Diabetes and metabolic syndrome

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According to the Canadian Diabetes Association there are 11 million Canadians living with diabetes or prediabetes today. Diabetes-related complications can be very serious and even life-threatening. Properly managing blood sugar levels reduces the risk of developing these complications. Read our resources for more information.

Collaborative care benefits adults suffering from depression and diabetes

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Telemedicine for foot care: Using technology to get back on your feet

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Do self-management programs for diabetes really work?

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110 Show All 17Blog Posts 49Evidence Summaries 44Web Resource Ratings 5Patient Decision Aids

Evidence Summary

Self-monitoring reduces blood-sugar levels in patients with non-insulin-treated Type 2 diabetes
Journal of Diabetes Science and Technology (2018)
Web Resource Rating

Type 2 diabetes: Screening for adults
Health Link B.C.

People at average risk for type 2 diabetes should be tested every 3 years after age 40. You may need to be tested more frequently if you are at higher risk. Find out your risk with the Canadian Diabetes Risk Assessment Questionnaire (link in this resource).
Evidence Summary

Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus
Cochrane Database of Systematic Reviews (2014)
Evidence Summary

Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin
Cochrane Database of Systematic Reviews (2012)
Evidence Summary

Culturally appropriate health education for type 2 diabetes mellitus in ethnic minority groups
Cochrane Database of Systematic Reviews (2008)
Evidence Summary

Combination of exercise and diet has small effects in reducing risk factors for type 2 diabetes
International Journal of Behavioral Nutrition and Physical Activity (2014)
Evidence Summary

Text-messaging interventions help people quit smoking and improve medication use among HIV positive
PLoS Medicine (2013)
Evidence Summary

Traditional Chinese medicine-based exercises tai chi and ba duan jin may improve biomedical and psychosocial well-being in adults with type 2 diabetes
International Journal of Nursing Studies (2018)
Evidence Summary

Vitamin D supplementation can improve blood sugar control among some people living with type 2 diabetes
Metabolism: Clinical & Experimental (2017)
Web Resource Rating

High blood sugar can increase cognitive decline
Berkeley Wellness

New research shows that if you have high blood sugar, you might be more at risk for cognitive decline as you age. Whether or not you have diabetes, it is important to keep your blood sugar under control.
Patient Decision Aid

Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?
OHRI

This patient decision aid helps People with prediabetes considering treatment to help prevent type 2 diabetes decide on whether to make a major lifestyle change or take the medicine metformin by comparing the benefits, risks, and side effects of both options.
Evidence Summary

Diet, physical activity or both for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus.
Cochrane Database Syst Rev (2017)
Evidence Summary

Vegetarian diets, particularly vegan diets, help with weight loss.
Journal of General Internal Medicine (2015)
Evidence Summary

Peer support programs help lower blood sugar in people with diabetes
BMC Public Health (2015)
Web Resource Rating

What should I eat? Types of fat
Harvard School of Public Health

There are three main types of fat: unsaturated, saturated and trans fat. Unsaturated fats can help improve cholesterol levels and lower inflammation and are found in olive oil, avocados, nuts, seeds and fish. Trans fats are common in fast foods, and can increase your risk of heart disease, stroke, diabetes and other chronic conditions.
Evidence Summary

 Self-management of Type 2 diabetes via smartphone applications may have beneficial effects on blood sugar levels
PLoS One (2016)
Evidence Summary

Home visits by healthcare providers help diabetic patients manage their condition
Journal of Diabetes Investigation (2017)
Evidence Summary

Mobile phone apps can help adults with Type 2 diabetes to control their glycemic levels
Diabetes Care (2016)
Evidence Summary

High intensity aerobic exercise lowers blood sugar levels and improves fitness in people with type 2 diabetes
Cardiovascular Diabetology (2017)
Evidence Summary

Interactive self-management programs help people with poorly controlled diabetes decrease blood sugar levels
Worldviews on Evidence-Based Nursing (2017)
Evidence Summary

Glucose targets for preventing diabetic kidney disease and its progression.
Cochrane Database Syst Rev (2017)
Evidence Summary

In the short-term, low-carb diets decrease blood sugar levels in people with type 2 diabetes
BMJ Open Diabetes Research & Care (2017)
Evidence Summary

Yoga combined with other diabetes management approaches improves blood sugar levels in people with type 2 diabetes
Complementary Therapies in Medicine (2016)
Evidence Summary

Exercise improves balance, lower limb strength and gait in older adults with diabetes
Journal of Diabetes and Its Complications (2016)
Evidence Summary

Low-calorie diet and exercise improve blood sugar levels in people without impaired glucose tolerance (IGT) or diabetes
Diabetes Research and Clinical Practice (2017)
Web Resource Rating

Medication for type 2 diabetes
Informed Health Online

Talk to your doctor about diabetes medications. Consider your treatment goals, age, weight, health conditions and other medications when deciding if a drug is right for you.
Evidence Summary

Leisure-time physical activities – especially yoga – lower blood sugar levels in people with type 2 diabetes
Diabetes Research and Clinical Practice (2016)
Web Resource Rating

Diabetic neuropathy
UpToDate - patient information

Neuropathy is the medical term for nerve damage, a common complication of type 1 and type 2 diabetes. Controlling blood sugar, taking care of your feet and pain management are three treatment priorities.
Evidence Summary

Mobile phone apps improve blood sugar levels in people with type 2 diabetes
Diabetes Care (2016)
Web Resource Rating

Type 2 diabetes: Patient FAQ
Canadian Task Force on Preventive Health Care

Find answers to frequently asked questions about type 2 diabetes in this resource. Help prevent diabetes: eat a healthy diet and limit fat, salt and alcohol, control your blood pressure and cholesterol levels and do not smoke.
Web Resource Rating

Type 2 diabetes: Patient FINDRISC
Canadian Task Force on Preventive Health Care

Use this risk calculator to find out your risk for type 2 diabetes and see if you should be tested. Many people with diabetes have no symptoms. Speak to your doctor if you notice diabetes symptoms such as unusual thirst, the need to pee a lot, lack of energy, blurred vision, tingling or numbness in your hands or feet.
Web Resource Rating

Women with diabetes: Double the heart risk
Berkeley Wellness

Women with diabetes have double the heart disease risk as men with the disease. Women with diabetes should take care to avoid heart health risks like obesity, high cholesterol and physical inactivity.
Evidence Summary

Additional nurse management leads to moderate improvements on some outcomes for patients with type 2 diabetes
International Journal of Evidence-Based Healthcare (2016)
Evidence Summary

In adults with type 2 diabetes, different glucose-lowering drugs have similar effects. Metformin manages blood sugar levels better than, or as well as, other drugs.
JAMA (2016)
Evidence Summary

Aspirin does not prevent cardiovascular disease (CVD) in people with diabetes who do not already have CVD
Diabet Med (2016)
Evidence Summary

Insulin monotherapy compared with the addition of oral glucose-lowering agents to insulin for people with type 2 diabetes already on insulin therapy and inadequate glycaemic control.
Cochrane Database Syst Rev (2016)
Evidence Summary

In diabetes, the benefits of BP-lowering drugs depend on systolic BP being 140 mm Hg or more before starting treatment
BMJ (2016)
Evidence Summary

In people with type 2 diabetes, intensive treatment that aims to lower blood sugar levels reduces nonfatal heart attacks and doesn’t increase deaths
Diabet Med (2016)
Web Resource Rating

Foot ulcers in people with diabetes: evidence round-up
Evidently Cochrane

People with diabetes have a higher risk of foot ulcers. Infected foot ulcers can lead to complications, including amputation. Pressure-relieving casts can help speed healing. More research is needed on the benefits of other treatments, like blood sugar control, different types of dressings and wound care.
Evidence Summary

Health education for ethnic minority groups with Type 2 diabetes
Diabetic Medicine: A journal of the British Diabetic Association (2016)
Evidence Summary

Diet and exercise promotion programs reduce risk of type 2 diabetes
Annals of Internal Medicine (2015)
Web Resource Rating

WHO report says eating processed meat is carcinogenic: Understanding the findings
Harvard School of Public Health

Red meat and processed meat may increase your risk of cancer, heart disease, and diabetes. For a healthy diet, reduce your intake of red meat and avoid processed meat. This resource answers other questions about the report.
Web Resource Rating

Why didn't they tell me?
Evidently Cochrane

Little high quality information is available about whether hormone replacement therapy (HRT) for women with type 1 diabetes affects management of blood sugar and menopause symptoms. This resource provides one woman's perspective on the issue.
Evidence Summary

Several drugs reduce pain related to diabetic neuropathy in the short-term
Ann Intern Med (2014)
Evidence Summary

Diet and exercise programs may help people with type 2 diabetes lose weight
Diabetes, Obesity and Metabolism (2015)
Evidence Summary

Follow-up consultations via telemedicine may be an effective alternative to face-to-face consultations for patients suffering from foot ulcerations
BioMed Central Health Services Research (2014)
Evidence Summary

Self-management programs can improve health outcomes in older adults with diabetes
Diabetic Medicine (2015)
Evidence Summary

Blood pressure control for diabetic retinopathy.
Cochrane Database Syst Rev (2015)
Evidence Summary

Anti-vascular endothelial growth factor for diabetic macular oedema.
Cochrane Database Syst Rev (2014)
Evidence Summary

In people with type 1 diabetes, detemir or glargine improved blood sugar control (HbA1c) by a small amount and reduced weight gain compared with once-daily NPH
BMJ (2014)
Evidence Summary

Lifestyle changes lower rates of type 2 diabetes among adults at increased risk, but may not prevent complications in those already diagnosed
Annals of Internal Medicine (2013)
Evidence Summary

In people with type 2 diabetes, GLP-1 agonists plus insulin controls blood sugar levels better than insulin or other treatments alone
Lancet (2014)
Evidence Summary

Collaborative care can improve the health of adults who suffer from both depression and diabetes
BMJ Open (2014)
Evidence Summary

In people with, or at risk of, heart disease, fatty acid supplements do not prevent heart attacks or death
Ann Intern Med (2014)
Evidence Summary

In people with diabetes, group medical visits reduce HbA1 levels more than usual care
CMAJ (2013)
Evidence Summary

In people with 2 to 4 diabetes risk factors, high-dose atorvastatin reduced cardiovascular risk but increased new-onset diabetes compared with low-dose statins
J Am Coll Cardiol (2013)
Evidence Summary

Counseling with activity monitors improves physical activity and health outcomes in patients with type 2 diabetes
Annals of Medicine (2013)
Evidence Summary

ACE inhibitors for high blood pressure prevent kidney disease and death in people with diabetes and normal kidney function
Cochrane Database Syst Rev (2012)
Web Resource Rating

GLP-1 agonists: Diabetes drugs and weight loss
Mayo Clinic

There is class of type 2 diabetes medication that can improve blood sugar control and also lead to weight loss. Depending on the exact medication and dose, weight loss could be 3 to 5.5 pounds, or more if you are actively trying to lose weight.
Web Resource Rating

Amputation and diabetes: How to protect your feet
Mayo Clinic

Diabetes can lead to nerve damage and poor blood circulation. This can cause skin sores on your feet. Proper diabetes management and foot care can prevent this. Inspect and wash your feet daily, and be careful when trimming your nails.
Web Resource Rating

Simple steps to preventing diabetes
Harvard School of Public Health

Prevent type 2 diabetes: maintain a healthy weight, exercise, eat healthy and avoid smoking. Choose whole grain foods and 'good fats' from nuts, seeds and oils. Avoid sugary drinks and red or processed meats.
Web Resource Rating

Diabetes and depression: Coping with the two conditions
Mayo Clinic

If you have diabetes and depression, managing one can positively impact the other. Manage both conditions together through diabetes self-management programs, psychotherapy, medications and lifestyle changes, and collaborative care.
Web Resource Rating

How could you live better with type 2 diabetes?
WebMD

Use this diagnostic tool to find out how well you (or a loved one) are living with diabetes.
Patient Decision Aid

Making Choices: Should I Start Insulin?
OHRI

This patient decision aid helps people with type 2 diabetes decide whether or not to start insulin. It also outlines alternative options such as doing nothing, following stricter diet and exercise programs and starting another type of injection or tablet.
Web Resource Rating

Rx for Change: Diabetic neuropathy
National Women’s Health Network

Symptoms of diabetic neuropathy (nerve pain) range from numbness to severe pain. Some evidence suggests alternative treatments may help with pain such as exercise, capsaicin skin cream or dietary supplements such as alpha-lipoic acid, vitamin B12 and vitamin D.
Web Resource Rating

Carbohydrates and blood sugar
Harvard School of Public Health

Many studies have shown an association between foods with a high glycemic index and an increased risk of type 2 diabetes or heart disease. Try to choose foods with medium or low glycemic index such as bran cereals, kidney beans, wheat tortillas, skim milk, peanuts and carrots. This resource provides other examples.
Web Resource Rating

Supplements for diabetes? Wishful thinking
Berkeley Wellness

Dietary supplements are unlikely to help treat diabetes and some may be harmful. Chromium, ginseng and cinnamon are somewhat promising options but further study is needed. Discuss any medications or herbal supplements with your doctor before taking them.
Web Resource Rating

Magnesium and type 2 diabetes prevention
GB HealthWatch

Magnesium deficiency is linked to insulin resistance. This can lead to an increased risk of type 2 diabetes. Beans, seeds and bran are good food sources of magnesium. Choose more of these foods to help prevent type 2 diabetes.
Web Resource Rating

Foot care in diabetes mellitus
UpToDate - patient information

Poor circulation, nerve damage, and skin dryness are common complications in diabetes patients. Quitting smoking, regular foot exams and wearing properly fitted shoes are all important ways to prevent complications.
Web Resource Rating

Preventing diabetes: exercise, eating and evidence
Evidently Cochrane

Type 2 diabetes is largely preventable. Control your weight, exercise regularly, quit smoking and abstain from alcohol to help reduce your risk of developing type 2 diabetes.
Web Resource Rating

Altered blood glucose: Introduction
Canadian Patient Safety Institute

Symptoms of hypoglycemia (low blood sugar) include sweating, shaking, anxiety, and dizziness. You might also get a headache or feel tired. Hypoglycemia is most common among people with diabetes, however some medications can also affect blood sugar.
Evidence Summary

For type 2 diabetes, canagliflozin lowers blood sugar levels more than other drugs in its class but increases risk of hypoglycemia and genital infections
Diabetes Obes Metab (2016)
Web Resource Rating

Obesity, type 2 diabetes and the ADIPOQ gene
GB HealthWatch

The ADIPOQ gene controls a hormone that helps with fat breakdown. People who carry a variant of this gene are at increased risk of obesity and type 2 diabetes. Choose a lower-fat diet with higher levels of unsaturated fats and get more physical activity to avoid weight gain.
Web Resource Rating

What should I eat? Dietary fat and disease
Harvard School of Public Health

Healthy (unsaturated) fats can improve your heart health and reduce your risk of diabetes. These fats can be found in vegetable oils, nuts and seeds. Omega-3 fats from fish can reduce your risk of fatal heart disease.
Web Resource Rating

Sugar: Cutting back has big benefits
Berkeley Wellness

A recent study in children found lowering sugar intake also lowers the risk of metabolic syndrome - improving blood pressure, blood sugar and cholesterol levels. The authors suggest cutting down on sugar will also benefit adults.
Web Resource Rating

Soft drinks and disease
Harvard School of Public Health

Soft drinks may significantly increase your risk of type 2 diabetes and heart disease. They may also affect your bone health.
Web Resource Rating

Type 2 diabetes: Does self-monitoring blood sugar have any advantages for people who don't use insulin?
Informed Health Online

People with type 2 diabetes who do not take insulin can monitor their blood sugar levels at home. More research is needed to find out if self-monitoring of blood sugar helps prevent diabetes-related illnesses.
Web Resource Rating

Fiber
Harvard School of Public Health

Eating fiber helps reduce your risk of diabetes and heart disease and eases digestive issues, such as constipation. Increase your fiber intake by eating whole fruits, whole grains, beans and raw vegetables.
Web Resource Rating

What should I eat?: Whole grains
Harvard School of Public Health

Some studies show that people who eat whole grains (which contain bran and fibre) may be less likely to develop type 2 diabetes or cardiovascular disease. Choose whole grains and be sure to check food labels at the grocery store because not all foods with a ‘whole grains’ label are healthy.
Evidence Summary

Strategies to increase the level of physical activity among persons with Type 2 diabetes are generally effective
Frontiers in Public Health (2013)
Web Resource Rating

More evidence on exercise
Evidence-based Living

If you have heart disease or have had a stroke, strongly consider exercise as part of your treatment process. Evidence has shown exercise is just as effective as drug treatments for treating heart disease and prediabetes and more effective after a stroke.
Web Resource Rating

Metabolic Syndrome
Mayo Clinic

If you have any of the components of metabolic syndrome (increased blood pressure, high blood sugar levels, excess body fat around the waist, abnormal cholesterol levels), aggressive changes to your lifestyle may be required to either delay or prevent serious health problems.
Web Resource Rating

Should you be tested for diabetes?
Berkeley Wellness

Get tested for diabetes if you are over 45 years old. People who are overweight, have high blood pressure, a family history of diabetes or other risk factors should get tested earlier. Early detection of diabetes may help you avoid using medication.
Web Resource Rating

ACCORD eye study finds two therapies slow diabetic eye disease progression
National Eye Institute

Learn about the ACCORD study’s findings. High-risk adults with type 2 diabetes may be able to slow diabetic retinopathy (vision loss) through intensive blood sugar control and combination lipid therapy. Talk to your doctor to develop a care plan tailored to you, and try to get regular exercise and eat a healthy diet.
Web Resource Rating

Managing your Caribbean diet
Ontario Ministry of Health and Longterm Care

After a diabetes diagnosis, diet changes can improve your health. Reduce carbohydrates, mix in whole grains, bake more and fry less, and limit sweets and fruit juices to prevent complications from diabetes. Watch this video to learn more about healthy changes you can make to your typical Caribbean diet.
Web Resource Rating

Managing your South Asian diet
Ontario Ministry of Health and Longterm Care

After a diabetes diagnosis, diet changes can improve your health. Cut down on carbohydrates, fry less and bake more and limit sweets to prevent complications from diabetes. Watch this video to learn more about healthy changes you can make to your typical South Asian diet.
Patient Decision Aid

Diabetes: Should I Get an Insulin Pump?
OHRI

This patient decision aid helps insulin dependent patients decide on whether or not to get an insulin pump by comparing the benefits, risks, and side effects of both options.
Patient Decision Aid

Diabetes Medication Choice.
OHRI

This patient decision aid helps physicians, physician assistants, and nurse practitioners managing diabetes in adults decide the best treatment choice by outlining and comparing the medications commonly used to treat type 2 diabetes.
Patient Decision Aid

Diabetes, Type 2: Should I Take Insulin?
OHRI

This patient decision aid helps people with type 2 diabetes decide on whether or not to take insulin by comparing the benefits, risks, and side effects of both options.
Web Resource Rating

Diabetes and dental care: Guide to a healthy mouth
Mayo Clinic

Diabetes may put you at a higher risk for developing cavities and gum disease. Control your blood sugar levels and practice proper dental care to manage your risk.
Web Resource Rating

Preventing diabetes
Harvard School of Public Health

Exercise regularly to prevent type 2 diabetes. Choose a diet rich in healthy fats, such as olive oil, avocados and nuts. Limit processed meats, white bread, sugary drinks, and other refined carbohydrates.
Web Resource Rating

Metabolic syndrome: Treatment
Healthy Women

Metabolic syndrome is diagnosed based on your blood sugar, triglyceride, blood pressure and cholesterol levels as well as your waist circumference. It more than doubles your risk of developing diabetes. The best treatment is lifestyle changes.
Blog Post

The Portfolio diet: An investment in your heart health?

When it comes to lowering your cholesterol, eating a “portfolio” of cholesterol-lowing foods may be a good way to invest in your heart health.
Blog Post

Traditional Chinese Medicine: A supplement to modern diabetes management?

Tai Chi and ba duan jin are Traditional Chinese Medicine practices that have been around for thousands of years. New research brings these age-old practices into the present as possible additions to standard type 2 diabetes care.
Blog Post

Vitamin D: A possible ally in the fight against diabetes

Could vitamin D supplementation help you improve your blood sugar control? Research shows promise for some people living with type 2 diabetes.
Blog Post

Yoga for diabetes: breathe, relax, stretch…and reduce your blood sugar levels?

Are you a yogi? If not, consider rolling out your mat and giving yoga a try. Research shows that adding yoga to your diabetes management plan may be an effective way to keep your blood sugar under control, and can also help improve blood pressure, body mass index, and cholesterol levels.
Blog Post

Telehealth: A new fix for an old problem – helping people with chronic conditions take better care of themselves

Is chronic illness getting you down? Telehealth is a promising way for you to connect with your health care provider and better manage your condition.
Blog Post

Living with diabetes? Your peers can help!

Do you struggle with managing your diabetes? If so, research shows that turning to your peers can improve your health.
Blog Post

Oh my veggies! Can a vegetarian diet help you lose weight?

With the numbers of overweight and obese adults on the rise globally, people are looking to different types of diets for solutions. To shed pounds, going lacto-ovo vegetarian or vegan may help.
Blog Post

Struggling with your weight? Get active and improve your health with high intensity interval training!

Short on time? Research suggests that high-intensity interval training can improve cardiovascular and metabolic health in people who are overweight or obese.
Blog Post

The diabetes epidemic: Don’t become a statistic!

The global prevalence of diabetes continues to rise. Don’t become a statistic with the help of these simple lifestyle changes.
Blog Post

3 research-based benefits of yoga for healthy aging

Want to age well? Consider making yoga part of your regular activities.
Blog Post

No one left out: Breaking down cultural barriers to support healthy aging

Not everyone has the same opportunity to access health promotion programs that can save lives and prevent serious illness. Culturally customized materials and approaches can help.
Blog Post

Do self-management programs for diabetes really work?

Managing diabetes can be challenging for anyone, but for older adults with multiple health and age-related conditions, it can be especially difficult. Dr. Diana Sherifali weighs in on how self-management programs can be adapted to best support older adults with diabetes.
Blog Post

Telemedicine for foot care: Using technology to get back on your feet

One study suggests that patients receiving follow-up care for diabetic foot or leg ulcers via telemedicine (online or by phone) may spend less time travelling without any negative effect on their health and lower costs to the healthcare system. Dr. Perry Mayer – an expert in diabetic foot care – offers his perspective on the issue.
Blog Post

Diabetic foot care: Awareness and prevention are vital

People with diabetes are at significantly higher risk for foot disease including ulcers that can lead to serious health problems. A leading expert in diabetic foot care provides important facts and strategies for prevention and protection.
Blog Post

New drug may be 'next big thing' in type 2 diabetes management

A new drug may improve blood sugar control for people with Type 2 diabetes, while helping them avoid weight gain.
Blog Post

Does wearable technology help with weight loss and other health goals?

Wearable technology encourages people to be more active (at least in the short term), which can lead to weight loss and other health benefits.
Blog Post

Collaborative care benefits adults suffering from depression and diabetes

People struggling to cope with both diabetes and depression are often at increased health risk. A collaborative care approach can reduce symptoms of both diseases and promote improved overall health.

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