Experts suggest that helping to address educational gaps could prevent diabetes onset. Passing the bill will help promote information and knowledge sharing in relation to diabetes prevention and treatment, which is absolutely vital. We can teach people how to create healthier lifestyles through balanced diets and exercise, and explain how these changes will decrease their risk for diabetes.

These educational campaigns can and should be tailored for each region and for specific cultural groups to address our most vulnerable communities that are most at risk due to genetic predispositions. We need to give people the tools to better understand and manage their own health so they can become more proactive in diabetes prevention.

The bill also specifically calls for promoting research and improving data collection on diabetes prevention and treatment when it comes to information gaps. The necessity for filling them is clear. Determining why some pregnant women with diabetes are not receiving special prenatal and obstetrical care is vital to ensuring they have access to these resources.

We also need more reliable information about the availability of—

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 2:25 p.m.
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The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Liberal Alexandra Mendes

I have to interrupt the hon. member as time is up.

Resuming debate, the hon. Parliamentary Secretary to the Leader of the Government in the House of Commons for two and a half minutes.