Navigating the Diabetes Canada Algorithm for Pharmacologic Glycemic Management of Type 2 Diabetes

Diabetes Canada updated their recommendations for the pharmacologic glycemic management of type 2 diabetes in adults in 2020, but how can clinicians interpret and implement these guidelines in their everyday practice?

Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Peter Lin, the Director of Primary Care Initiatives at the Canadian Heart Research Centre and a Family Physician based in Toronto. He has been heavily involved in physician education, serving as an Associate Editor for the Elsevier WebPortal – Practice Update Primary Care, and was a contributing author to the 2013 and 2018 Diabetes Canada Clinical Practice Guidelines on Cardiovascular Protection in People With Diabetes.

This episode discusses how the newly updated recommendations by Diabetes Canada have shifted the focus of pharmacologic management of type 2 diabetes, to now include consideration of other clinically relevant outcomes such as cardiovascular and renal benefits. Our experts take a comprehensive, in-depth walkthrough of the treatment algorithms presented in these updated guidelines. They also discuss practical considerations when selecting an antihyperglycemic agent at various points throughout the type 2 diabetes patient journey: at diagnosis; when reviewing, adjusting, or advancing therapy; and when starting or advancing insulin.

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The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Goldenberg:

• Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. 

Dr. Lin:

• Direct financial relationship including receipt of honoraria: Astrazeneca, BoehringerIngelheim, Bayer, Eli Lilly, Merck, Sanofi, Amgen, mdBriefCase, Canadian Heart Research Center, Bayer, Lincorp Medical Inc., CCRN, CoreCare, CHIEF, LMC Diabetes & Endocrinology Group, Diabetes Canada, Novo Nordisk, Humber River Hospital, Canadian Medical & Surgical Knowledge Translation Research Group, HLS, Medexus, Pri-med Canada, liV Agency, Meducomm, The Rounds, Peterborough Medical Society, the Peterborough Regional Health Centre Foundation and Peterborough Public Health, WebMD, Medscape, Moderna, LifeLabs, Acino. Membership on advisory boards or speaker’s bureau: Astrazeneca, Boehringer Ingelheim, Bayer, Eli Lilly, Merck, Sanofi, Amgen, mdBriefCase, Canadian Heart Research Center, Lincorp Medical Inc., CCRN, CoreCare, CHIEF, LMC Diabetes & Endocrinology Group, Diabetes Canada, Novo Nordisk, Humber River Hospital, Canadian Medical & Surgical Knowledge Translation Research Group, HLS, Medexus, Pri-medCanada, liV Agency, Meducomm, TheRounds, Peterborough Medical Society, the Peterborough Regional Health Centre Foundationand Peterborough Public Health, WebMD, Medscape, Moderna, LifeLabs, Acino.