Practical Implementation of Diabetes Canada Guideline Updates for Type 2 Diabetes Management in Primary Care

Authors

  • Jennifer Fu, MD, FRCPC Division of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario; University of Toronto, Toronto, Ontario
  • Jeremy Gilbert, MD, FRCPC Division of Endocrinology & Metabolism, Department of Medicine, Sunnybrook Health Sciences; Centre and University of Toronto, Toronto, Canada

DOI:

https://doi.org/10.58931/cpct.2024.2126

Abstract

Type 2 diabetes (T2DM) is a growing global health epidemic identified by the World Health Organization (WHO) as a major public health challenge of the 21st century.1 By 2050, it is estimated that 1.31 billion people worldwide could be living with T2DM. Across Canada, T2DM affects >9% of our population (i.e., >3.6 million individuals), and age-adjusted prevalence is also increasing at an alarming rate averaging 3.3% per year. More than 90% of people living with diabetes have T2DM, and most of these individuals are cared for in the primary care setting. With rising rates of obesity and metabolic risk factors, along with an aging Canadian population, the burden of T2DM facing primary care is only expected to increase over time. 

T2DM care is complex, tailored to the individual, and rapidly advancing. A May 2023 survey commissioned by Diabetes Canada estimated that over one-third of family practitioners’ time is spent treating diabetes, and that most healthcare providers find T2DM challenging to treat.3 The Diabetes Canada Clinical Practice Guidelines (DCAN CPG) provides useful and practical guidance on T2DM management. It has recently shifted its update structure from a comprehensive overhaul every five years, to a select few focused chapter updates each year in recognition of the rapidly shifting body of evidence. More recently, updated chapters of the DCAN CPG include a Pharmacologic Glycemic Management of Type 2 Diabetes in Adults chapter in 2020; Blood Glucose Monitoring in Adults and Children with Diabetes chapter in 2021; Remission of Type 2 Diabetes special article in 2022; and Hypoglycemia in Adults chapter and Position Statement on DIY Automated Insulin Delivery special article in 2023. The purpose of this review is to provide a pragmatic overview of these recent chapter updates and to highlight priorities for T2DM management in primary care. 

Author Biographies

Jennifer Fu, MD, FRCPC, Division of Endocrinology, Sunnybrook Health Sciences Centre, Toronto, Ontario; University of Toronto, Toronto, Ontario

Dr. Jennifer Fu is a Clinical Associate Endocrinologist at Sunnybrook Health Sciences Centre and Lecturer in the Division of Endocrinology and Metabolism at University of Toronto. She recently graduated from the Endocrinology & Metabolism Residency Program at University of Toronto, and is pursuing advanced training in clinical epidemiology and quality improvement at the Institute of Health Policy, Management and Evaluation (IHPME) and Centre for Quality Improvement and Patient Safety (CQuIPS). She is passionate about diabetes and metabolic disease management in young adults and developing programs to improve pre‑and inter-conception care for women living with diabetes. 

Jeremy Gilbert, MD, FRCPC, Division of Endocrinology & Metabolism, Department of Medicine, Sunnybrook Health Sciences; Centre and University of Toronto, Toronto, Canada

Dr. Jeremy Gilbert completed his medical degree, internal medicine training and endocrinology residency at the University of Toronto. He is an associate professor at the University of Toronto. He is the former program director for adult endocrinology and metabolism at the University of Toronto. He has authored a chapter in the 2013 and 2018 Diabetes Canada Guidelines and is a member of the steering committee of the Diabetes Canada Guidelines. He is the national lead for dissemination and implementation for the Diabetes Canada Guidelines. He is on the executive and is a national editor for the Canadian Journal of Diabetes. He is the endocrinology section chair at the Royal College of Physicians and Surgeons of Canada. He is a passionate teacher and his academic interest in undergraduate, postgraduate and continuing medical education in diabetes and endocrinology. He has received numerous awards for outstanding teaching including the 2021 Canadian Society of Endocrinology and Metabolism's Harvey Guyda Educator of the Year Award. 

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Published

2024-06-17

How to Cite

1.
Fu J, Gilbert J. Practical Implementation of Diabetes Canada Guideline Updates for Type 2 Diabetes Management in Primary Care. Can Prim Care Today [Internet]. 2024 Jun. 17 [cited 2024 Jul. 19];2(1):25—29. Available from: https://canadianprimarycaretoday.com/article/view/2-1-fu-et-al

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Articles