Type 2 Diabetes

rxfiles.ca/diabetes

Our comprehensive guide to the management of Type 2 Diabetes Mellitus, with a focus on optimizing drug therapy. 

Overview of
Diabetes

Pharmacotherapy
(non-insulin)

Insulin

Diabetes
Tools

Landmark
Trials

Overview of Diabetes

Introduction

page 2

Welcome to the second edition of RxFiles: Type 2 Diabetes.

Top Diabetes Clinical Pearls

page 3

A collection of learnings, pearls, and things that may surprise you.

Screening, Diagnosis, & Approach to Treatment

page 4

How to screen for T2DM, risk factors for T2DM, diagnosis tree, and an approach to T2DM therapy

PERSPECTIVES ON: Glycemic Targets

page 5

A guide to individualizing glycemic targets for your patient.

Modifiable Risk Factors in Diabetes

page 6

Guidelines and FAQs for blood pressure, lipids, ACEI/ARB, ASA, and lifestyle change.

PERSPECTIVES ON: Lifestyle Change

page 7

Lifestyle change: the best available treatment for type 2 diabetes. 

PERSPECTIVES ON: Diabetes and the Kidneys

page 8

A guide to protecting and preserving the kidneys in diabetes.

PERSPECTIVES ON: Diabetes and Heart Failure

page 9

A guide to comanaging patients with both diabetes and heart failure. 

Pharmacotherapy (non-insulin)

Introduction

page 10

Key messages for using pharmacotherapy in diabetes.

PERSPECTIVES ON: Metformin

page 11

Metformin: first-line, and the backbone of pharmacotherapy. 

PERSPECTIVES ON: GLP1 Agonists & SGLT2 Inhibitors

page 12

The arguments for and against using GLP1 agonists & SGLT2 inhibitors often and early.

Colour Comparison Chart of Pharmacotherapy

page 14

Side-by-side comparisons of diabetes pharmacotherapy using a 'traffic light' approach.

GLP1 Agonist Adverse Effects Infographic

page 16

Common, less common, rare, and uncertain adverse effects of GLP1 agonists. 

SGLT2 Adverse Effects Infographic

page 17

Common, less common, rare, and uncertain adverse effects of SGLT2 inhibitors. 

Diabetes Drug Comparison Charts

page 18

Efficacy, indications, adverse effects, contraindications, drug interactions, monitoring parameters, dosing, and cost comparisons of diabetes pharmacotherapy. 

Weight Loss Pharmacotherapy Chart

page 21

Efficacy, indications, adverse effects, contraindications, drug interactions, monitoring parameters, dosing, and cost comparisons of weight loss pharmacotherapy.

Insulin

Introduction

page 22

Key messages for using insulin in diabetes.

Insulin Pens

page 23

Compares and lists the different disposable and reusable insulin pens.

Insulin Comparison Chart

page 24

Side-by-side comparisons of the different BASAL and PRANDIAL insulins available.

Insulin Initiation, Titration, and Follow Up

page 26

How to initiate insulin, injection tips and common mistakes, troubleshooting titration, converting between insulins, using insulin to treat corticosteroid hyperglycemia, and travel tips.

Hypoglycemia and Sick Day Management

page 28

Treating hypoglcyemia, glucagon drug info, and diabetes 'sick day' guidelines. 

PERSPECTIVES ON: Hypoglycemia Risk

page 29

How to assess and address a patient's risk of hypoglycemia.

Selecting a Basal Insulin

page 30

Comparison of basal insulins by cost, coverage, convenience, and hypoglycemia.

Self Monitoring of Blood Glucose

page 31

Guidance on how often patients should self monitor blood glucose, and a comparison of available blood glucose meters. 

Diabetes Tools

Introduction

page 32

An overview of the diabetes tools in this book.

Shared Decision Making in Diabetes

page 33

A user-friendly approach to helping patients decide which diabetes therapy might be best for them. 

The Long Story Short - Infographic

page 35

Optimizing the choice and use of insulin needles.

Physical Activity Prescription

page 36

Evidence suggests that prescribing physical activity is more powerful than simply talking to patients about it. 

SADMANS Patient Handout

page 37

A handout guiding patients how to pause, and when to restart, medications that can cause acute kidney injury or other side effects when patients are dehydrated. 

Diabetes Patient Booklet

A patient booklet for patients with type 2 diabetes, designed to motivate patients to exercise, take their medications regularly, test their sugars only when needed, inject insulin properly, and hold SADMANS medications when dehydrated. 

Landmark Diabetes Trials

Introduction

page 38

An overview of the landmark diabetes trials collected here. 

Cardiovascular Outcome Landmark Trials

page 39

Describes the population studied, intervention, A1c achieved, and macrovascular outcomes of landmark diabetes cardiovascular outcome trials. 

Glycemic Target Landmark Trials

page 40

Describes the population studied, intervention, A1c achieved, microvascular outcomes, and macrovascular outcomes of landmark glycemic target trials. 

Insulin Landmark Trials

page 41

Describes the population studied, intervention, efficacy outcomes, and safety outcomes of landmark insulin trials. 

Modifiable Risk Factors Landmark Trials

page 42

Describes the population studied, intervention, and results of landmark lipid, ASA, blood pressure, and diabetes prevention trials.