TORONTO — A new report on diabetes paints a disturbing picture of the burden the disease places on the health-care system and the individuals who develop the disease.

Despite making up only six per cent of Ontario's population, diabetics in the province account for nearly one-third of heart attack and stroke patients, 70 per cent of amputation patients and more than half of the new dialysis cases, says the report, Diabetes in Ontario.

The report also noted that there was a 31 per cent jump in the number of Ontarians with diabetes in the past five years, a figure that surprised even the scientific director of a national institute on research into diabetes.

"I think it's going up faster than we might have expected," said Diane Finegood, who heads the Canadian Institutes of Health Research's institute of Nutrition, Metabolism and Diabetes.

While the authors drew on Ontario medical data for the report, Finegood (who was not involved in producing the report) and others believe it is probably indicative of the situation across the country.

The report was a joint product of the Institute of Clinical Evaluative Sciences in Toronto and the Canadian Diabetes Association.

Co-editor Dr. Jan Hux said the project was undertaken to see how well the health care system is doing at detecting and treating diabetes.

"In diabetes, we now have rich information about ways to reduce the burden of heart disease, of kidney disease, to get better control of blood sugar," said Hux, a scientist at ICES and an internal medicine specialist at Sunnybrook and Women's College Health Sciences Centre.

"And so we felt it was important to see to what extent those research findings are being translated into practice in Ontario and where gaps might exist between the 'is' and the 'ought.' "

The report does not differentiate between Type 1 diabetes, which generally strikes early in life, and Type 2, which used to be known as late-onset diabetes. Both, if not managed correctly, lead to blood pressure problems, heart and kidney disease and circulation problems that can lead to amputations of extremities.

The modern western lifestyle of low levels of activity and high-fat, high-calorie diets is creating a diabetes epidemic, experts have warned. Risk factors for developing diabetes include being overweight, inactive and having a family history of the disease.

Traditionally people have viewed Type 2 diabetes as much more benign disease than the early onset form, a perception that could be hindering efforts to combat its spread, the experts acknowledge.

"It's easy to think that diabetes is just a disease of blood sugar, and in fact sometimes people simplify it (by saying): 'Oh, I have a little (extra blood) sugar,' " Hux said.

"Well, when you have diabetes you have far more than a little sugar. You have dramatically elevated risk of a whole host of cardiac and vascular complications."

Also worrisome is the fact that the statistics show the disease is taking a toll earlier. Rates of heart disease in young adults with diabetes look like those of people 15 or 20 years older, the study found.

The heart attack rate among women aged 20-34 with diabetes was more than 30 times higher than the heart attack rate among their peers who didn't have the disease. Diabetics aged 20-49 were at greater risk of stroke than non-diabetics in the 50-64 age group. Amputation rates in the 20-to-49 age group among people with diabetes were the same as those of non-diabetics over age 75, Hux said.

"We used to think of Type 2 diabetes as somehow being a less worrisome that mostly older people got. Now it's clear that Type 2 diabetes needs to be taken at least as seriously," she added.

The impact on health-care resources is clear. In fact, the report suggests diabetic Canadians cost the system $9 billion a year to treat.

But the costs are also individual. With people developing Type 2 diabetes at a younger age, they face years of trying to manage their blood sugar to stave off kidney failure, heart disease and other unpleasant complications.

"If the blood sugars are rising,. . . over the preferred area that we like to see it in, the complications are starting," said Donna Lillie, national director of research at the Canadian Diabetes Association

"You're starting to do damage. So the earlier you diagnose it . . . the better chance you have for quality of life down the road."