Endocrine Disorders

Endocrine disorders are those that affect the secretion of hormones into the bloodstream. Examples of endocrine disorders include diabetes mellitus, osteoporosis, hypothyroidism, and hyperthyroidism.

Diabetes is the most prevalent endocrine disorder — it is a chronic disease characterized by the body’s inability to produce enough insulin or to use it properly.

The condition is classified as follows:

• Type 1 diabetes results when little or no insulin is made by the body.
• Type 2 diabetes results when the body makes insulin but is unable to use it effectively.
• Gestational diabetes presents during pregnancy as glucose intolerance and is usually a temporary condition.

The chronic complications of diabetes affect many organs and are responsible for the majority of mortality and morbidity associated with the disease.

According to the Canadian Diabetes Association, an estimated 3.0 million Canadians have diabetes: 90% of patients have type 2 diabetes and 10% have type 1 diabetes. Canada’s aging population and rising rates of obesity suggest that the number of Canadians with type 2 diabetes will continue to increase.

Why this theme area?

The Canadian Agency for Drugs and Technologies in Health (CADTH) has selected endocrine disorders as a priority theme area for a number of reasons:

• Diabetes is a growing concern within Canada, affecting its people and its economy.
• The Canadian Diabetes Association reports that the economic burden of diabetes in Canada was about $12.2 billion for 2010 and is estimated to rise to $16.9 billion in 2020.
• Rising costs are due in part to the increasing number of diabetes cases, along with newer, more expensive treatment options that have entered the market, for which there is a lack of clear consensus for optimal use.
• The endocrine disorders priority theme supports the Government of Canada’s Diabetes Strategy, which was launched in 1999 and renewed in 2005.

CADTH research

To date, most of CADTH’s reports within this priority theme area focus on diabetes.

CADTH has researched several issues spanning various components of diabetes management, including insulin analogues, self-monitoring of blood glucose, and second- and third-line therapies for type 2 diabetes.  This priority theme was originally called Diabetes, but it has recently been expanded to include other endocrine disorders.

The work carried out will aid decision-making across the spectrum of the health care system, from ministries and health regions to hospitals, caregivers, and patients. In particular, this priority theme has a strong patient outreach component. CADTH has hosted open-forum discussions (Café Scientifiques) across Canada in collaboration with the Public Health Agency of Canada and is also disseminating its findings through peer-reviewed articles in journals, intervention tools, and speaking engagements.

The CADTH priority themes reflect the needs of Canada’s health care system. CADTH is focusing on developing products and services to support health care decision-makers within the priority themes.