Canadian Journal of Diabetes最新文献

{"title":"Lowering the Diagnostic Threshold for Gestational Diabetes: A Comparison of 2 Centres","authors":"Sanaz Azizi MD, MSc ,&nbsp;Agnieszka Majdan MD ,&nbsp;Rachel Bond MD ,&nbsp;Natasha Garfield MD ,&nbsp;Sara Meltzer MD ,&nbsp;Shaun Eintracht MD ,&nbsp;Kathryn Morrison PhD ,&nbsp;Julia Ma MPH ,&nbsp;Kaberi Dasgupta MD, MSc ,&nbsp;Tricia Peters MD, PhD","doi":"10.1016/j.jcjd.2025.10.176","DOIUrl":"10.1016/j.jcjd.2025.10.176","url":null,"abstract":"<div><h3>Objective</h3><div>In this study, we compared 2 gestational diabetes mellitus (GDM) diagnostic thresholds in relation to large-for-gestational-age (LGA) status and secondary adverse pregnancy outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study examined 840 pregnant women who underwent 2-step GDM screening at 2 hospital centres in Montréal that use distinct GDM diagnostic thresholds. At the second step of GDM screening, one centre used glucose thresholds suggested by the Diabetes Canada preferred approach and the other centre used the lower International Association of Diabetes and Pregnancy Study Groups thresholds. We defined mild hyperglycemia (MH) as having intermediate glucose values that were diagnostic of GDM at one centre but not the other (fasting plasma glucose [PG] 5.1 to 5.2 mmol/L, 1-hour PG 10 to 10.5 mmol/L, or 2-hour PG 8.5 to 8.9 mmol/L). We conducted multivariable linear and logistic regression analyses to evaluate outcomes for women with untreated or treated MH compared to those diagnosed with GDM by higher glucose thresholds within the same centre, and we also explored differences between centres.</div></div><div><h3>Results</h3><div>The odds of LGA offspring were 3-fold higher (adjusted odds ratio [OR] 3.01, 95% confidence interval [CI] 1.47 to 6.19) among women with untreated MH compared with women treated for GDM at the same centre. Also, the odds of macrosomia were over 2-fold higher when comparing treated MH with GDM. In addition, untreated compared with treated MH had lower odds of induction of labour (adjusted OR 0.28, 95% CI 0.11 to 0.70).</div></div><div><h3>Conclusion</h3><div>Failure to optimally treat MH during pregnancy is associated with fetal overgrowth and may affect obstetrical management.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 1","pages":"Pages 47-54.e1"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454228","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":"CanDEG: Launching the Canadian Diabetes Epidemiology Group","authors":"Baiju R. Shah MD, PhD ,&nbsp;Kimberley Hanson MBA ,&nbsp;Gillian L. Booth MD, MSc ,&nbsp;Sonia Butalia MD ,&nbsp;Ghazal S. Fazli PhD ,&nbsp;Calvin Ke MD, PhD ,&nbsp;Lorraine L. Lipscombe MD, MSc ,&nbsp;Meranda Nakhla MD ,&nbsp;Brandy Wicklow MD ,&nbsp;Roseanne O. Yeung MD ,&nbsp;Kaberi Dasgupta MDCM ,&nbsp;Canadian Diabetes Epidemiology Group","doi":"10.1016/j.jcjd.2025.10.177","DOIUrl":"10.1016/j.jcjd.2025.10.177","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 1","pages":"Pages 55-57"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454139","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":"General Population Screening for Type 1 Diabetes in Canada---CanScreenT1D","authors":"Peter A. Senior BMedSci, MBBS, PhD ,&nbsp;Ashish Marwaha BMBCh, MA(Oxon), PhD ,&nbsp;Holly O. Witteman PhD ,&nbsp;Pranesh Chakraborty MD ,&nbsp;Robin Z. Hayeems ScM, PhD ,&nbsp;Diane K. Wherrett MD ,&nbsp;CanScreenT1D Consortium","doi":"10.1016/j.jcjd.2025.11.001","DOIUrl":"10.1016/j.jcjd.2025.11.001","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 1","pages":"Pages 58-61"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491157","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":"Postpartum Diabetes Screening and Conversion Rates Among Women Diagnosed With Gestational Diabetes Mellitus Using Standard vs Modified Criteria During the COVID-19 Pandemic","authors":"Sonia Butalia MD, FRCPC, MSc ,&nbsp;Olesya Barrett PhD ,&nbsp;Anamaria Savu PhD ,&nbsp;Vichy Liyanage PhD ,&nbsp;Peter Senior MD ,&nbsp;Roseanne O. Yeung MD, FRCPC, MPH ,&nbsp;Padma Kaul PhD","doi":"10.1016/j.jcjd.2025.10.001","DOIUrl":"10.1016/j.jcjd.2025.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>Our aim in this work was to examine postpartum diabetes screening and rates in women diagnosed with gestational diabetes mellitus (GDM) using standard vs modified criteria during the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Women with GDM pregnancies between January 1, 2020, and December 31, 2021, in Alberta, Canada, were stratified by the GDM diagnosis criteria and followed for 18 months postpartum diabetes screening. Proportions of prediabetes and diabetes were compared between the standard vs modified GDM criteria groups at 6 and 18 months. Multivariable logistic regression analysis was used to examine differences in prediabetes and diabetes rates between the 2 GDM criteria groups after adjusting for baseline differences.</div></div><div><h3>Results</h3><div>Among 10,238 individuals with GDM, 780 were diagnosed using the modified criteria and 9,458 were diagnosed using the standard criteria. There was no difference in the proportion of individuals who underwent postpartum screening by 6 months (27.1% vs 28.9%, p=0.29) or by 18 months (43.1% vs 45.3%, p=0.24) among the modified and standard groups, respectively. Diabetes proportions were higher in women diagnosed with GDM using the modified criteria compared with those diagnosed using the standard criteria (27.0% vs 4.2%, p&lt;0.0001; adjusted odds ratio 8.18, 95% confidence interval 5.76 to 11.6). Proportions of prediabetes and diabetes at 18 months were 15.2% and 20.8% (p=0.014) and 29.8% and 6.1% (p&lt;0.0001) for modified and standard groups, respectively.</div></div><div><h3>Conclusions</h3><div>Regardless of the GDM diagnostic method, postpartum diabetes screening among women with GDM was suboptimal during the COVID-19 pandemic. The modified criteria for GDM identified a group of women who were at higher risk for conversion to diabetes.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 1","pages":"Pages 1-7"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276947","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":"“It’s a Chronic, Vicious Cycle”: Diabetes Health-care Professionals’ Perceptions of the Impact of Knee Osteoarthritis on Type 2 Diabetes Management","authors":"Joy Du BSc, MD ,&nbsp;Esther J. Waugh PhD, BScPT, MSc ,&nbsp;Rebecca Voth MD ,&nbsp;Crystal MacKay PhD, BScPT ,&nbsp;Ian Stanaitis BMSc ,&nbsp;Gillian A. Hawker MSc, MD, FRCPC ,&nbsp;Lorraine L. Lipscombe MD, MSc, FRCPC ,&nbsp;Lauren K. King MD, PhD, FRCPC","doi":"10.1016/j.jcjd.2025.10.169","DOIUrl":"10.1016/j.jcjd.2025.10.169","url":null,"abstract":"<div><h3>Objectives</h3><div>Type 2 diabetes (T2D) and knee osteoarthritis (OA) frequently co-occur, and concomitant knee OA increases risk for diabetes complications. Despite this, OA is frequently undertreated. Diabetes health-care professionals’ (HPs’) perceptions of the impact of knee OA in people with T2D may impact how it is addressed in clinical practice. We aimed to understand how diabetes HPs perceive the impact of knee OA on diabetes management and outcomes.</div></div><div><h3>Methods</h3><div>In this qualitative study we performed a secondary analysis of semistructured interviews with 18 diabetes HPs (primary care providers, endocrinologists, and diabetes educators) in Ontario, Canada. Transcripts were inductively coded and thematically analyzed.</div></div><div><h3>Results</h3><div>We developed 3 themes: 1) Patients commonly raise OA-related concerns during diabetes appointments; 2) Impact of OA on diabetes management; and 3) Conscious disconnect between perceived patient and HP priorities. Diabetes HPs recognized that knee OA commonly co-occurred in their patients. Most HPs perceived that OA has deleterious effects on diabetes management through physical inactivity, as well as other mechanisms. Despite observing OA’s impact on their patients, most participants did not address OA due to the focussed structure of diabetes appointments, “single-problem” appointments, and culture of siloed care.</div></div><div><h3>Conclusions</h3><div>Diabetes HPs recognized the high prevalence of knee OA in their patients and its deleterious effects on diabetes management, although OA management was usually not prioritized. This highlights a missed opportunity in optimizing care for people with T2D. Implementing strategies to promote OA care during diabetes visits may improve disease outcomes for both conditions.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"50 1","pages":"Pages 8-14.e2"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288071","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":"Predicting the Risk of COVID-19 Among Adult Patients With Diabetes: A Machine Learning Approach","authors":"Dean T. Eurich PhD ,&nbsp;Darren Lau MD ,&nbsp;Weiting Li MSc ,&nbsp;Olivia Weaver MSc ,&nbsp;Tanya Joon MSc ,&nbsp;Ming Ye PhD ,&nbsp;Finlay A. McAlister MD ,&nbsp;Padma Kaul PhD ,&nbsp;Salim Samanani MD","doi":"10.1016/j.jcjd.2025.09.001","DOIUrl":"10.1016/j.jcjd.2025.09.001","url":null,"abstract":"<div><h3>Objectives</h3><div>In this study our aim was to develop a machine learning model that could accurately predict the risk of acquiring COVID-19 in community-dwelling adults with type 1 and/or type 2 diabetes in Alberta, Canada.</div></div><div><h3>Methods</h3><div>This predictive supervised machine learning study included adults (≥18 years old) living in Alberta, Canada, between April 1, 2019, and March 31, 2021, with pre-existing diabetes (n=372,055, excluding 2,541 due to migration; final sample size 369,514). The outcome of interest was a positive severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2) polymerase chain reaction test result between March 1, 2020, and March 1, 2021. Model features were extracted from routinely collected Alberta administrative health data from March 1, 2015, to March 1, 2020. Fifteen algorithms were trained on 67% of the data and the top performer (Light Gradient Boost [LGBoost] model) was validated on the remaining 33%. The model was calibrated and model performance was assessed using area under the receiver-operating characteristic curve (AUROC), area under the precision recall curve (AUPRC), and threshold analyses.</div></div><div><h3>Results</h3><div>Among the 369,514 individuals with diabetes, 140,511 were tested, of whom 13,082 had a positive SARS-CoV-2 test. The LGBoost model incorporated 367 features with AUROC and AUPRC of 0.69 and 0.08, respectively. The model was well-calibrated for common risk thresholds (&lt;0.2 probability) with high specificity (≥0.98 at all thresholds); however, sensitivity and positive predictive values were low at all thresholds (≤0.08 and ≤0.18, respectively).</div></div><div><h3>Conclusions</h3><div>The LGBoost model lacked the sensitivity to be clinically useful in predicting SARS-CoV-2 infection in Albertans with diabetes. Alternative data sources may be required to improve future COVID-19 prediction models from the community.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 8","pages":"Pages 446-453.e10"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056521","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":"A Diabetes Peer Mentorship Program for First Nations Youth and Young Adults: An Intervention Protocol","authors":"Sahar Fazeli PhD, MSc ,&nbsp;Jonathan Linton ,&nbsp;Paul Linton ,&nbsp;Lucy Trapper ,&nbsp;Catherine Godin PDt, MSc ,&nbsp;Helene Porada DtP, ADA ,&nbsp;Deborah Da Costa PhD ,&nbsp;Kaberi Dasgupta MD, MSc, FRCPC ,&nbsp;Isabelle Malhame MD, MSc ,&nbsp;Claudia Mitchell PhD ,&nbsp;Elham Rahme PhD ,&nbsp;Julia Elisabeth Von Oettingen MD, PhD, MMSc, FRCP ,&nbsp;Romina Pace MD","doi":"10.1016/j.jcjd.2025.07.003","DOIUrl":"10.1016/j.jcjd.2025.07.003","url":null,"abstract":"<div><h3>Objectives</h3><div>The rising incidence of type 2 diabetes (T2D) among Indigenous peoples, exacerbated by historic injustices and health inequities, underscores the need for culturally sensitive health interventions that address both the physiological and psychological burdens of diabetes. This research protocol describes a community-driven initiative aimed at enhancing diabetes management among Indigenous youth and young adults in Canada, leveraging the lived experience and leadership of Indigenous young adults. This project seeks to integrate traditional Indigenous practices with modern health strategies to foster better health outcomes and psychosocial support through peer mentorship.</div></div><div><h3>Methods</h3><div>The program, developed and led by an Eeyou Istchee Cree community member, involves various health-promoting activities, including dietary guidance, physical exercise, and traditional land-based practices. These activities are designed to improve self-management of diabetes and to address diabetes distress, a significant factor in diabetes care.</div></div><div><h3>Results</h3><div>Anticipated outcomes include improved psychosocial factors (reduced distress and enhanced resilience) and clinical measures of diabetes management (glycemia, body mass index, and blood pressure). The project's methodology combines quantitative assessments of psychological and health outcomes with qualitative feedback from participants, captured through innovative methods like Photovoice to ensure participants’ voices and experiences directly inform the intervention’s efficacy and adaptability.</div></div><div><h3>Conclusions</h3><div>Overall, this protocol outlines a framework for a scalable, sustainable model of health intervention that respects and revitalizes Indigenous cultural practices and community autonomy. The expected results aim to demonstrate the effectiveness of peer-led and culturally informed interventions in improving psychological and health outcomes, with the potential to guide similar initiatives in other Indigenous and marginalized communities worldwide.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 8","pages":"Pages 417-423"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755437","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":"Assessment of Clinical Factors Influencing Glucose Management Indicator and Glycated Hemoglobin Discordance in Children With Type 1 Diabetes: A 1-Year, Real-world Data Observation","authors":"Grażyna Deja PhD ,&nbsp;Aleksandra Brudzińska ,&nbsp;Łukasz Wybrańczyk ,&nbsp;Rafał Deja PhD ,&nbsp;Przemysława Jarosz-Chobot PhD","doi":"10.1016/j.jcjd.2025.08.002","DOIUrl":"10.1016/j.jcjd.2025.08.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Published data still highlight discordances between glucose management indicator (GMI; the parameter estimating glycated hemoglobin [A1C] from continuous glucose monitoring [CGM] reporting) and laboratory A1C, for reasons yet to be explored. In our study we aimed to identify potential clinical factors contributing to these discordances.</div></div><div><h3>Methods</h3><div>A retrospective study of 99 children (mean 12.92±4.03 years) was conducted using CGM devices (Dexcom G6-31, FreeStyle Libre 2-30, and Guardian 3-38). Inclusion criteria for patients were type 1 diabetes (T1D), continuous use of one type of CGM (with &gt;70% sensor activity) over the previous year, and quarterly visits. At each visit, we collected data for age, sex, body mass index, diabetes duration, daily insulin dose, CGM report (14 of 90 days), and laboratory A1C.</div></div><div><h3>Results</h3><div>We confirmed linear dependency between A1C and GMI—that is, higher A1C led to more A1C–GMI differences. The A1C–GMI 90-day discordance was categorized into 4 thresholds: 48.7% at &lt;0.25, 20.1% between 0.25 and 0.5, 22.4% between 0.5 and 0.75, and 8.7% at &gt;0.75. Children with A1C–GMI 90 discordance &lt;0.5% had significantly lower A1C (6.80% vs 7.59%), shorter T1D duration (&lt;5 years), and more stable A1C (differences &lt;0.4 between results). The analysis of participants’ stability based on comparing A1C–GMI 90 discordances at subsequent follow-up visits confirmed an individual variability of &lt;0.25 in two-thirds of participants. Other factors were not associated with the A1C–GMI discordance.</div></div><div><h3>Conclusions</h3><div>One-year, real-world data show that clinically significant discordances (A1C–GMI 90 &gt;0.5%) occurred in &lt;30% of the children. A greater difference is more likely in individuals with higher A1C, longer diabetes duration, and less stable glycemic management. Individual A1C–GMI 90 discordance was mostly stable, although with varying degrees of difference.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 8","pages":"Pages 439-445"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857232","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":"Identifying Potential Sustainable and Scalable Interventions to Recognize Signs of Diabetes in Children Across Canada","authors":"Zeenat Ladak BSc, MD ,&nbsp;Priscilla Medeiros PhD ,&nbsp;Geneviève Rouleau PhD ,&nbsp;Jennifer Shuldiner PhD ,&nbsp;Shazhan Amed MSc, MD ,&nbsp;Elizabeth Cummings MD ,&nbsp;Manpreet Doulla MD ,&nbsp;Josephine Ho MD ,&nbsp;Mark Inman MD, FRCPC ,&nbsp;Sarah E. Lawrence MD ,&nbsp;Patricia Li MD, MSc, FRCPC ,&nbsp;Elizabeth Moreau BA ,&nbsp;Meranda Nakhla MD, MSc ,&nbsp;Julia Von Oettingen MD, PhD, MMSc, FRCP ,&nbsp;Elizabeth Sellers MD, MSc ,&nbsp;Diane K. Wherrett MD ,&nbsp;Rayzel Shulman MD, PhD, FRCPC ,&nbsp;Celia Laur PhD","doi":"10.1016/j.jcjd.2025.09.002","DOIUrl":"10.1016/j.jcjd.2025.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Delayed diagnosis of diabetes in children can lead to diabetic ketoacidosis, a life-threatening condition occurring in 10% to 80% of children at diabetes diagnosis. Ketoacidosis is preventable with prompt recognition of signs, urgent attendance to care, and rapid diagnosis and management. Our aim in this study was to plan for the development of an intervention to recognize signs of diabetes in children and prevent ketoacidosis that is evidence and theory informed and has potential for widespread implementation and long-term impact across Canada.</div></div><div><h3>Methods</h3><div>This qualitative exploratory study included researchers, educators, parents, caregivers, and representatives from relevant health-care organizations (n=41). Through targeted recruitment and snowball sampling, participants took part in a focus group or interview on opportunities to adapt, sustain, scale, and evaluate various diabetes awareness interventions. Transcripts were analyzed using content analysis to examine barriers and facilitators of potential interventions.</div></div><div><h3>Results</h3><div>Participants proposed several interventions, including using posters, magnets, educational take-home cards, and mass media, to increase awareness about the signs of diabetes in children and the need to rapidly seek care to prevent delayed diagnosis. Each strategy was noted to have advantages, such as refrigerator magnets being visible for a long time, and disadvantages, such as high-cost resources required for mass media. Participants also identified challenges in evaluating interventions and about how to tailor strategies for specific populations while remaining relevant across Canada.</div></div><div><h3>Conclusions</h3><div>This work informs the development, implementation, and evaluation of a Canadian strategy to recognize signs of diabetes in children and prevent a delay in diagnosis.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 8","pages":"Pages 454-460.e9"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115320","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":"Physician-reported Pediatric Diabetes Virtual Visit Quality and Outcome Not Associated With Social Determinants of Health","authors":"Laurence Bastien MD ,&nbsp;Ellen B. Goldboom MD ,&nbsp;Ewa Sucha PhD ,&nbsp;Richard J. Webster PhD ,&nbsp;Ivan Terekhov PhD ,&nbsp;Caroline Zuijdwijk MD","doi":"10.1016/j.jcjd.2025.08.001","DOIUrl":"10.1016/j.jcjd.2025.08.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Social determinants of health (SDH) impact diabetes outcomes. In response to the COVID-19 pandemic, virtual care ensured health-care access. However, socially disadvantaged groups have less technology access and skills, leading to potential disparities. We assessed the association between SDH and virtual visit success in children living with diabetes.</div></div><div><h3>Methods</h3><div>We conducted a secondary study of prospectively collected data for children attending a virtual diabetes physician visit from December 1, 2020, to March 31, 2021. Simultaneously, a quality improvement study required physicians to rate visit success indicators, including comparability to in-person visit (same/better/worse) and outcome (successfully/unsuccessfully replaced in-person visit). These data and patient characteristics were extracted from the electronic health record. Postal code–based deprivation indices were used to determine SDH. Statistical analysis tested for the association between deprivation quintiles and virtual visit success.</div></div><div><h3>Results</h3><div>Data were obtained for 447 children (age 12.7±3.8 years, 52.3% boys, 93.1% with type 1 diabetes, glucose management indicator 8.0±1.41%). Physicians reported 17.7% worse visits and 13.3% unsuccessful visits. Overall, 20.7% visits were worse or unsuccessful. The odds of having a worse or unsuccessful visit were not different in those with highest vs lowest degree of material deprivation (odds ratio [OR] 1.12, 95% confidence interval [CI] 0.39 to 3.20), social deprivation (OR 0.92, 95% CI 0.32 to 2.66), or ethnic concentration (OR 0.71, 95% CI 0.29 to 1.72).</div></div><div><h3>Conclusions</h3><div>In our pediatric diabetes population, virtual visit success was not associated with SDH measures, suggesting equitable delivery of virtual care regardless of socioeconomic status. Further studies are required to assess this association in other populations.</div></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":"49 8","pages":"Pages 431-438.e1"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857231","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}