The Canadian Diabetes Association has released its 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada, which aim to improve prevention strategies and the quality of care for those living with the disease.
Diabetes rates in Canada have doubled over the past decade, with one in every three Canadians projected to have either diabetes or pre-diabetes by 2020. Without proper management, diabetes can lead to many devastating secondary complications such as heart disease, stroke, blindness, kidney failure and limb amputations, which can significantly reduce the quality and length of life.
These new guidelines will be crucial for the growing number of people affected by diabetes from coast-to-coast. There are also new interactive web-based tools for both healthcare providers and people with diabetes available at guidelines.diabetes.ca. These tools will bring the new guidelines to life, helping to simplify assessment and personalizing the management of the disease.
The guidelines were developed through a rigorous process by an expert committee of 120 leading health professionals across the country. They carefully identified, evaluated and synthesized the latest scientific evidence and then translated actionable recommendations for people living with diabetes and their healthcare team.
This edition of the guidelines highlights the following:
- New approaches, such as using the A1C test—a single practical measure of average blood glucose—to help diagnose people with diabetes or those at risk of developing diabetes without the need to abstain from eating for 12 hours.
- Clearer diagnostic criteria: Under the new recommendations, people with an A1C level of 6.5% or greater will be diagnosed with diabetes, and those with an A1C level of 6.0% to 6.4% will be diagnosed with pre-diabetes.
- Innovative new ways to select treatment targets that reflect the clinical condition and personal goals of the individual. For example, sets of newly defined factors, such as age, how long the person has lived with diabetes and whether or not the person has heart disease, will help establish individual care plans toward improving quality of life.
- New ways to protect people living with diabetes from heart attack, stroke and other diabetes-related complications. An emphasis on vascular protection for all adults living with diabetes is recommended and may include active treatment strategies to prevent blood vessel-related complications, including new educational tools, adopting lifestyle changes and considering heart-protecting medications.
Developed by experts across 19 different medical disciplines, the Canadian Diabetes Association guidelines are internationally recognized, and the 2013 edition provides new recommendations based on the most up-to-date published clinical data published since 2008.
New 2013 Clinical Practice Guidelines Highlights
Screening and Diagnosis of Diabetes – Know Your Number, Know Your Diagnosis
In an effort to identify Canadians who are unaware that they are living with diabetes or pre-diabetes, the guidelines offer more ways to identify those at risk. Screening for Type 2 diabetes should be performed every three years for all Canadians over 40 years of age, or earlier and more frequently in those with risk factors.
Diabetes and Cardiovascular Disease – Protect Your Heart (Know Your ABCDEs)
Heart disease is a major cause of death and disability for people living with diabetes. The new guidelines encourage people living with diabetes to know their heart health ABCDEs and work to educate healthcare teams to address them:
A – A1C (a measure of average blood glucose) in optimal range
B – Blood pressure optimally controlled
C – Cholesterol in target range
D – Drugs – heart-protecting medications for the right patients
E – Exercise and other lifestyle measures
S – Stop smoking
Lowering Blood Glucose Levels – Managing Your Blood Sugars
Managing blood glucose levels can reduce the risk of diabetes-related health problems. The Canadian Diabetes Association recommends that the vast majority of people living with diabetes should be targeting an A1C of 7%. However, there may be situations when the target should be changed to best suit the individual—the new guidelines define those specific scenarios.
Additional recommendations from the 2013 guidelines include specific strategies for the prevention and management of Type 2 diabetes in children and Aboriginal peoples, and new approaches for the delivery of integrated care and effective self-management of the disease.