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Can Fam Physician. 2019 Jan;65(1):14-24.

Diabetes Canada 2018 clinical practice guidelines: Key messages for family physicians caring for patients living with type 2 diabetes.

Author information

1
Scientist at Women's College Research Institute in Toronto, Ont, a family physician at Women's College Hospital, Adjunct Scientist in ICES, Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, and Innovation Fellow at the Women's College Hospital Institute for Health System Solutions and Virtual Care. noah.ivers@utoronto.ca.
2
Medical student at Queen's University in Kingston, Ont.
3
Family physician at Nymark Medical Centre in Toronto.
4
Associate Professor in the Department of Family Medicine at the University of Manitoba in Winnipeg and a family physician at the Family Medical Centre at the University of Manitoba.
5
Family physician at Fraser Street Medical in Vancouver, BC, and Clinical Associate Professor in the Department of Family Medicine at the University of British Columbia.
6
Director of Education and Customer Insight at the Canadian Diabetes Association in Toronto.
7
Staff endocrinologist in the Department of Medicine at St Michael's Hospital in Toronto, Chair of the Clinical Practice Guidelines Dissemination and Implementation Committee at the Canadian Diabetes Association, Associate Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St Michael's Hospital, and Assistant Professor in the Department of Medicine at the University of Toronto.

Abstract

OBJECTIVE:

To summarize the 2018 Diabetes Canada clinical practice guidelines, focusing on high-priority recommendations for FPs managing people who live with type 2 diabetes.

QUALITY OF EVIDENCE:

A prioritization process was conducted to focus the efforts of Diabetes Canada's guideline dissemination and implementation efforts. The resulting identified key messages for FPs to consider when managing patients with type 2 diabetes are described. Evidence supporting the guideline recommendations ranges from levels I to IV and grades A to D.

MAIN MESSAGE:

Three key messages were identified from the 2018 guidelines as priorities for FPs: discussing opportunities to reduce the risk of diabetes complications, discussing opportunities to ensure safety and prevent hypoglycemia, and discussing progress on self-management goals and addressing barriers. A theme cutting across these key messages was the need to tailor discussions to the needs and preferences of each person. These important guideline recommendations are highlighted, along with information about relevant tools for implementing the recommendations in real-world practice.

CONCLUSION:

High-quality diabetes care involves a series of periodic conversations about self-management and about pharmacologic and nonpharmacologic treatments that fit with each patient's goals (ie, shared decision making). Incorporating these conversations into regular practice provides FPs with opportunities to maximize likely benefits of treatments and decrease the risk of harms, to support patients in initiating and sustaining desired lifestyle changes, and to help patients cope with the burdens of diabetes and comorbid conditions.

PMID:
30674509
PMCID:
PMC6347316

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