Recognize: Consider diabetes risk factors for all of your patients and screen appropriately for diabetes. Register: Develop a registry for all of your patients with diabetes to track care. Resource: Support self-management through the use of interprofessional teams, which could include the primary care provider, diabetes educator, registered dietitian, nurse, pharmacist, specialists and self-management supports, including linkage to community services. Relay: Facilitate information sharing between the person with diabetes and the health-care team for coordinated care and timely management changes. Recall: Develop a system to remind your patients and caregivers of timely review and reassessment.Conflict of interest statements can be found on page S33. Can J Diabetes 42 (2018) S27-S35

If glycemic targets are not achieved within 2 to 3 months of lifestyle management, antihyperglycemic pharmacotherapy should be initiated. Timely adjustments to, and/or additions of, antihyperglycemic agents should be made to attain target glycated hemoglobin (A1C) within 3 to 6 months. In patients with marked hyperglycemia (A1C 8.5%), antihyperglycemic agents should be initiated concomitantly with lifestyle management, and consideration should be given to initiating combination therapy with 2 agents, 1 of which may be insulin. Unless contraindicated, metformin should be the initial agent of choice, with additional antihyperglycemic agents selected on the basis of clinically relevant issues, such as contraindication to drug, glucose lowering effectiveness, risk of hypoglycemia and effect on body weight.

Diabetes care should be organized around the person living with diabetes who is practising self-management and is supported by a proactive, interprofessional team with specific training in diabetes. Diabetes care should be delivered using as many elements as possible of the chronic care model. The following strategies have the best evidence for improved outcomes and should be used: promotion of self-management, including selfmanagement support and education; interprofessional team-based care with expansion of professional roles, in cooperation with the collaborating physician, to include monitoring or medication adjustment and disease (case) management, including patient education, coaching, treatment adjustment, monitoring and care coordination. Diabetes care should be structured, evidence based and supported by a clinical information system that includes electronic patient registries, clinician and patient reminders, decision support, audits and feedback. HELPFUL HINTS BOX: ORGANIZATION OF CARERecognize: Consider diabetes risk factors for all of your patients and screen appropriately for diabetes.Register: Develop a registry for all of your patients with diabetes.Resource: Support self-management through the use of interprofessional teams which could include the primary care provider, diabetes educator, dietitian, nurse, pharmacist and other specialists.Relay: Facilitate information sharing between the person with diabetes and the team for coordinated care and timely management changes.Recall: Develop a system to remind your patients and caregivers of timely review and reassessment.

No abstract

No abstract