Canadian Diabetes
Published quarterly, Canadian Diabetes provides practical, current information to family physicians on diagnosis and treatment issues associated with diabetes.
Insulin Initiation in Type 2 Diabetes: Not so Tricky After All!
As the incidence and prevalence of type 2 diabetes grow exponentially, the care of people with type 2 diabetes inevitably falls to family physicians and generalists, as there are not enough endocrinologists in Canada to manage the burgeoning patient population.
Sara J. Meltzer MD FRCPC, Sarah E. Capes MD MSc FRCPC
La mise en route de l’insulinothérapie en présence de diabète de type 2 : pas si difficile que ça!
Étant donné la croissance exponentielle de l’incidence et de la prévalence du diabète de type 2, ce sont inévitablement les médecins de famille et les omnipraticiens qui doivent traiter les personnes atteintes de diabète de type 2, car il n’y a pas assez d’endocrinologues au Canada pour s’occuper de tous les patients.
Sara J. Meltzer, MD, FRCPC, et Sarah E. Capes, MD, MSc, FRCPC
The Rules of 3’s: Insulin Use in Type 2 Diabetes
Approximately one-half of Canadians with known type 2 diabetes are at the recommended glycated hemoglobin (A1C) target of ≤7.0% (1). Although this is quite an accomplishment and there has definitely been improvement over time (2,3), a large proportion of people with type 2 diabetes are not at glycemic target and require more aggressive glycemic management. Compared with other therapeutic areas that have a dearth of therapeutic options, diabetes is relatively rich in the number of effective glucose-lowering therapies available for use in Canada, with various routes of administration and mechanisms of action. Insulin remains the oldest and most effective therapy for glucose lowering; however, its use remains relatively low (12–15%) given the care gap that still exists regarding glycemic control (1,3).
Alice Y.Y. Cheng MD FRCPC
Insulin Initiation: A Case Study
Christine weighs 80 kg and, at a height of 165 cm, she has a body mass index of 29.4 kg/m2. At her last doctor’s appointment, her blood pressure was 118/78 mm Hg and her physical examination was otherwise normal. Despite her best efforts at diet and exercise, and educational sessions with a nurse and dietitian, over the past year Christine’s glycated hemoglobin (A1C) was 8.8% and her fasting blood glucose (FBG) ranged from 9.8 to 12.1 mmol/L. She has been resistant to taking insulin, believing that it would label her a “failure” at diabetes management.
David Miller MD FRCPC
Canadian Diabetes Spring 2011 - Full Issue
Production of materials has been made possible through a financial contribution from the Public Health Agency of Canada.
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