Canadian Journal of Diabetes
Assessing the Effect of Quality-Improvement Strategies for Organization of Care in Type 2 Diabetes Outcomes in Adults: Aim-Strait
To observe the effect of an organization-of-care improvement process on the achievement of therapeutic goals for people with type 2 diabetes mellitus (T2DM).
The Diabetes Canada Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (CPG) were last published in 2018 (1). New evidence has been published since the 2018 guidelines, prompting this update to our recommendations for Chapter 13, “Pharmacologic Glycemic Management of Type 2 Diabetes in Adults” (1).
Diabetes Canada prepares clinical practice guidelines to provide a synthesis of the best evidence to help practitioners. Evidence-based medicine seeks to integrate the best evidence with clinical expertise and the values of persons living with diabetes. It is challenging to balance the goals of providing guidelines based on high-quality evidence with addressing the needs of practitioners who commonly face clinical scenarios for which there is no robust evidence.
Intergenerational Impacts of Colonization: Outcomes of Diabetes in Pregnancy for First Nations Families
Rates of youth- and early-onset type 2 diabetes (T2D) are on the rise in Canada, a disease that, until the early 1980s, was only seen in older adults. As a result, more women have T2D during pregnancy than ever. Currently, approximately 6% of pregnancies in Canada are complicated by maternal diabetes, which contributes significantly to greater rates of antenatal, perinatal and postnatal complications for both mother and child (1). To compound matters, mounting evidence demonstrates that exposure to diabetes in utero increases the likelihood that the offspring will develop T2D, and at a significantly younger age, creating a cycle of pregnancies complicated by diabetes and another generation having greater risk of T2D development.
I read the qualitative study titled, “The ketogenic diet as a normal way of eating by adults with type 1 and type 2 diabetes: A qualitative study,” which was published in the Canadian Journal of Diabetes (1). I want to congratulate the authors for their interesting trial.
Increasing Access to Patient-Centred Care: Initial Observations and Feasibility of a Pediatric Diabetes Drop-in Clinic
For children and youth with diabetes, the quotidian tasks of blood glucose (BG) monitoring, counting carbohydrates and adjusting insulin can be a heavy burden of disease (1). The health-care team (HCT) aims to empower patients’ self-management (2). Pediatric diabetes professional societies recommend HCT follow up every 3 to 4 months or more frequently for very young children or those struggling with self-management (3).
Our aim in this study was to determine the distribution of glycated hemoglobin (A1C) in the Ontario diabetes population and identify subgroups with a high risk of poor glycemic control.
Identifying behaviour change techniques and motivational interviewing techniques in a diabetes prevention program situated in a community site
Risk of developing type 2 diabetes (T2D) can be reduced through diet and exercise changes. Given the rapidly increasing prevalence of T2D and the associated burden on the healthcare system, there is a need for affordable and scalable diet and exercise programs to be delivered in communities. Small Steps for Big Changes (SSBC) is an evidence-based diabetes prevention program for improving diet and exercise adherence in individuals at risk for developing T2D. Detailed reporting of intervention components as SSBC transitions from laboratory to communities is an essential step to understand its effectiveness, and subsequent uptake.
The Challenges of Being Physically Active: A Qualitative Study of Young People With Type 1 Diabetes and Their Parents
Benefits of physical activity are well recognized for youth with type 1 diabetes mellitus (T1DM), but being active is challenging. In this study, we aimed to investigate the challenges experienced by adolescents, their parents and young adults with T1DM when they are physically active.
Prospective Study of Skipping Meals to Lose Weight as a Predictor of Incident Type 2 Diabetes With Potential Modification by Cardiometabolic Risk Factors: The Canadian 1995 Nova Scotia Health Survey
Skipping meals is an increasingly common practice to lose weight among North American adults. However, the long-term effect of this practice on incident type 2 diabetes mellitus (T2DM) remains unknown. We assessed whether skipping meals to lose weight is associated with T2DM risk and whether this association is modified by cardiometabolic risk factors.
Association of Diabetes Mellitus and Cholangiocarcinoma: Update of Evidence and the Effects of Antidiabetic Medication
Diabetes mellitus (DM) is a risk factor for cancer in many organs and associated with an increased risk of cholangiocarcinoma (CCA). The molecular linkage between these diseases has been demonstrated in preclinical studies, which have highlighted the role of hyperinsulinemia and hyperglycemia in the carcinogenesis and progression of CCA. Recent studies on the emerging role of antidiabetic medication in the development and progression of CCA showed a subclass of antidiabetic drug with a therapeutic effect on CCA.
Practical Considerations and Rationale for Glucagon-like Peptide-1 Receptor Agonist Plus Sodium-Dependent Glucose Cotransporter-2 Inhibitor Combination Therapy in Type 2 Diabetes
Glucagon-like peptide-1 receptor agonists and sodium-dependent glucose cotransporter-2 inhibitors have demonstrated clinically significant benefits on glycated hemoglobin, weight, blood pressure and cardiorenal outcomes. The emerging evidence from clinical trials and meta-analyses that assessed the combination of these 2 classes of drugs has been promising. An expert forum that included individuals with expertise in endocrine, cardiology and nephrology issues was held in May 2020 to review the literature on the metabolic and cardiorenal benefits of these 2 classes, independently and in combination, in adults with type 2 diabetes mellitus.
Fasting May Alter Blood Glucose Responses to High-Intensity Interval Exercise in Adults With Type 1 Diabetes: A Randomized, Acute Crossover Study
In individuals with type 1 diabetes (T1D), changes in blood glucose (BG) during high-intensity interval exercise (HIIE) are smaller than those observed during aerobic exercise. Study outcomes, however, have been variable, with some demonstrating significant BG decreases and others showing BG increases. This study compared BG outcomes between fasting (AME) and postprandial (PME) HIIE in T1D to test the hypothesis that AME would produce a BG increase, yet PME would cause BG to decline.
Outcomes of Diabetic Foot Ulcers in a Tertiary Referral Interdisciplinary Clinic: A Retrospective Canadian Study
The objectives of this work were to evaluate demographic data, healing rate, recurrence rate, amputation rate and death rate of patients with diabetic foot ulcers (DFUs) treated in a Québec outpatient diabetic foot ulcer multidisciplinary clinic. Another objective was to determine factors associated with higher ulcer recurrence.
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