Canadian Journal of Diabetes

Pharmacologic Glycemic Management of Type 2 Diabetes in Adults: 2020 Update


1 month 3 weeks ago

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 Clinical Practice Guidelines Expert Committee, Lorraine Lipscombe, Sonia Butalia, Kaberi Dasgupta, Dean T. Eurich, Lori MacCallum, Baiju R. Shah, Scot Simpson, Peter A. Senior

Pharmacologic Glycemic Management of Type 2 Diabetes in Adults: 2020 Update – The User’s Guide


1 month 3 weeks ago

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.
Diabetes Canada Clinical Practice Guidelines Steering Committee, Peter A. Senior, Robyn L. Houlden, James Kim, Dylan Mackay, Seema Nagpal, Doreen Rabi, Diana Sherifali, Harpreet S. Bajaj

Intergenerational Impacts of Colonization: Outcomes of Diabetes in Pregnancy for First Nations Families


1 month 3 weeks ago

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.
Taylor S. Morriseau, Brandy A. Wicklow, Barry Lavallee

Increasing Access to Patient-Centred Care: Initial Observations and Feasibility of a Pediatric Diabetes Drop-in Clinic


2 months ago

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).
Gloria M. Wheeler, Michelle Bauman, Mary M. Jetha, Elizabeth T. Rosolowsky

Identifying behaviour change techniques and motivational interviewing techniques in a diabetes prevention program situated in a community site


2 months ago

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.
M.M. MacPherson, T.E. Dineen, K.D. Cranston, M.E. Jung

The Challenges of Being Physically Active: A Qualitative Study of Young People With Type 1 Diabetes and Their Parents


2 months 1 week ago

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.
Leanne Fried, Tarini Chetty, Donna Cross, Lauren Breen, Elizabeth Davis, Heather Roby, Tanyana Jackiewicz, Jennifer Nicholas, Tim Jones

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


2 months 1 week ago

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.
Allie S. Carew, Rania A. Mekary, Susan Kirkland, Olga Theou, Ferhan Siddiqi, Robin Urquhart, Chris Blanchard, Ratika Parkash, Mark Bennett, Kerry L. Ivey, Kenneth Mukamal, Frank Hu, Eric B. Rimm, Leah E. Cahill

Association of Diabetes Mellitus and Cholangiocarcinoma: Update of Evidence and the Effects of Antidiabetic Medication


2 months 1 week ago

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.
Charupong Saengboonmee, Wunchana Seubwai, Worachart Lert-itthiporn, Thanachai Sanlung, Sopit Wongkham

Practical Considerations and Rationale for Glucagon-like Peptide-1 Receptor Agonist Plus Sodium-Dependent Glucose Cotransporter-2 Inhibitor Combination Therapy in Type 2 Diabetes


2 months 2 weeks ago

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.
Ronald M. Goldenberg, Vineeta Ahooja, Kristin K. Clemens, Jeremy D. Gilbert, Megha Poddar, Subodh Verma

Fasting May Alter Blood Glucose Responses to High-Intensity Interval Exercise in Adults With Type 1 Diabetes: A Randomized, Acute Crossover Study


2 months 2 weeks ago

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.
Jane E. Yardley

Outcomes of Diabetic Foot Ulcers in a Tertiary Referral Interdisciplinary Clinic: A Retrospective Canadian Study


2 months 2 weeks ago

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.
Cynthia Fournier, Narcisse Singbo, Nadesh Morissette, Marie-Marthe Thibeault

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