The death rate from diabetes fell by one-third between 1994 and 2005, according to new research.
But the drop in mortality was dramatically greater in high-income groups than among low-income groups, underscoring that diabetes is increasingly a disease of poverty in Canada.
"Our findings illustrate the widening impact of income on the health of diabetes patients," said Lorraine Lipscombe, a scientist at the Women's College Research Institute of Women's College Hospital in Toronto.
She noted that while Canada has a publicly funded medicare system (which provides "free" access to hospital and physician services), "income-based inequities in health and access to care remain."
Notably, under medicare, prescription drugs are rarely covered for those under the age of 65.
Diabetes is a condition that is often treated with a panoply of drugs. Individuals routinely spend between $1,000 and $15,000 a year out-of-pocket, according to the Canadian Diabetes Association.
The new research, published in Monday's edition of the Canadian Medical Association Journal, was based on data collected in Ontario.
In 2005, there were 843,629 people over the age of 30 with diabetes in the province, up from 367,426 in 1994. That is an increase of 130 per cent; during the same time period, that over-30 population increased by 17 per cent.
Dr. Lipscombe and her team found that, in 1994, more than 4 per cent of diabetics died. By 2005, however, the number of diabetics who died fell to 2.8 per cent.
That is a 31-per-cent decrease.
However, mortality is significantly higher among people aged 65 and older (5.2 per cent) than among those aged 30 to 64 (0.8 per cent) in 2005.
The researchers also examined mortality rates by income quintile. They found a striking 40-per-cent difference in the diabetes death rate between the highest-income and lowest-income earners in the 30 to 64 age group.
"We need to raise awareness that the low-income population is more vulnerable and ensure they have adequate health resources," Dr. Lipscombe said.
In the over 65 age group - who receive prescription drugs at no cost - there was little difference in mortality based on income.
André Picard