Useful Documents | Understanding Diabetes
Table presenting all types of antidiabetic drugs. A leaflet that brings together the most up-to-date dietary recommendations to help you prevent cardiovascular complications related to diabetes. Learn more about chronic kidney failure related to diabetes. This leaflet explains what is chronic kidney failure, its causes, its consequences, as well as the screening tests and the means of prevention. Learn more about the effects of smoking on the potential complications of diabetes, the steps needed to get rid of tobacco, and the resources available to empower those in the process of cessation. Table presenting all type of insulins available. Illustrated symptoms and steps totreat low blood sugar in a conscious individual. Steps to treat hypoglycemia in a conscious individual. Definition and recommendations for hyperglycemia. Document designed for people with type 2 diabetes to educate them about what to do on sick days. To order this document, please contact Ms. Siobhan Lough at [emailprotected] , or your local Janssen Inc. representative. The paper tool is available in French and English. Continue reading >>
A Day Of Family Health For Gp's - Cme Sessions - Markham, On
Session #1: A 21st Century Approach to Smoking Cessation After completing this program, participants will be able to: Recognize the fundamental importance of smoking cessation in every practice setting; Examine the different approaches to smoking cessation (including pharmacotherapies); Discuss the safety, efficacy, and mechanisms of action of various smoking cessation aids; Analyze the latest clinical data examining the risk of neuropsychiatric adverse events associated with smoking cessation; Recall the clinical practice guidelines for smoking cessation and the evidence around the treatment options for different patient populations, such as those with psychiatric, cardiovascular, and other comorbidities; and Recognize the advantages of systemic approaches to identification and treatment of smokers. Session #2: Advancements in Basal Insulin: Tailoring treatment to patient needs After attending this program, participants will be able to: Recognize the role of basal insulin therapy in the T2DM treatment continuum Identify and overcome barriers to insulin initiation and optimization from the patient and physician perspective, including hypoglycemia Differentiate basal insulin options, with a focus on the newer basal insulins Individualize basal insulin treatment based on patient characteristics and insulin profiles Session #3: Hypertension 2017: Putting the guidelines into practice At the conclusion of this activity, participants will be able to: Apply appropriate methods for making a diagnosis of hypertension Implement evidence-based threshold and target BPs Integrate new guidelines for hypertension management including: Use of longer-acting over shorter-acting diuretics Use of single pill combinations as a first-line treatment Learning objectives are currently unavaila Continue reading >>
Diabetes
For the treatment of type 2 diabetes, in combination with one or more antidiabetic agents, in persons with a history of atherosclerotic heart disease (ASIC) or atherosclerotic vascular disease (ASK) and whose glycated hemoglobin (HbA1c) is 7%. The nature of atherosclerotic heart disease (MCAS) or atherosclerotic vascular disease (MVAS) should be provided upon request by the Rgie. For the treatment of people with type 2 diabetes whose optimal maximum dose of metformin has been stable for at least one month. Individuals must also meet the requirements of the recognized indication for the payment of empagliflozin. For the treatment of people with type 2 diabetes: In combination with metformin, for the treatment of people with type 2 diabetes with inadequate glycemic control and with a body mass index (BMI) above 30 kg/m2. When a DPP-4 inhibitor is contraindicated, not tolerated or ineffective. The maximum duration of each authorization is 12 months. At the time of the first request to extend treatment, the physician is required to provide proof of benefit through a glycosylated hemoglobin (HbA1c) reduction of at least 0.5% or through the achievement of a target value of 7% or less. Authorization is given for a maximum daily dose of 1.8 mg. Inefficacy means non-achievement of an HbA1c value tailored to the patient. For the treatment of people with type 2 diabetes: In combination with metformin, for the treatment of people with type 2 diabetes with inadequate glycemic control and with a body mass index (BMI) above 30 kg/m2. When a DPP-4 inhibitor is contraindicated, not tolerated or ineffective. The maximum duration of each authorization is 12 months. At the time of the first request to extend treatment, the physician is required to provide proof of benefit through a glycos Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Diabetes doctors: Which specialists treat diabetes?
Valtrex Antibiotic Interaction
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Ckd Pathway - Medical Management
Adequate fluid intake: Fluid restriction is not necessary for most patients. Healthy diet: low sodium diet (2000 mg/day) Prescribe an ACEi or ARB unless contraindicated. Prescribe an ACEi or ARB if ACR > 30 mg/mmol and no contraindications. Women with childbearing potential should only use an ACEi or ARB if there is reliable contraception. Check potassium and eGFR within 2 weeks of starting or dose changes. Combined therapy of ACEi and ARB not recommended. ACEi or ARBs can cause a reversible reduction in eGFR when treatment is initiated (approximately 25%): If the reduction in eGFR exceeds 25% below the baseline value, stop ACEi or ARB. If the reduction in eGFR is 5 to 25%, re-check in 2-3 weeks to exclude further deterioration. Increases in serum potassium of up to 0.5mmol/L can be expected with ACEi or ARB use. ACEi or ARBs can safely be prescribed at all stages of CKD and should not be deliberately avoided with reduced eGFR. Assess for baseline cough, if bothersome cough with ACEi consider switching to ARB. Check the potassium and eGFR in times of acute illness, particularly influenza and diarrheal illness. Age > 50: Prescribe statin unless contraindicated. : Prescribe statin if no contraindications and if any one of the following: Known coronary disease (myocardial infarction or coronary revascularization). Continue reading >>
Type Ii Diabetes
Diabetes is a major health concern, affecting up to 10% of Canadians and leading to a two-fold risk of premature death. There are up to 60,000 new cases of diabetes in Canada each year, and between 80-90% of people with diabetes mellitus have T2DM. Though numbers are likely now drastically higher, in 2006, over 230 million people had diabetes - almost 6% of the world's adult population - and over 3 million die of it yearly ( World Diabetes Foundation, 2006 ). India appears to have the highest rates. Diabetes is expensive. In 2010, it accounted for 11.6% of total gobal healthcare expenditures (International Diabetes Federation). Comorbidities can cause major challenges. People with Type II diabetes are frequently obese and are often over 40, though it is being increasingly seen in children and adolescents. Patients with type II diabetes have a combination of insulin resistance and dysfunctional beta cells, though they do not require insulin. Metabolic changes are milder than in Type I, as levels of insulin secretion do restrict ketogenesis and ketoacidosis. obsesity, especially abdominal; hypertension, hyperlipidemia, CAD, vascular disease history of impaired glucose tolerance or fasting glucose ethnic Aboriginal, Hispanic, Asian, or African background It is the leading cause of end-stage renal disease, adult-onset blindness, and nontraumatic leg amputations. The prevalence of diabetes is increasing due to increased rates of obesity and inactivity. Rates of Type II diabetes in children are increasing at a disturbing rate. Recent data suggests an American child born in 2000 stands a one in three chance of being diagnosed with diabetes in his or her lifetime. (www.diabetes.ca) For people born in the US in 2000, the risk of developing T2DM is 1/3 for males and 2/5 for fema Continue reading >>
Diabetes Mellitus | Springerlink
Diabetes mellitus is a group of metabolic diseases characterized by elevated blood glucose levels (hyperglycemia) which could be caused by flaws in the secretion of insulin, its action, or both. Around 6% of the worlds population were living with diabetes in 2014. The two major types of diabetes are type I and type II. Insulin should be started at the day of diagnosis for patients with type I diabetes. Insulin regimens should be individualized based on age, general health, lifestyle, diet, hypoglycemia awareness, ability for self-management, general health, adherence, and social and financial aspects. The most successful insulin regimens for managing type I diabetes are those that combine basal and bolus insulin. Such regimens attempt to mimic the pancreas normal activity. Type II diabetes treatment regimens and glycemic targets should be individualized. Such treatment regimens should aim to avoid and treat hyperglycemia and reduce the risk of macrovascular and microvascular complications. The choice of the treatment regimen at the diagnosis of type II should depend on the difference between the patients A1C and their individual target and the presence of symptomatic hyperglycemia and/or metabolic decompensation. If not contraindicated, metformin is considered the first line of treatment in patients with type II diabetes. The presence of clinical cardiovascular disease (CVD) governs the choice of the second line agent. If the patient has clinical CVD, then we should choose an agent with demonstrated cardiovascular benefits and that includes empagliflozin, canagliflozin, and liraglutide. If the patient does not have clinical CVD, the choice of the second line agent should consider the patients medical history, social and work factors, their preferences and values, and t Continue reading >>
Oscarmcmaster / List Oscarmcmaster-bc-users Archives
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Diabetes
- How can I add the app to the home screen of my mobile device? To get the procedure to add this app, select the button corresponding to your mobile device. Note that the procedure may be slightly different depending on the version of the operating system used. - Do I have to download the application to be able to use it? No. The application is hosted on a server and accessible via a web browser. The technologies used to develop this web application are the same as those used for the creation of websites. You can add a shortcut to the home screen of your mobile device. - Does the application also work on my computer? Yes. Although this application targets mobile devices first it will run properly on most modern web browsers (Mac and PC). - The application does not seem to work normally. Make sure Javascript is enabled in your device's web browser (usually enabled by default). - How can I search for information in the app? A search engine is located on the homepage below the navigation bar. You can clean the field by typing a new request or by using the to the right of the search button. Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Diabetes doctors: Which specialists treat diabetes?
Bringing Diabetes Guidelines To Life
Prefer to access the Guidelines on your smartphone or tablet? Download the CDA CPG App which is available for Apple and Android platforms. For patients, the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada (Guidelines) provide an opportunity to take control of their diabetes and share information with their health care team. For health care providers, they provide the most up-to-date recommendations for the management of diabetes based on the best available evidence. However, the Guidelines wont do anyone any good if they just sit on health care providers shelves. In order to affect change and create better patient outcomes and a better quality of life for the more than 10 million people in Canada who live with diabetes or prediabetes, they must be accessible and useful. To meet this goal, the committee responsible for Guidelines dissemination and implementation, under the leadership of Dr. Catherine Yu, has developed professional tools and materials, as well as patient resources. The committee also identified five key areas that are essential for improving the quality of life for people living with diabetes, improving the quality of diabetes care, and reducing illness and death from diabetes and its complications. They are screening and diagnosis, vascular protection, blood glucose lowering, self-management education, plus team and organizing care. Here are tools from our web-based Guidelines that providers can incorporate into their daily practices. Diabetes is common in people who are in hospital for a variety of other diagnoses. Proper management of the diabetes in hospital can help improve certain outcomes. The nine recommendations within chapter 16 address the issues of organization of care, g Continue reading >>
Medication Management On Sick Days
Go to: SUMMARY Patients may be susceptible to adverse drug events during acute illness due to comorbidities or medicine use. Acute illness should prompt careful monitoring or dose adjustment in patients prescribed certain medicines. Patient factors, severity and expected duration of illness, and class of drug should be considered to minimise the risk of adverse drug events. Some drugs may need to be temporarily suspended, such as metformin, diuretics and sodium-glucose co-transporter 2 inhibitors when there is a risk of hypovolaemia. Those with chronic kidney disease are at risk of acute kidney injury due to limits in their physiological reserve. This may be compounded by medicine use. Temporary increases in dose may be required for insulin and corticosteroids. Withdrawal syndromes may occur with controlled-release drugs, such as dopamine agonists, antidepressants and analgesics, due to malabsorption. An action plan may be needed for medicine use on sick days. Patient education around supplemental dosing of oral contraceptives to maintain efficacy after acute illness is important. Continue reading >>
Sick-day Guidelines
CLINICAL DIABETES VOL. 18 NO. 3 Summer 2000 PATIENT INFORMATION Diabetes can be more difficult to control when you are ill. Plan ahead for illness by having individually wrapped Ketostix and special foods (such as regular Jell-O and Gatorade) on hand. When you are ill, the following guidelines can help you keep your diabetes under control. Report any illness to your physician when it increases blood glucose levels and causes urine ketones. See your doctor without delay if you need guidance in handling the illness or if there is no improvement in 6–8 hours. Test blood glucose and ketones frequently, at least every 2–4 hours, until results are normal. Call your physician to ask for guidance, especially if high blood glucose levels (250 mg/dl or greater) last for more than 6 hours, if urine ketones last for more than 6 hours, if you are unable to take fluids or food for 4 hours, if you have a fever (101.5°F), if illness lasts more than 24 hours or if you are dehydrated, have severe abdominal pain, or have other unexplained symptoms. When contacting the physician, have handy the results of glucose and ketone testing, symptoms of illness, and body temperature. Continue taking insulin even if you are unable to eat solid foods or are vomiting. Your insulin needs may stay the same or increase when you are ill. If you take pills for diabetes, take your usual dose. If the pills will not stay down, call your physician. If you have blood glucose levels less than 70 mg/dl and take a diabetes pill that can cause low blood glucose, call your physician. Continue eating foods and drinking fluids even if you are vomiting, having diarrhea, or your blood glucose level is high. Take in at least 45–50 g of carbohydrate every 3–4 hours to prevent low blood glucose while your insulin Continue reading >>
Sick Day Guidelines For Those With Type 2 Diabetes
I N F O R M A T I O N B O O K L E T It is important to know how to take care of yourself if you are ill, have an infection or injury, or are under stress. You need to know that: • Hypoglycemia (low blood glucose) can occur if you are not able to eat or drink, or if you have symptoms of an illness, such as vomiting and/or diarrhea. • Hyperglycemia (high blood glucose) can occur in response to the body’s release of stress hormones when you are ill or under stress. Other causes include certain medications, such as steroids, a missed insulin dose, or injection site issues. • Hyperosmolar Hyperglycemic State (HHS) can occur as a result of hyperglycemia. HHS is a life threatening condition and requires immediate medical attention. Warning signs include: hyperglycemia, dehydration, nausea, vomiting, a decreased level of awareness, weakness, loss of vision, etc. Do not confuse these symptoms with symptoms of the flu! Developed by the Diabetes Education Team at the OSMH Diabetes Education Centre. Adapted from materials developed by the Canadian Diabetes Association (CDA) and based on the 2013 CDA Clinical Practice Guidelines. Revised July 2013. 7. Seek immediate medical assistance if: • You are not well enough or able to follow these guidelines or are worried about your symptoms; • You have vomited and/or have had diarrhea 1 or more times in 4 hours; • You are unable to eat or drink; • You are showing signs of dehydration, like a very dry mouth, cracked lips, dry skin or sunken eyes; • Your blood glucose has been higher than 20 mmol/L for more than 12 hours; and/or • You cannot keep your blood glucose above 4 mmol/L or you are having a severe hypoglycemic reaction. 8. Prepare for tests and procedures. Plan in advance. Continue reading >>
Diabetes Topics Catalogue
To search this Diabetes Topics Catalogue, hold "Ctrl" + "f" (PC) or "Cmd" + "f" (Mac) and type in your search word. Consider giving all your patients the short list of Diabetes Resources for Patients (diabetes phone-lines, classes, urgent help, routine 1:1 help). Patient Worksheet - Managing Your Blood Sugars (AHS) The following are some of the many tools available for determining the carbohydrate content of foods. Not all sources of carbohyrate content may be acccurate (particularly for apps). Labels: Subtract grams of fibre from the grams of carbohydrate for the portion on the label. Related "Matching Carbohydrate to Insulin" handout in Diabetes Type 1 heading below. Restaurant websites: Many fast food and other restaurants have nutrient analysis posted online for their products. Nutrient Analysis Apps: Through smart phones' app stores or AppCrawlr . General carbohydrate estimates. One carbohydrate choice contains 15 grams of carbohydrate (after the fibre is subtracted).A general guideline for the number of carbohydrate choices to eat per meal is 2-4 for most women and 4-6 for most men. For snacks: 0-1 for women and 0-2 carb choices for men. 1/2 cup (125 mL) cooked pasta/potato/other starch To access AHS Nutrition handouts see Nutrition Resources below. Other handouts available through a dietitian. Nutrient Analysis Websites (we cannot verify accuracy of data): Encourage patients to contact their Primary Care Network (PCN) regarding classes. PCN information can be accessed through mypcn.ca Client Centered Counseling (Motivational Interviewing) Continuous Glucose Monitoring (CGM) Dexcom Trend Arrows: Preventing high and low glucose readings by adjusting See Diabetes Services Calgary page for referral documents Nutrition handouts for diabetes in pregnancy see Nutrition Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Leeds diabetes clinical champion raises awareness of gestational diabetes for World Diabetes Day
- Diabetes doctors: Which specialists treat diabetes?
The Canadian Diabetes Association S 2013 Clinical Practice Guidelines And The Pharmacist Rob Roscoe, B.sc.pharm., Acpr, Cde, Cpt
The Canadian Diabetes Association s 2013 Clinical Practice Guidelines and the Pharmacist Rob Roscoe, B.Sc.Pharm., ACPR, CDE, CPT Welcome! Thank you for joining the webinar: The Canadian Diabetes Association s 2013 Clinical Practice Guidelines and the Pharmacist Rob Roscoe, B.Sc.Pharm., ACPR, CDE, CPT The webinar will begin shortly. Please ensure that your computer speakers are turned on If you experience audio problems, please dial 1.800.660.7225 and enter the event passcode 5237877# If you experience other technical issues during the webinar, please email [email protected] Updating Pharmacy Practice What we need to know from the recently released 2013 Canadian Diabetes Association Clinical Practice Guidelines (CDA-CPG s) OBJECTIVES Better understand the role of Disease-based Guidelines. Review the changes of the newly released 2013 CDA Clinical Practice Guidelines (CPG) recommendations & how these changes may effect the practice of Pharmacy. Illustrate how these changes may effect diabetes management by following a typical patient from diagnosis to advanced therapy and comparing this patient to an older family member who has had diabetes diagnosed about 10 years earlier. Role of Disease-based Guidelines: Looks at multiple aspects of a disease including: Diagnosis, management, special situations, treatment goals, evidence based approach to best manage and approach treatment of the condition. Ideal scenario, based on research and evidence. Challenge is to adapt to real world practice. Provides guidance on how to approach the global aspects of the Disease (not just treatment). By using scheduled updates, ensure current info & amendments are scheduled to be added on a electronic version. Canadian Diabetes Association Clinical Practice Guideline s Objective (CDA Continue reading >>
