Canadian Journal of Diabetes最新文献

{"title":"What Is the Effectiveness of Type 2 Diabetes–related Patient Decision Aids? Secondary Analysis of a Systematic Review","authors":"Sandhya Goge RN, MN, CDE ,&nbsp;Christopher Tran MD, FRCPC, MMEd ,&nbsp;Krystina B. Lewis RN, MN, PhD, CCN(C) ,&nbsp;Meg Carley BSc ,&nbsp;Carol Bennett MSc ,&nbsp;Dawn Stacey RN, PhD, FCAHS, FAAN, FCAN, FRSC","doi":"10.1016/j.jcjd.2025.02.003","DOIUrl":"10.1016/j.jcjd.2025.02.003","url":null,"abstract":"<div><h3>Objectives</h3><div>Patient decision aids (PtDAs) are evidence-based interventions to help people faced with difficult health-care decisions. Little is known about their effectiveness in people facing diabetes-related decisions. The aim of this study was to evaluate the scope and effectiveness of diabetes-related PtDAs for screening, prevention, and treatment decisions.</div></div><div><h3>Methods</h3><div>A secondary analysis of randomized controlled studies (RCTs) from the 2024 Cochrane review of PtDAs comparing decision aids on diabetes screening, prevention, or treatment to usual care (e.g. patient education, no intervention) was conducted. Two reviewers independently screened citations, extracted data, and assessed study quality. Primary outcomes included quality of the decision and decision-making process. Meta-analyses were conducted for similar outcome measures.</div></div><div><h3>Results</h3><div>Of the 209 RCTs, 11 eligible studies evaluated diabetes PtDAs for treatment (n=7), screening (n=3), and prevention (n=1). Common decisions were about diabetes treatment intensification (n=4) and statin initiation (n=3) in people with type 2 diabetes. Compared with usual care, the PtDA group reported increased knowledge (mean difference [MD] 16.06, 95% confidence interval [CI] 8.38 to 23.75) and clearer values (MD −7.43, 95% CI −13.23 to −1.63) and no difference in accurate risk perceptions. After removing high-risk-of-bias studies, PtDAs led to fewer patients feeling uninformed about their options (MD −6.38, 95% CI −9.58 to −3.19) and more participants starting new medications (relative risk ratio 1.65, 95% CI 1.06 to 2.56). Six studies measured adherence to a chosen option: 1 reported greater adherence, whereas another reported lower adherence in PtDA vs usual care and the remaining 4 reported no difference.</div></div><div><h3>Conclusions</h3><div>Patients given PtDAs can improve their knowledge and feel informed and clearer about their values while being more likely to start new medications. Future research can strengthen the certainty of these findings and should explore PtDA use within the chronic disease context.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 3","pages":"Pages 174-182"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Type 1 Diabetes: Evaluating a Transition Care Model From Pediatric to Adult Care at the McGill University Health Centre","authors":"Samantha Jacobson MSc ,&nbsp;Isabella Albanese MDCM, MSc ,&nbsp;Jonathan-Raphaël Stetco ,&nbsp;Natasha Garfield MDCM, FRCPC","doi":"10.1016/j.jcjd.2024.12.001","DOIUrl":"10.1016/j.jcjd.2024.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Our aim in this study was to describe a type 1 diabetes mellitus (T1DM) transition care model by assessing clinic attendance, glycemic management, and diabetes-related hospitalizations.</div></div><div><h3>Methods</h3><div>This work is a descriptive, longitudinal, single-centre study of patients with T1DM, who were 18 to 25 years of age and referred to our transition clinic from 2012 to 2021 (N=179).</div></div><div><h3>Results</h3><div>Our data analysis demonstrates an average clinic attendance rate of 79% and mean time between last pediatric and first adult visit of 6.9±5.8 months. Glycated hemoglobin levels at last pediatric visit, first transition visit, and last transition visit were 8.92±1.84%, 9.03±1.84%, and 8.47±1.74%, respectively. There was no change in frequency of diabetes-related hospitalizations after transfer to transition clinic.</div></div><div><h3>Conclusions</h3><div>Youth attending our transition clinic had high clinic attendance and improved glycemic management at their last transition visit compared with the last pediatric visit without an increase in diabetes-related hospitalizations. This work highlights the potential importance of comprehensive support in addressing psychosocial and lifestyle challenges during the critical transition period from pediatric to adult care.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 128-132.e1"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrinologists’ Acceptability and Implementation of Glycated Hemoglobin Targets Among Adults With Type 1 Diabetes","authors":"Sanchit Kaushal BHSc ,&nbsp;Patience Fakembe BSc ,&nbsp;Ilana J. Halperin MD, MSc ,&nbsp;Gillian A. Hawker MD, MSc ,&nbsp;Alanna Weisman MD, PhD","doi":"10.1016/j.jcjd.2024.12.005","DOIUrl":"10.1016/j.jcjd.2024.12.005","url":null,"abstract":"<div><h3>Objectives</h3><div>Attainment of the glycated hemoglobin (A1C) target of ≤7.0% is consistently low among those living with type 1 diabetes. We evaluated endocrinologists’ acceptability and implementation of A1C targets.</div></div><div><h3>Methods</h3><div>All 309 adult endocrinologists in Ontario were invited to complete an online questionnaire between October 31, 2023, and January 16, 2024. The questionnaire consisted of 4 sections: 1) acceptability of the A1C target of ≤7.0%, evaluated by agreement with statements pertaining to the 7 domains of the Theoretical Framework of Acceptability; 2) endocrinologists' perceptions of patient attainment of A1C targets, frequency of setting and discussing A1C targets, common targets used, and open-ended questions regarding A1C targets; 3) influence of patients’ characteristics on selecting individualized A1C targets different from 7.0%; and 4) respondents’ characteristics.</div></div><div><h3>Results</h3><div>One hundred forty-eight endocrinologists (48%) completed the questionnaire. Endocrinologists agreed that the A1C target of ≤7.0% is important (87% agreed or strongly agreed) and the correct threshold (75% agreed or strongly agreed). However, endocrinologists overestimated A1C target attainment among their own patients and recognized that the A1C target of &lt;7.0% may be unrealistic for patients, difficult to achieve, and could cause patient distress. Patients’ psychosocial characteristics (such as mental health disorders) and use of technologies (such as continuous glucose monitors and automated insulin delivery systems) emerged as important, yet previously underemphasized, factors when selecting individualized A1C targets.</div></div><div><h3>Conclusions</h3><div>Endocrinologists endorsed the A1C target of ≤7.0%, but simultaneously expressed concerns regarding its feasibility. Future studies should evaluate how this discrepancy may impact physician discussions and counselling regarding A1C targets.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 87-94.e4"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Diabetes Prevention Programs Reaching Those Most at Risk? A Scoping Review","authors":"Cara E. Johnston BHK,&nbsp;Megan M. MacPherson PhD,&nbsp;Mary E. Jung PhD","doi":"10.1016/j.jcjd.2024.11.006","DOIUrl":"10.1016/j.jcjd.2024.11.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous reviews have highlighted the efficacy of lifestyle diabetes prevention programs (DPPs) in decreasing type 2 diabetes (T2D) risk, but the participating populations were predominantly White. This is concerning, as ethnically diverse populations are disproportionately affected by T2D. The objective of this scoping review was to 1) summarize existing tailored DPPs and 2) provide recommendations for future program implementation to improve access and reach for diverse populations.</div></div><div><h3>Methods</h3><div>This work represents a subanalysis of a larger scoping review synthesizing DPPs. Several databases were searched for studies relating to T2D risk and lifestyle programs. Study characteristics were systematically extracted using the Template for Intervention Description and Replication checklist.</div></div><div><h3>Results</h3><div>Of 25,110 screened publications, 351 (220 programs) were included in the larger review. Only 29% (64 programs) of the 220 programs were identified as specifically serving ethnically diverse populations and were included in this subanalysis. An updated search was run that identified an additional 10 publications (10 programs). Over a third (35%) of programs reported strategies used to tailor their intervention to the target population; of those that reported, 62% tailored the content of the intervention to be culturally appropriate and relevant as well as accommodate the geographic and cultural context.</div></div><div><h3>Conclusions</h3><div>Based on recruitment, tailoring, and provision strategies used in DPPs targeting specific underresourced populations, this review provides recommendations on how future program developers can increase access and reach, improving individual- and population-level health outcomes via T2D reduction in those at highest risk.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 104-113.e1"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Improve Attendance for Diabetic Retinopathy Screening: Ideas and Perspectives From People With Type 2 Diabetes and Health-care Professionals","authors":"Gabriela B. Petersen PhD ,&nbsp;Lene E. Joensen PhD ,&nbsp;Jette K. Kristensen Prof ,&nbsp;Henrik Vorum Prof ,&nbsp;Stine Byberg PhD ,&nbsp;Mia V. Fangel PhD ,&nbsp;Bryan Cleal PhD","doi":"10.1016/j.jcjd.2024.11.004","DOIUrl":"10.1016/j.jcjd.2024.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Our aim in this study was to identify how to improve diabetic retinopathy screening from the perspectives of people with type 2 diabetes and health-care professionals and to elicit their thoughts on initiatives to increase attendance.</div></div><div><h3>Methods</h3><div>A total of 38 semistructured interviews were conducted with people with type 2 diabetes (n=20), general practitioners (n=10), and ophthalmic staff (n=8). The interviews examined ideas for improving screening and elicited feedback on 3 initiatives: getting a fixed appointment; same-day screening; and outsourcing screening to general practice, including the use of artificial intelligence (AI). Data analysis was guided by content analysis approaches.</div></div><div><h3>Results</h3><div>Ideas for improving screening were centred around reducing the inconvenience of attendance, making appointment scheduling easier, and improving health-care professionals’ communication. Participants recognized the potential benefits of the initiatives but expressed important reservations to consider. Concerns included the following: that a fixed appointment would cause less active patient involvement and negatively affect attendance; that same-day screening may result in loss of patient–provider communication; that people with type 2 diabetes may be uneasy with having the screening performed outside the eye clinic; and that health-care professionals were concerned about the finances, validity, and examination quality associated with outsourcing screening and using AI.</div></div><div><h3>Conclusions</h3><div>Participants’ thoughts on how to improve diabetic retinopathy screening should be seen as starting points for potential future interventions. Although outsourcing screening and the use of AI have gained traction, our study indicates that the target population has reservations that are important to consider in future development and implementation of such strategies.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 121-127"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Switching From Open-source to Commercial Advanced Automated Insulin Delivery System: Glucose Management and Patient Perspective in an Adult Living With Type 1 Diabetes","authors":"Maha Lebbar MD, MSc ,&nbsp;Anne Bonhoure MSc ,&nbsp;Rémi Rabasa-Lhoret MD, PhD ,&nbsp;Zekai Wu MD, PhD","doi":"10.1016/j.jcjd.2024.12.004","DOIUrl":"10.1016/j.jcjd.2024.12.004","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 133-135"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Gestational Diabetes in Manitoba From 1981 to 2019: A Descriptive Study With Geospatial Mapping","authors":"Nicole M. Brunton MSc ,&nbsp;Kevin Friesen MSc ,&nbsp;Jennifer M. Yamamoto MD ,&nbsp;Heather J. Prior MSc ,&nbsp;Jonathan McGavock PhD","doi":"10.1016/j.jcjd.2024.11.005","DOIUrl":"10.1016/j.jcjd.2024.11.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to describe trends in incidence of gestational diabetes in Manitoba and within subgroups that often experience health inequities.</div></div><div><h3>Methods</h3><div>We leveraged provincial administrative health data to describe trends in gestational diabetes incidence between 1981 and 2019, stratified by subpopulations based on age, urbanicity, and neighbourhood-level average household income. We calculated yearly incidence across subgroups and annual percent change in incidence to assess trends over time. Geospatial mapping was used to visualize changes by neighbourhood cluster.</div></div><div><h3>Results</h3><div>Gestational diabetes incidence increased from 1.3% to 8.6% between 1981 and 2019, with an upward inflection occurring around 2010. The annual percent change (APC) between 1981 and 2009, prior to the inflection point, was 1.9% (95% confidence interval [CI] 1.4% to 2.5%), and it was 11.7% (95% CI 8.9% to 14.7%) postinflection---from 2010 to 2019. After 2010, gestational diabetes incidence increased most among urban residents (APC 18.1%, 95% CI 13.9% to 22.5%), among those &gt;35 years of age (APC 12.0%, 95% CI 8.4% to 15.7%), and among individuals in the highest socioeconomic status (SES) group (APC 14.8%, 95% CI 9.4% to 20.4%). Geospatial mapping showed that incidence increased more in neighbourhoods with the highest proportion of recent immigrants to Canada.</div></div><div><h3>Conclusions</h3><div>Incidence of gestational diabetes increased 6-fold in Manitoba over the past 20 years, particularly among those with high SES and higher age. Further research is required to clarify the role of screening practices in the trends observed in this work.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 114-120.e1"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease in Diabetes: A Clinical Practice Guideline","authors":"Sheldon W. Tobe MD, MScCH, FRCPC, FACP, FAHA,&nbsp;Harpreet S. Bajaj MD, MPH,&nbsp;Navdeep Tangri MD, PhD, FRCPC,&nbsp;Rahul Jain MD, CCFP, MScCH, FCFP,&nbsp;Thuy Pham NP, MN, MScCH,&nbsp;Valerie Beaudin RN,&nbsp;Phil McFarlane MD, PhD, FRCPC,&nbsp;Diabetes Canada Clinical Practice Guideline Steering Committee","doi":"10.1016/j.jcjd.2025.01.004","DOIUrl":"10.1016/j.jcjd.2025.01.004","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 73-86.e14"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Resistance Training and Diabetes Education on Physical Functioning, Frailty Status, and Glycemia in Older Adults With Short- and Long-Duration Type 2 Diabetes: A Secondary Analysis of the Band-Frail Study","authors":"Amy M. Thomson MScKin ,&nbsp;Isaac C. Cull MScKin ,&nbsp;Logan E. Peskett BScKin ,&nbsp;Danielle R. Bouchard PhD ,&nbsp;Martin Sénéchal PhD","doi":"10.1016/j.jcjd.2024.12.002","DOIUrl":"10.1016/j.jcjd.2024.12.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Diabetes duration is an underappreciated risk factor in type 2 diabetes (T2DM) management that can increase the risk of complications and potentially decrease the effectiveness of lifestyle interventions. However, it is unclear whether T2DM duration impacts the efficacy of an elastic band resistance training intervention for older adults living with comorbid T2DM and frailty. In this analysis we aimed to investigate and better understand the impact of a 16-week elastic band resistance training and diabetes education intervention on physical functioning, glycemia, and frailty in older adults of different T2DM durations.</div></div><div><h3>Methods</h3><div>This secondary analysis of the Band-Frail Study includes 130 adults (≥65 years) living with T2DM and pre-frailty/frailty who completed 16 weeks of elastic band resistance training and diabetes education. Participants were categorized as 1) short-duration T2DM (&lt;10 years) and 2) long-duration T2DM (&gt;10 years). Outcome measures included physical functioning (Short Physical Performance Battery), glycemia (glycated hemoglobin [A1C]), and frailty (Fried Frailty Scale).</div></div><div><h3>Results</h3><div>Participants in both the short- and long-duration T2DM groups improved in physical functioning and frailty status postintervention (p&lt;0.05). The long-duration group improved A1C significantly more than the short-duration group (p=0.03).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that older adults, irrespective of T2DM duration, improve physical functioning and frailty status after 16 weeks of elastic band resistance training and diabetes education, and that longer duration T2DM is associated with greater improvements in A1C.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 95-103.e3"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Possible Drug Interaction Between Elexacaftor-Tezacaftor-Ivacaftor and Repaglinide in an Adult With Cystic Fibrosis–related Diabetes","authors":"Mirna Gerges MScOT, BSc ,&nbsp;Meredith Chiasson MD, FRCPC ,&nbsp;Carly Nichols RD, CDE ,&nbsp;Nancy Morrison MD, FRCPC, FCCP ,&nbsp;Barna De MD, FRCPC","doi":"10.1016/j.jcjd.2024.12.003","DOIUrl":"10.1016/j.jcjd.2024.12.003","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 2","pages":"Pages 136-137"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}