The Guidelines and Protocols Advisory Committee’s (GPAC) updated Diabetes Care guideline is available at www.BCGuidelines.ca. The updated guideline describes the care objectives for the prevention, diagnosis, and management of diabetes mellitus in adults who are 19 years of age or older. It focuses on the approaches and systems that are, ideally, in place to improve care for the majority of patients the majority of the time. Diabetes in pregnancy (gestational diabetes) is outside the scope of this guideline.
• Diabetes care is centred on the person who is living with diabetes and should include an individualized management plan developed by the patient and their primary care providers.
• The five Rs describe the key components to consider when organizing diabetes care in the office or clinic: recognize, register, resource, relay, and recall.
• Glycosylated hemoglobin (A1C; $12.69*) or glucose testing (e.g., fasting plasma glucose [FPG; $1.46] or 2-hour plasma glucose [2hPG; $12.94]) can be used for diagnosis and screening. Best choice of test will depend on clinical circumstances.
• Individualized glycemic targets are based on the patient’s age, duration of diabetes, risk of hypoglycemia, cardiovascular disease presence, and life expectancy.
• Measure A1C every 3 months to assess glycemic goals are met. Consider testing every 6 months if targets are consistently met and treatment and lifestyle are stable.
• There are a number of new anti-hyperglycemic agents available for treatment of type 2 diabetes that can be considered as part of an individualized care plan.
• A systematic approach to vascular protection is recommended, including lifestyle management, glycemic control, blood pressure control, and pharmacological interventions.
* Prices as per the Schedule of Fees—Laboratory Services Payment Schedule as of 1 October 2015.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org