TORONTO -- September 18, 2008 -- The Canadian Diabetes Association has released new clinical practice guidelines to emphasise the importance of early identification of risk factors in the prediabetes stage in order to prevent the onset of diabetes and the aggressive management of those risk factors in order to prevent the serious complications associated with the disease.
Healthcare professionals are encouraged to incorporate the guidelines into their daily practice as they offer strategies to help Canadians with diabetes live longer, healthier lives.
"The Guidelines provide clinicians with detailed information about how to best manage diabetes, with a large focus on the prevention and management of the serious complications associated with diabetes, particularly heart disease," said Gillian Booth, MD, Department of Medicine, University of Toronto, and Expert Committee for the 2008 Clinical Practice Guidelines, Toronto, Ontario.
"The reality is more and more Canadians are being faced with diabetes and its complications, which means that healthcare professionals and people with diabetes need to work closely together to identify risk factors for diabetes early, and to manage other risk factors as quickly as possible after diagnosis to reduce the risk of serious and deadly complications."
The Expert Panel committee responsible for the development of the Guidelines includes 99 volunteers representing a broad variety of healthcare professionals from across the country. A number of new chapters have also been added to the Guidelines, widening the scope to address emerging research in diabetes-related care.
Cardiovascular Disease
The Guidelines recommend a multifaceted, comprehensive approach to diabetes management, which includes healthy meal planning, physical activity, smoking cessation and tight control of important targets, such as blood pressure, cholesterol, and blood glucose levels.
Furthermore, the Guidelines now provide clinicians with more information on how to best screen people with diabetes for cardiovascular risk. Research has proven that the risk of heart disease can be reduced by more than 50% through a combination of lifestyle approaches and medications that protect against cardiovascular disease.
Prediabetes
The Guidelines define prediabetes as a fasting plasma glucose (FPG) level of 6.1 to 6.9 mmol/L or presence of impaired glucose tolerance on a 75-gram oral glucose tolerance test (OGTT). For those individuals with an FPG level between 5.6 and 6.0 mmol/L and one or more risk factors for diabetes, the Guidelines recommend performing an OGTT.
Development of type 2 diabetes in patients with prediabetes can be delayed or prevented with lifestyle changes and if required, medication.
Select Recommendations
ˇ Early identification and treatment of risk factors for diabetes-related complications such as cardiovascular disease, kidney, and eye disease is essential through proper disease management to avoid serious complications.
ˇ The Guidelines are now recommending that people with diabetes who are at risk for developing heart disease be aggressively treated to lower low-density lipoprotein (LDL) cholesterol to <=2 mmol/L. This lower level, in combination with strict blood pressure control, is proven to help substantially reduce heart disease and stroke.
ˇ People with diabetes are encouraged to perform resistance exercises in addition to moderate to vigorous aerobic exercises, such as brisk walking.
ˇ Adults with diabetes should consume no more than 7% of total daily energy from saturated fat and should limit intake of trans fatty acids to a minimum.
SOURCE: The Canadian Diabetes Association
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