2008 Clinical Practice Guidelines - Canadian Diabetes Association

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2008 CLINICAL PRACTICE GUIDELINES x Acknowledgements Financial assistance for the Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada was generously provided by the following sponsors, in the form of unrestricted educational grants. Sponsors were not involved in any aspect of guidelines development, literature interpretation, the decision to publish, or any other aspect of publication of the guidelines. Primary Sponsors GlaxoSmithKline Inc. Novo Nordisk Canada Inc. sanofi-aventis Canada Inc. Servier Canada Inc. Secondary Sponsors AstraZeneca Canada Inc. Bayer Inc. Eli Lilly Canada Inc. Merck Frosst Canada Ltd. Pfizer Canada Inc. Hoffmann-La Roche Ltd.
Page 1: Canadian Publication Mail Agreement
Page 4 and 5: 2008 CLINICAL PRACTICE GUIDELINES i
Page 6 and 7: 2008 CLINICAL PRACTICE GUIDELINES i
Page 8 and 9: 2008 CLINICAL PRACTICE GUIDELINES v
Page 10 and 11: 2008 CLINICAL PRACTICE GUIDELINES v
Page 15 and 16: Introduction Canadian Diabetes Asso
Page 17 and 18: of tools, including medications, de
Page 19 and 20: Methods Canadian Diabetes Associati
Page 21 and 22: GUIDELINE DEVELOPMENT Expert Commit
Page 23 and 24: Zubin Punthakee MD MSc FRCPS ABIM A
Page 25 and 26: Diabetes A fasting plasma glucose (
Page 27 and 28: glucose and incident cardiovascular
Page 29 and 30: tant prognostic implications (15).
Page 31 and 32: Prevention of Diabetes Canadian Dia
Page 33 and 34: early detection of type 2 diabetes
Page 35 and 36: medication, nutrition, physical act
Page 37 and 38: eview and economic evaluation. Heal
Page 39 and 40: Self-management Education Canadian
Page 41 and 42: EDUCATIONAL SETTINGS SME conducted
Page 43 and 44: Targets for Glycemic Control Canadi
Page 45 and 46: RECOMMENDATIONS 1. Glycemic targets
Page 47 and 48: ments have identified benefits of m
Page 49 and 50: 6. Rohlfing CL, Wiedmeyer HM, Littl
Page 51 and 52: Physical Activity and Diabetes Cana
Page 53 and 54: 4. Laaksonen DE,Atalay M, Niskanen
Page 55 and 56: glucose in the small intestine, the
Page 57 and 58: Table 3. Summary of nutritional con
Page 59 and 60: high dietary fiber intake in patien
Page 61 and 62: glulisine, another short-acting ana
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associated with improvement in the
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Diabetes. 1997;46:271-286. 41. Egge
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Pharmacologic Management of Type 2
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• Improved cardiovascular outcome
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smaller underpowered studies sugges
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16. Yki-Järvinen H, Ryysy L, Nikki
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mine-based insulin lispro formulati
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long duration of diabetes (9,12), a
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Hyperglycemic Emergencies in Adults
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MANAGEMENT Objectives of management
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ketoacidosis in older versus younge
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In-hospital Management of Diabetes
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hospital stay (26-28). Intraoperati
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trials. Arch Intern Med. 2004;164:2
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Management of Obesity in Diabetes C
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Pharmacotherapy Pharmacotherapy for
Page 95 and 96:
formin. N Engl J Med. 2002;346:393-
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SCREENING All individuals with diab
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interventions to improve glycaemic
Page 101 and 102:
5. Smith SA, Poland GA, American Di
Page 103 and 104:
The principal benefit of islet tran
Page 105 and 106:
Complementary and Alternative Medic
Page 107 and 108:
26. Nazaimoon WW, Sakinah O, Gapor
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Identification of Individuals at Hi
Page 111 and 112:
6. Malmberg K,Yusuf S, Gerstein HC,
Page 113 and 114:
Screening for the Presence of Coron
Page 115 and 116:
Management of Acute Coronary Syndro
Page 117 and 118:
Table 2. Priorities for vascular an
Page 119 and 120:
(7±8% risk reduction). Within this
Page 121 and 122:
Dyslipidemia Canadian Diabetes Asso
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type 2 diabetes. Although originall
Page 125 and 126:
mally controlled with a statin), ni
Page 127 and 128:
12. Moy CS, Songer TJ, LaPorte RE,
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Treatment of Hypertension Canadian
Page 131 and 132:
Add-on therapy consists of combinat
Page 133 and 134:
Management of Acute Coronary Syndro
Page 135 and 136:
of diabetes mellitus in patients wi
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Treatment of Diabetes in People Wit
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OTHER RELEVANT GUIDELINES Physical
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Table 1. Stages of classic diabetic
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Twenty-four-hour urine collections
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Referral Most people with CKD and d
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Efficacy in Nephropathy. Lancet. 19
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erative retinopathy was 2%, and non
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REFERENCES 1. Klein R, Klein BEK.Vi
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vascular endothelial growth factor
Page 155 and 156:
Table 1. Oral medications for the m
Page 157 and 158:
Foot Care Canadian Diabetes Associa
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2nd ed. Bethesda, MD: National Diab
Page 161 and 162:
Erectile Dysfunction Canadian Diabe
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of Erectile Function. Urology. 1999
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have failed to demonstrate an impro
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Figure 1. Immediate assessment and
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Vibration and monofilament testing
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RECOMMENDATIONS 18.Adolescents with
Page 173 and 174:
of presentation at diagnosis of typ
Page 175 and 176:
etes. N Engl J Med. 2002;347:797-80
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compared to the general pediatric p
Page 179 and 180:
RECOMMENDATIONS 1. Anticipatory gui
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glycemic crisis: an acute life-thre
Page 183 and 184:
comes by educating women about the
Page 185 and 186:
Pharmacologic interventions Insulin
Page 187 and 188:
Management Untreated GDM (116) or I
Page 189 and 190:
Long-term risks in offspring There
Page 191 and 192:
Obstet Gynecol. 1995;172:151-155. 5
Page 193 and 194:
strict glycemic control. Obstet Gyn
Page 195 and 196:
Diabetes in the Elderly Canadian Di
Page 197 and 198:
or a standard nutritional formula f
Page 199 and 200:
Nutr Metab. 1997;10:78-81. 56. Cosc
Page 201 and 202:
Type 2 Diabetes in Aboriginal Peopl
Page 203 and 204:
dedicated diabetes clinical staff (
Page 205 and 206:
Type 2 Diabetes in High-risk Ethnic
Page 207 and 208:
glycemic control, lipid profiles, a
Page 209 and 210:
Appendix 2. Sample Diabetes Patient
Page 211 and 212:
Appendix 3 Examples of Insulin Init
Page 213 and 214:
Appendix 4 Rapid Screening for Diab
Page 215:
Appendix 6 Diabetic Foot Ulcers: Es
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2008 Clinical Practice Guidelines - Canadian Diabetes Association

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