Seven years ago, Canadian singer-songwriter Dan Hill watched as the diabetes that had already claimed his father's legs took his life as he lay in a coma.
It was a heartbreaking and poignant moment for the Grammy and Juno award winner, but not only because he had lost his father. Hill, too, was living with diabetes. So was his younger brother. And here was the grimmest reality of their disease.
"It was so horrifying to see the man I love more than any other man... brought down by diabetes," recalls Hill, who lives in Toronto and was diagnosed with Type 2 diabetes in 1996.
"I was that much more determined to not let that happen to me. In a way, it was a wake-up call and I became very healthy."
Hill, 56, and his brother are among more than nine million Canadians with diabetes -- Type 1 or Type 2 -- or prediabetes, a condition that can lead to the disease.
But despite its pervasiveness and the multibillion-dollar toll it takes annually on Canada's health-care system, some diabetics and experts say the disease remains burdened by misconceptions and a general lack of awareness.
Of particular concern is the spread of Type 2 diabetes, which accounts for about 90 per cent of all cases. It occurs when the pancreas does not produce enough insulin -- a hormone that controls the amount of glucose in the blood -- or when the body does not effectively use the insulin that is produced.
Unlike Type 1, which typically occurs in children and adolescents, Type 2 usually develops in adulthood.
The Canadian Diabetes Association says an aging population, soaring obesity rates and a growing number of people adopting a couch-potato lifestyle are contributing to the rise of Type 2 diabetes.
"It's epidemic in North America and it's becoming somewhat pandemic around the world," says Michael Cloutier, the association's president.
What's also growing is the cost of diabetes. This year, Type 1 and Type 2 diabetes in Canada is expected to carry a price tag of $12.2 billion -- nearly double what it was in 2002. In the next decade, the number is expected to jump to $16.9 billion.
Treating complications associated with diabetes, including heart attack, stroke, blindness and non-traumatic limb amputations, carries significant costs.
"There's a tremendous amount that needs to be done in terms of curbing those costs and it really requires a lot of action now," says Cloutier.
Part of that, he says, is raising awareness and dispelling lingering myths.
Alison Armstrong, who was diagnosed with Type 1 diabetes as a young university student 22 years ago, agrees. Type 1 diabetes occurs when the pancreas is unable to produce insulin.
"A lot of people think you're fat, you're lazy, that's why you have it, when that's not true at all -- especially for Type 1. We don't know why we get it, we just do," says Armstrong, 40. "Nobody else in my family has it. I'm a fairly thin individual who was very active at the time I was diagnosed."
Dr. Ian Blumer, a Toronto-based diabetes specialist, says it's unfair to blame diabetics for their own disease when active people with healthy weights can also develop it.
"Sure, being sedentary and overweight increases one's likelihood of having Type 2 diabetes," said Blumer, who's authored several books on the subject. "But it's clearly not the only reason because lots of overweight people -- most overweight people -- don't have diabetes."
Armstrong, who uses an insulin pump daily and has made maintaining a healthy lifestyle a priority, says some people shrug off diabetes because they underestimate its seriousness.
People think "you're not going to die from it today, so don't worry about it," she says.
Cloutier says some people also question what else there is to be done in diabetes research since the discovery of insulin by Canadians Frederick Banting and Charles Best.
"I think it is seen by some people in society as being a cure in some ways and it isn't; it's a treatment," he says.
In his work, Blumer says he strives to eliminate misconceptions that some diabetics have about their own disease, namely that complications are unavoidable.
Blumer says ongoing research and medical advancements mean that's simply not the case. Patients can, to a certain extent, exert control over their disease by exercising, maintaining a healthy weight, monitoring cholesterol and so on.
"It's not like it used to be where the day you were diagnosed you saw doom and gloom ahead and nothing else," he says.
Hill, whose grandfather also died from complications associated with Type 2 diabetes, says he was about 40 pounds overweight at the time of his diagnosis. After his father's death, he began running 16 kilometres a day, cut out empty carbohydrates, stopped drinking alcohol and eating desserts.
While he has the occasional potato-chip slip, Hill says he's had no complications from his diabetes.
"The beautiful thing about the human body is how responsive it is," says Hill, who works as a goodwill ambassador for the Canadian Diabetes Association.
"If you treat your body well, it's amazing how it comes back and responds in such a magnificent way."
