Diabetes video series

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[Music]
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Welcome to our educational video series
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on clinical practice guidelines for
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people with diabetes my name is Candace
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and I'm from diabetes Canada did you
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know that diabetes Canada works with
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experts to create best practices for
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diabetes Management in this video Dr
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harpi Bajaj will explain what the
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clinical practice guidelines are how
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they are created why they are important
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and how you can use them for your
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Diabetes Care Dr Bajaj is an
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endocrinologist and the medical director
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of endocrine and Metabolic Research at
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LMC Healthcare and centricity research
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he's the principal investigator of the
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Canadian diabetes prevention program a
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nationwide collaborative effort between
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LMC diabetes Canada and the public
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health agency of Canada Dr Bajaj
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currently serves diabetes Canada as the
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chair of the clinical practice
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guidelines steering committee over to
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you Dr
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bashash hello everyone uh so thank you
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Candace for that kind introduction and
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it's a pleasure to be here uh talking to
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you about the diabetes Canada clinical
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practice guidelines so here's an
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overview of what I'm going to take you
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through in the next few minutes uh first
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of all what are the guidelines and why
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do we need them is what I'm going to
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address also uh not uh in depth but but
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I'll show you superficially how the
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guidelines for diabetes Canada are
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created and then more importantly how
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you can use
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them okay so let's ask the question
What are Clinical Practice Guidelines
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first what are clinical practice
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guidelines so these are a set of
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comprehensive evidencebased guidelines
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chapters uh what does that mean that
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means it uh it U is a broad way of uh
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combining multiple research topics into
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easy to read chapters or or topics for
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the healthcare providers that actually
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help treat and manage diabetes for
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people living with diabetes um so these
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are evidence-based evidence as in uh not
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the legal kind of evidence but research
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kind of evidence uh what is the best
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research out there uh from any country
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not just in Canada globally worldwide
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that is looked at into various topics
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and the topics include uh what's there
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for diet what's there for exercise
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what's there for medications what about
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pregnancy what about glucose testing all
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of that has its has its own chapter and
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topics that are assigned that are then
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researched through a library of
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published research from the highest to
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the lowest levels and then we come up
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with this
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guidelines now you might be thinking oh
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why do we need the guidelines uh just
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like any other uh thing for example
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driving driving has a guideline that is
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set right uh and it should be
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standardized so that everybody follows
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the same rules and so that's kind of the
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basis of why uh there are clinical
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practice guidelines for diabetes similar
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guidelines for example uh are there for
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many other disease areas as well for
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example Cardiology has their own
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guidelines uh for how to manage heart
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problems or nephology has guidelines
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around how to manage blood pressure or
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kidney problems as well so then why do
Why do we need Clinical Practice Guidelines
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we need guidelines for diabetes is
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because the these guidelines can inform
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General Diabetes Care and kind of
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standardize them so that
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uh each person living with
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diabetes uh gets about the same standard
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of care as their neighborhood as their
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next uh as the next uh uh person in the
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clinic would as well uh this of course
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is with the whole idea or the background
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for this is uh is to try and prevent
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diabetes and prevent diabetes
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complications so that's the goal or the
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end game for this uh development of
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guidelin lines what we strive for is to
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try and prevent the disease from
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happening so diabetes from progressing
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or happening uh in people who who uh who
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don't have diabetes at at that time um
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there is a lot of research that uh doing
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certain things in terms of behavior
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modification which could be dietary
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Behavior changes or lifestyle exercise
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type of behavior changes that people who
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are at high risk uh diabetes can be
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prevented using those methods as such so
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that's one of the goals the other is for
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people living with diabetes how to
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prevent complications now diabetes is a
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silent kind of condition what I mean is
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that it does not cause pain or fever Etc
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so people may not know about it and so
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uh testing and screening for these
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complications of diabetes is important
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what are the complications you may ask
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some of the complications of diabetes
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include eye disease uh kidney disease as
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well as neuropathy or nerve damage
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mostly happens in the feet in people
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with
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diabetes uh those are uh those three so
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the eye disease kidney disease and the
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nerve damage are together called
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microvascular complications which mean
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the small vessels small blood vessels in
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the body is what is responsible
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for those complications in addition to
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those microvascular complications there
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are macrovascular complications of
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diabetes which means the big vessels and
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these are the heart blood vessels so
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heart attack and stroke are those M
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macrovascular complications so overall
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in nutshell these guidelines are
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developed to help uh standard of care
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for people uh with diabetes or people at
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risk for diabetes
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to help their Healthcare
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Providers enhance diabetes prevention as
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well as to reduce the burden or
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development of diabetes complications is
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the idea behind these guidelines so the
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next question you may ask is how are
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they created and who's responsible for
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them so here is kind of a pictorial or a
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cartoon of uh how many uh committees are
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involved in development of these
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guidelines um
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what I'll tell you is it's it's it's a
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comprehensive process which involves
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many many different uh committees as
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well as processes so steps many
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different steps are involved in this
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development um this is to make sure that
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the maximum number of perspectives from
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these committee members is gained so
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that everybody can come to a consensus
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as to how this should be implemented in
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the the real world in the Canadian uh uh
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Healthcare System it's itself right um I
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should also say that most of the
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committee members so expert committee
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Who develops the chapters steering
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committee who oversees the development
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of the chapters as well as the executive
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committee um which uh which uh you know
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deals with all the processes and
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methodology of all of
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this all of these experts in these
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committees are actually volunteers for
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diabetes Canada I'm one of the
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volunteers uh currently I'm the chair of
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the steering committee as well as some
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on the executive and expert committee as
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well so all these volunteers uh in these
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committees and we are very thankful for
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their work are putting in um volunteer
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hours into developing these guidelines
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they look at U what questions need to be
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answered in each particular topic and
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then
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set out parameters for searching those
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topics in the research literature
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research Publications that have been
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already published and then uh look at
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the literature look at the search
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results that we get and then finally uh
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come up with what
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recommendations should be for the end
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user the healthcare provider who has to
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help the person living with
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diabetes on the sides of this figure you
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can see the other um committees or other
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people that may be involved in
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development of this this includes
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external reviewers which means people
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who are not involved in developing those
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chapters but external maybe experts uh
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could be National or International that
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actually look at these guideline
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recommendations finally and say yes this
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makes sense or maybe you should consider
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changing this or that and then there's
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also the independent method meths
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committee looking to make sure that the
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right processes were done that the right
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citations were done and make sure that
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the the evidence from the research is
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marked at the right level of evidence or
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grading as well and then there's the
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diabetes Canada support staff who are
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very very important in making sure that
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all of this uh is is completed in a
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timely fashion and then finally we have
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the dissemination and implementation
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committee it's one thing to come up with
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a chapter but it's another to
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disseminate it across Canada across uh
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the provinces uh uh from east to west to
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the north as well and so that's the uh
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kind of the work that dissemination and
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implementation committee uh engages with
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uh this could be online education it
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could be in print education uh to the
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healthcare provider Etc as well so what
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I mentioned until now to you is what is
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relevant in terms of creation of
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guidelines and how maybe Healthcare
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Providers uh get to see these guidelines
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and use it as well so now that you've
How to use the Clinical Practice Guidelines
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learned uh what the guidelines are and
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how they are created and how they help
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the healthcare provider let's talk about
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how you as a person with diabetes or or
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a relative of a person with diabetes
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could use these clinical practice
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guidelines I think these guidelines
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would be important to increase your
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knowledge about diabetes prevention
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diabetes treatment as well as care in
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general you know there is a lot of
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information that is available online and
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some of it is good and some of it is
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unfortunately not so good what I mean is
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it may not be uh may not be accurate
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information or sometimes unfortunately
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it can be even misleading as well so
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that's why you need a resource that you
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can actually rely on and diabetes Canada
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overall uh uh on online information that
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diabetes Canada provides as well as the
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clinical practice guidelines is
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something that you can rely on to get
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that information and this uh may serve
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the purpose of raising your awareness of
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the guidelines uh as well as you know
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you can discuss and maybe this may spark
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a conversation with your Healthcare team
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about certain aspects of your care um
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you know there hopefully the healthare
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team that you're dealing with is uh
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aware of the of the most recent
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guidelines as well and they're following
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them as well so when um you converse
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with them or you communicate with them
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in terms of those guideline uh
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recommendations uh then it might
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actually um you know uh work better as a
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team so that uh so that the team that
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you're dealing with helps with your care
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even more in a team environment together
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and of course uh this may also help you
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speak up and advocate for your care if
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uh those recommendations uh you think
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are not being applied to the right uh
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degree as such so you can maybe advocate
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for
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yourself uh at the same time you know we
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have to also realize that the
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recommendations are recommendations and
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just like any guideline there are
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guidance documents um and each treatment
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or management has to be individualized
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to the person that we're dealing with as
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well in the clinic um for example you
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know uh I might be seeing a person with
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diabetes and the next person I see with
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diabetes may have a different completely
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completely different situation as such
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and I might have to tailor that based on
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my experience uh in terms of diabetes
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management as well so yes there are
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guidelines recommended for uh
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standardization of care but then there's
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an element of
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individualization uh which means that
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each individual is treated according to
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the circumstances according to uh
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various medical uh diagnosis and and
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availability and access as
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well where do you find all this
Resources
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information um so here's a great
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resource so so diabetes Canada online uh
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the website but also if you search for
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the guidelines themselves uh within the
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diabetes Canada guidel diabetes Canada
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website you'll find that the the
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guidelines are listed now most of this
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is listed uh as as full guidelines or
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guideline chapters each of them you can
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go through and they have a special kind
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of a box or or at the top top of each
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chapter there are key messages for
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people with diabetes that you can go
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through and those key messages in each
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chapter um you know it it may or may not
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apply to each of the situation so you
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can select which chapters May apply to
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you and then go through the key messages
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uh itself as well also of Interest maybe
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at the bottom the circle the uh lower
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green circle that you see around here on
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the left side uh there are there are
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good handouts or videos or tip sheets
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that you may find uh that that might be
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useful for you uh to understand further
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uh Basics into your diabetes management
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as well so I would encourage you to
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explore the education video library uh
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that is available through diabetes
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Canada website and all these tools that
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are available to you uh at your
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fingertips uh if if you choose to uh the
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website is mentioned at the bottom the
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guidelines di.
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diabetes.com line is the guidelines are
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comprehensive they're developed by
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volunteers who are experts in that field
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and they're based on Research evidence
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and they are based on that so as to make
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it prag atic or practical for the
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Canadian healthare structure that we
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have and this may enhance your treatment
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plan but then your treatment plan has to
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be tailored to you and to your values as
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well as preferences uh that you have as
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well I think it's important that the
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whole team including yourself as the
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most important part of the team as well
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as the whole Healthcare team is on the
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same page when we are talking about what
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what's best what's best uh Management in
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terms of diabetes care for you so I hope
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uh you'll use this to support assist and
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guide in terms of your management good
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luck to all of you um thank you for your
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attention
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