Canadian Journal of Diabetes

BACKGROUND: Pharmacological treatment of type 2 diabetes mellitus (T2DM) follows a stepwise approach. Typically, metformin monotherapy is first-line treatment, followed by other non-insulin anti-hyperglycemic agents (NIAHAs) or progression to insulin if hemoglobin A1c (A1C) targets are not achieved. We aimed to describe real-world patterns of basal insulin initiation in people with T2DM and A1C not at target despite treatment with ≥2 NIAHAs. METHODS: A retrospective cohort study was conducted using administrative health data from Alberta, Canada among adults with T2DM, indexed on the first test with 7...

OBJECTIVES: The Hypoglycemia During Hospitalization (HyDHo) score predicts hypoglycemia in a population of Canadian inpatients by assigning various weightings to 5 key clinical criteria known at the time of admission, in particular age, recent presentation to an emergency department, insulin use, use of oral hypoglycemic agents, and chronic kidney disease. Our aim in this study was to externally validate the HyDHo score by applying this risk calculator to an Australian population of inpatients with diabetes...

OBJECTIVES: The purpose of this qualitative study is to identify barriers minimizing the effectiveness of motivational interviewing during virtual clinic encounters for individuals with type 2 diabetes based on the capability, opportunity, motivation, and behaviour (COM-B) model. METHODS: One-on-one semistructured interviews were conducted from March to June 2023, with 17 adults with type 2 diabetes (64.7% female; median age 69 years, range 47 to 83 years) followed at St...

OBJECTIVE: Our aim in this study was to systematically assess the association of sodium-glucose cotransporter-2 inhibitors (SGLT2i) vs dipeptidyl peptidase-4 inhibitors (DPP4i) with pneumonia, COVID-19, and adverse respiratory events in patients with type 2 diabetes mellitus (DM). METHODS: PubMed, Embase, and Cochrane Library databases were retrieved to include studies on DM patients receiving SGLT2i (exposure group) or DPP4i (control group). Stata version 15.0 statistical software was used for the meta-analysis...

OBJECTIVES: The objectives of this study were: 1) to examine and compare changes in functional limitations during the COVID-19 pandemic among older adults with and without diabetes; and 2): to identify key risk factors associated with developing functional limitations among older adults with and without diabetes during the pandemic. METHODS: We analyzed data collected from the Canadian Longitudinal Study on Aging. The analysis was restricted to those with no functional limitations in the follow-up 1 wave (2015 to 2018) (final sample N=6,045)...

OBJECTIVES: To determine the correlation between fructosamine, used to assess glycemia when HbA1c is not appropriate, with average blood glucose as measured by continuous glucose monitoring (CGM) in children with type 1 diabetes. METHODS: 97 blood samples were collected from 70 participants in the CGM TIME Trial. Each eligible participant had 3 weeks of CGM data with at least 60% CGM adherence prior to blood collection. Ordinary least squares linear regression incorporating restricted cubic splines was used to determine association between fructosamine and mean blood glucose...

BACKGROUND: This manuscript explores sociocultural and systemic factors influencing diabetes management among South Asian (SA) caregivers in Peel Region, Ontario. METHODS: Twenty-one semi-structured interviews were conducted with SA caregivers using a qualitative descriptive design. Data were analyzed using thematic analysis and intersectionality analysis. RESULTS: Identified themes were: 1) Prioritizing family caregiving over diabetes self-management; 2) Labour market impacts on diabetes self-management; and 3) Challenges navigating Canadian health and social service systems...

OBJECTIVE: To explore the association between place of residence (metropolitan, urban, rural) and guideline concordant processes of care in the first year of type 2 diabetes management. METHODS: We conducted a retrospective cohort study of new metformin users between April 2015 and March 2020 in Alberta. Outcomes were identified as guideline concordant processes of care through the review of clinical practice guidelines and published literature. Using multivariable logistic regression, the following outcomes were examined by place of residence: dispensation of a statin, angiotensin-converting-enzyme-inhibitor (ACEi) or angiotensin-II-receptor-blocker (ARB), eye examination, and glycated hemoglobin A1C, cholesterol, and kidney function testing...

BACKGROUND: The rising prevalence of type 2 diabetes (T2D) in Canada poses a significant health challenge. Despite the convenience of screening for diabetes with glycated hemoglobin concentration, people experiencing homelessness (PEH) often face barriers to accessing diabetes screening, potentially leading to underdiagnosis. This study aims to assess the prevalence of undiagnosed diabetes among PEH in Calgary, Alberta, contributing insights for planning healthcare services and public health initiatives...

No abstract text is available yet for this article.

OBJECTIVES: Since 2016, clinical guidelines have recommended sodium-glucose cotransporter-2 inhibitors (SGLT2is) for people with type 2 diabetes with heart failure. We examined SGLT2i dispensation, factors associated with dispensation, and heart failure hospitalization and all-cause mortality in people with diabetes and heart failure. METHODS: This retrospective, population-based cohort study, identified people with diabetes and heart failure between Jan 1, 2014 to Dec 31, 2017 in Alberta, Canada and followed them for a minimum of three years for SGLT2i dispensation and outcomes...

Type 2 diabetes (T2D) is a significant public health challenge for which effective lifestyle interventions are needed. A growing body of evidence supports the use of both plant-based eating patterns and early time-restricted eating (eTRE) for the prevention and treatment of T2D, but research has not yet explored the potential of these dietary strategies in combination. In this narrative review we assessed the evidence by which plant-based diets, in conjunction with eTRE, could support T2D care. The electronic databases MEDLINE and the Web of Science were searched for relevant articles published throughout the last decade...

BACKGROUND: No data are available regarding glycemic control of patients with type 1 diabetes mellitus (T1D) during Passover. OBJECTIVE: To assess the effect of Passover on diabetes management and glycemic control in adults with T1D with nutritional changes during Passover (observant) compared with patients who did not change their dietary habits during Passover (non-observant). METHODS: Observational pre-post study of adult patients with T1D, followed in a diabetes clinic in Israel...

BACKGROUND: Diabetes distress has been understudied in the pregnancy population. Pregnancy is known to be a complex, highly stressful time for women with diabetes because of medical risks and the high burden of diabetes management. OBJECTIVE: This study aimed to explain and understand diabetes distress in women with pre-existing diabetes in pregnancy. METHODS: An explanatory, sequential mixed methods study was undertaken. The first strand consisted of a cross-sectional study of 76 women with type 1 and type 2 diabetes...

AIM: Diabetes prevention programs targeting dietary and physical activity behavior change have been shown to decrease the incidence of type 2 diabetes; however, more thorough reporting of intervention characteristics is needed to expedite the translation of such programs into different communities. This scoping review aims to synthesize how diabetes prevention programs are being reported and implemented. METHODS: A scoping review following the Arkey and O'Malley methods was conducted following the PRISMA guidelines...

OBJECTIVE(S): To (1) explore barriers and enablers to patient and healthcare providers (HCPs) behaviours related to SDMG, (2) identify theory-informed strategies to advise SDMG intervention design, and (3) obtain perspectives on an eHealth tool for this purpose. METHODS: A qualitative descriptive study using qualitative conventional content analysis was undertaken. Interviews and focus groups were held with patients and HCPs from January 2021 to April 2022. Data was analyzed using the behaviour change wheel and theoretical domains framework to inform intervention design...

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BACKGROUND: Diabetes care in Australia is often fragmented and provider-centered, resulting in suboptimal care. Innovative solutions to bridge the evidence-practice gap are needed, and technology can facilitate the redesign of type 2 diabetes care. To increase the chances of fulfilling stakeholders' needs we used Participatory Design. Using this method, we explored solutions aimed at redesigning diabetes care, focusing on the previously identified needs. METHODS: The Participatory Design project was guided by stakeholders' contributions...

AIMS: Glycoprotein acetyls (GlycA) is a biomarker of systemic inflammation and cardiovascular disease, yet little is known about its role in type 1 diabetes (T1D). We examined the associations among GlycA, central adiposity, insulin resistance, and early kidney injury in youth with T1D. METHODS: Glomerular filtration rate (GFR) and renal plasma flow (RPF) by iohexol and p-aminohippurate clearance, urine albumin-to-creatinine ratio (UACR), central adiposity by DXA, and estimated insulin sensitivity were assessed in fifty youth with T1D (16±3...

No abstract text is available yet for this article.