For this manuscript, we sought further input from FPs on the D&I committee to ensure that no important recommendations or concepts had been missed in summarizing the high-priority aspects of the guideline for the management of people with type 2 diabetes by FPs. This involved providing these FPs with the full list of recommendations via e-mail and asking them to identify any missing high-priority recommendations. During the process of converting themes into key messages, and during the process of writing this manuscript, input was sought from members of the D&I committee who live with diabetes to ensure that the content was informed by their needs and perspectives. As a final step, the entire committee identified tools that might support implementation of the key messages. To the extent possible, tools are informed by evidence regarding implementation of evidence in practice.12–15 Some of these tools are identified in this manuscript; these and many others can be accessed at guidelines.diabetes.ca.
Cons: MySugr doesn’t sync with blood glucose meters, but Apple users can use the MySugr Scanner app to scan and import readings, though the app can be glitchy. Does not sync with insulin pumps. To generate health reports as PDFs, you must buy MySugr PRO. The MySugr Coaching feature—a nice touch—is available only on Apple devices, and it can take a couple of hours to a few days to be able to text with a health coach through the app.
Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.
Diabetes is a number of diseases that involve problems with the hormone insulin. Normally, the pancreas (an organ behind the stomach) releases insulin to help your body store and use the sugar and fat from the food you eat. Diabetes can occur when the pancreas produces very little or no insulin, or when the body does not respond appropriately to insulin. As yet, there is no cure. People with diabetes need to manage their disease to stay healthy.
Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).
Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which a T cell-mediated autoimmune attack leads to the loss of beta cells and thus insulin. It causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults, but was traditionally termed "juvenile diabetes" because a majority of these diabetes cases were found in children.
Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels. The goal of treatment is an HbA1C level of 6.5%, but should not be lower than that, and may be set higher. Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise. Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal, however.