Canadian Journal of Diabetes

Sodium-Glucose Cotransporter-2 Inhibitors and Risk of Diabetic Ketoacidosis Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis

1 month 3 weeks ago

The magnitude and precision regarding the risk of diabetic ketoacidosis (DKA) with sodium-glucose cotransporter-2 (SGLT2) inhibitors is unclear. Thus, we examined the risk of DKA with SGLT2 inhibitors in both observational studies and large clinical trials.
Michael Colacci, John Fralick, Ayodele Odutayo, Michael Fralick

Motivational Stage at CGM Initiation in Pediatric Type 1 Diabetes is Associated with Current Glycemic Control but does not Predict Future CGM Adherence or Glycemic Control

2 months ago

The CGM TIME Trial is a multicentre RCT in children with type 1 diabetes comparing simultaneous pump and CGM to CGM initiation 6 months later (Paradigm™ Veo™, Enlite™ sensor, Medtronic Canada). This study examined SOCRATES’ ability to classify children and parents into distinct motivational stages and the stages’ association with HbA1c at trial entry and outcomes 6 months after CGM initiation.
Kate C. Verbeeten, Jason Chan, Nadia Sourial, Jennilea M. Courtney, Brenda J. Bradley, Karen McAssey, Cheril Clarson, Susan Kirsch, Jacqueline R. Curtis, Farid H. Mahmud, Tammy Cooper, Christine Richardson, Margaret L. Lawson, CGM TIME Trial Study Group…

Association Between Parental Type 1 and Type 2 Diabetes Diagnosis and Major Osteoporotic Fracture Risk in Adult Offspring: A Population-Based Cohort Study

2 months ago

Previous research suggests an intergenerational influence of diabetes on bone health. We examined the association between parental diabetes and major osteoporotic fracture (MOF) risk in offspring.
Amani F. Hamad, Lin Yan, William D. Leslie, Suzanne N. Morin, Randy Walld, Leslie L. Roos, Shuman Yang, Lisa M. Lix

Cardiovascular Comorbidity Associated With Albuminuria in Youth-Onset Type 2 Diabetes: Analyses From the iCARE Study

2 months 1 week ago

Little is known about the relationship between albuminuria in youth with type 2 diabetes (T2D) and cardiovascular risk. We aimed to determine whether youth with T2D and albuminuria have evidence of increased cardiovascular risk and/or early cardiovascular dysfunction compared with youth with T2D without albuminuria.
Elizabeth A.C. Sellers, Allison B. Dart, Jonathan McGavock, Brandy A. Wicklow

A Multi-Intervention Campaign Lowers Pediatric and Young Adult Diabetic Ketoacidosis Hospitalizations in a Canadian Province

2 months 1 week ago

The Newfoundland and Labrador diabetic ketoacidosis Project (NLdkaP) is a multi-intervention, province-wide project aimed at lowering rates of diabetic ketoacidosis (DKA) within the pediatric and young adult populations.
Georgia Darmonkow, Roger Chafe, Rana Aslanova, Donna Hagerty, Laurie Twells, Ola Jill Barter, Leigh Anne Allwood Newhook

A New Hypothesis for Type 1 Diabetes Risk: The At-Risk Allele at rs3842753 Associates With Increased Beta-cell INS Messenger RNA in a Meta-Analysis of Single-Cell RNA-Sequencing Data

2 months 3 weeks ago

Type 1 diabetes is characterized by the autoimmune destruction of insulin-secreting beta cells. Genetic variants upstream at the insulin (INS) locus contribute to ∼10% of type 1 diabetes heritable risk. Previous studies showed an association between rs3842753 C/C genotype and type 1 diabetes susceptibility, but the molecular mechanisms remain unclear. To date, no large-scale studies have looked at the effect of genetic variation at rs3842753 on INS mRNA at the single-cell level.
Su Wang, Stephane Flibotte, Joan Camunas-Soler, Patrick E. MacDonald, James D. Johnson

Equity in Health Services Research—Finding Our Way Back

2 months 3 weeks ago

Over the past decade, many Health Services Research (HSR) studies have been guided by the Triple Aim Framework, which was introduced by the Institute for Healthcare Improvement ( in 2007, and includes 3 dimensions: “improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care” (1). The Triple Aim has proven a useful framework for quality improvement and health systems research. This issue of the Canadian Journal of Diabetes features several articles that relate to one or more of the 3 aims: changing Alberta’s insulin pump therapy eligibility criteria to improve selection and safety of individuals living with diabetes (2); using sensor-based technology to improve glycemia in individuals with type 1 diabetes (3); switching primary care providers from fee-for-service to capitation-based remuneration to improve diabetes care (4); and combining SGLT2 inhibitors with GLP-1 receptor agonists to improve cardiorenal outcomes (5), among others.
David J.T. Campbell

Organization of Diabetes Care: Time to Move from Theory to Action

2 months 3 weeks ago

Decades of study has demonstrated the proportion of patients who are not meeting evidence-based targets for management of their diabetes. In this issue of the Journal, Shah et al add to this literature, showing that about one-fifth of the people living with diabetes in Ontario in 2019 had a glycated hemoglobin (A1C) of >8% (1). In their study from Brazil, Bergonsi de Farias and colleagues show that two thirds of their study population were not meeting A1C target levels (2). Patry and colleagues used the framework of structure, process and outcome measures and showed that, despite excellent achievement in structure and process indicators for diabetic foot ulcer management, the outcomes remained suboptimal; the authors hypothesize that additional structural supports are needed to address patient-level factors (3).
Noah Ivers, Ilana Halperin

Adequacy Between Canadian Clinical Guidelines and Recommendations Compared With International Guidelines for the Management of Diabetic Foot Ulcers

2 months 4 weeks ago

Although quality of care in the prevention and management of diabetic foot ulceration (DFU) has improved with the use of comprehensive evidence-based clinical practice guidelines, disparities between national and international guidelines have been demonstrated in one study conducted in Western Pacific regions. Although there are challenges of systematic implementation of evidence-based care in some clinical settings, their applications have demonstrated positive outcomes on DFU-associated burdens in many countries.
Virginie Blanchette, Jérôme Patry, Magali Brousseau-Foley

Glycated Hemoglobin as a First-line Screening Test for Cystic Fibrosis‒Related Diabetes and Impaired Glucose Tolerance in Children With Cystic Fibrosis: A Validation Study

2 months 4 weeks ago

Our aims in this study were to document the screening rate for cystic fibrosis‒related diabetes (CFRD) in children followed at a cystic fibrosis (CF) clinic in Canada and to evaluate the accuracy of various glycated hemoglobin (A1C) cutoffs to screen for CFRD and impaired glucose tolerance (IGT) in a pediatric CF population.
Florence Racine, Azadeh Shohoudi, Valérie Boudreau, Cécile Q.T. Nguyen, Marie-Hélène Denis, Katherine Desjardins, Quitterie Reynaud, Rémi Rabasa-Lhoret, Geneviève Mailhot

Insulin Therapy: The Discovery That Shaped a Century

3 months ago

The events and people surrounding the discovery of insulin as an effective therapy for diabetes in 1921 represent a compelling story that is directly relevant to the lives, and indeed the existence, of tens of millions of people worldwide. This story begins in the 19th century with the recognition that diabetes is a disease of hyperglycemia that arises because of the absence of a pancreatic hormone, that rapidly leads to death in people classified as having “thin diabetes” and that is linked to serious end-organ damage and other health consequences in people identified as having “fat diabetes.” It continues with the recognition that pancreatic extracts can treat this problem in de-pancreatectomized dogs, and culminates with the dogged determination of a young, newly certified Canadian physician, Frederick Banting.
Hertzel C. Gerstein, Christopher J. Rutty

Use of Virtual Care for Glycemic Management in People With Types 1 and 2 Diabetes and Diabetes in Pregnancy: A Rapid Review

3 months 2 weeks ago

Our objective in this study was to answer the main research question: In patients with diabetes, does virtual care vs face-to-face care provide different clinical, patient and practitioner experience or quality outcomes? Articles (2012 to 2020) describing interventions using virtual care with the capability for 2-way, individualized interactions compared with usual care were included. Studies involving any patients with diabetes and outcomes of glycated hemoglobin (A1C), quality of care and/or patient or health-care practitioner experience were included.
Catherine B. Chan, Naomi Popeski, Mortaza Fatehi Hassanabad, Ronald J. Sigal, Petra O’Connell, Peter Sargious

1 hour 14 minutes ago
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