Why BC's Type 2 Diabetes Crisis Demands a Network Response, Not Another Pilot Project

Written by Clare Koning Rn , PhD | April 2026

British Columbia has a type 2 diabetes problem that individual programs cannot solve.

Over the next decade, the province is projected to experience a 44 per cent increase in diabetes prevalence, the second largest increase among Canadian provinces, with direct costs to the health system already exceeding $418 million a year. Diabetes Canada 

There are now 1.5 million British Columbians living with diabetes or prediabetes, second only to Ontario in total cases. Diabetes Canada

Behind those numbers is a more uncomfortable truth: the burden is not evenly distributed. The prevalence of diabetes among adults in the lowest income groups is 2.1 times that of adults in the highest income group, and adults who have not completed high school have a diabetes prevalence 1.9 times that of adults with a university education. Diabetes Canada 

In BC's interior, diabetes rates among Indigenous peoples rose from 4.7% to 9.0% between 2001 and 2016, a pace outstripping the national average, with First Nations peoples living on-reserve facing a prevalence nearly three times that of the general population. ScienceDirect

These are not clinical statistics. They are a policy failure made visible.

The Problem With Pilots

BC has never lacked for innovative ideas about how to address type 2 diabetes. It has lacked the infrastructure to move those ideas out of their time-limited containers and into the permanent architecture of the health system.

This pattern is well documented beyond BC's borders. Canada's fragmented, provincially managed health system creates a regulatory environment where digital health solutions often prove their value during pilot projects but struggle to move into procurement contracts, with a 2024 survey finding that only 29% of physicians can even exchange patient clinical summaries with providers outside their own practice. Digitalhealthcanada 

Specialist wait times have climbed to 30 weeks nationally in 2025, up by 2.3 weeks from 2024, even as spending increases, with the system's core challenge identified not as investment levels but as productivity. Digital Journal

More investment into more pilots, without the connective tissue to scale and sustain them, is unlikely to change this picture.

What a Network Does That a Program Cannot

The BC Type 2 Diabetes Network, established in 2018 through a partnership between Health Quality BC and IHSTS, is not a program. It is an ecosystem, a sustained provincial infrastructure that connects clinicians, researchers, community organizations, digital platforms, and people with lived experience around a shared strategy focused on prevention, self-management, and remission pathways.

This distinction matters enormously for health system leaders. A program has a budget, a term, an end date, and an accountability structure calibrated to outputs. A network has a mandate to keep building relationships, translating evidence, adapting to emerging science, and holding space for communities that are often the last to benefit from innovation. The T2D Network's recent focus on rural populations and community screening, including a $10,000 grant from Peace Arch Hospital Foundation for community type 2 diabetes screening, demonstrates exactly this kind of adaptive, community-embedded responsiveness.

The gap is not in the evidence. It is in the structured, scalable community delivery infrastructure that allows these approaches to reach people in Prince George as reliably as in Vancouver. That infrastructure does not emerge from a pilot. It has to be built, sustained, and governed - over years, not funding cycles.

For health system leaders reading this, the question is not whether BC can afford to invest in sustained provincial coordination for type 2 diabetes prevention and management. Given the trajectory, the question is whether it can afford not to.

The T2D Network is a provincial initiative supported by IHSTS, Health Quality BC, and a growing network of clinical, community, and digital health partners. Learn more at www.t2dnetwork.ca.