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CDE Diabetes

Flash Cards: Organization of Diabetes Care (Chapter 6)

Welcome to the Flash Card section for Chapter 6: Organization of Diabetes Care.

While clinical chapters often rely on pathophysiology and pharmacology, Chapter 6 introduces a specific organizational “language”—the Chronic Care Model (CCM). Success in this section of the CDE exam requires more than just understanding the general concepts; you need precise recall of definitions and frameworks.

Why use flash cards for this chapter? The guidelines categorize interventions into six distinct components of the CCM. On the exam, you may be asked to classify a specific activity (like a patient registry or a reminder system) into its correct component. These flash cards are designed to help you strictly define these categories and memorize the evidence-based recommendations.

Use these cards to move from passive reading to active recall, ensuring you can quickly identify the correct organizational strategy on exam day.

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CDE Diabetes

Practice Exam: Organization of Diabetes Care (Chapter 6)

Now that you have reviewed the study guide for Chapter 6: Organization of Diabetes Care, it’s time to test your knowledge.

While clinical topics like medications and screening criteria often get the most attention, the CDE exam frequently includes questions on how care is delivered. The guidelines emphasize that the structure of your practice—specifically the Chronic Care Model (CCM)—is just as vital to patient outcomes as the prescriptions you write.

What to expect in this quiz: This practice exam focuses on the “non-clinical” but essential frameworks of diabetes management. You will be tested on:

  • Identifying the 6 components of the Chronic Care Model in real-world scenarios.

  • Understanding the specific definitions of Case Management and Facilitated Relay of Information.

  • Recognizing the evidence-based benefits of Telehealth and team-based care.

  • The hierarchy of Quality Improvement (QI) strategies (e.g., knowing that multicomponent interventions are superior to single ones).

1. A diabetes educator is advising a clinic on implementing evidence-based flow sheets. What is the association with flow sheet use?

2. According to the guidelines, which quality improvement strategy has excellent evidence for reducing A1C?

3. What is the significant decrease in A1C observed with collaborative pharmacist intervention?

4. A primary care practice wants to assess their alignment with the CCM. What practical tool can help identify gaps and develop a more robust CCM?

5. What age range defines “emerging adults” who require specialized diabetes care according to the guidelines?

6. A diabetes educator is developing a case management program. According to the evidence, which factor has the greatest impact on A1C lowering?

7. According to Diabetes Canada guidelines, who is the most important member of the diabetes health-care team?

8. According to the guidelines, case management is defined as using at least how many of the following components: patient education, coaching, treatment adjustment, monitoring, and care coordination?

9. Which of the following is NOT one of the 6 components of the Chronic Care Model?

10. Case: A health system is evaluating shared care models. According to the evidence, which population shows the most evidence for benefit from specialized care?

11. What percentage of medical care for people with diabetes in Canada takes place in primary care?

12. According to the evidence on telehealth, what baseline A1C level shows better improvement in glycemic control?

13. How many essential components are included in the Chronic Care Model (CCM)?

14. At what baseline A1C level were case management programs found to be more effective according to the meta-analysis?

15. Case: A primary care clinic wants to improve diabetes outcomes. Which combination of QI strategies has been shown to improve A1C, BP, and cholesterol?

16. What does the “5 Rs” framework include for the organization of care?

17. What does the evidence suggest about the relationship between telehealth effect on glycemic control over time?

18. According to the guidelines, what is the definition of “shared care” in diabetes management?


 

REFERENCE

Clement M, Filteau P, Harvey B, Jin S, Laubscher T, Mukerji G, Sherifali D. Diabetes Canada Clinical Practice Guidelines Expert Committee. Organization of Diabetes Care. Can J Diabetes. 2018;42(Suppl 1):S27-S35. doi:10.1016/j.jcjd.2017.10.005

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CDE Diabetes

Study Guide: Organization of Diabetes Care (Chapter 6)

Welcome to the next section of our CDE Exam Study Guide series. While the previous chapters focused on who to screen and what prevention interventions to use, Chapter 6 shifts the focus to how that care is delivered.

“Organization of Diabetes Care” might sound dry compared to clinical topics, but do not skip this section. The CDE exam tests your understanding of the Chronic Care Model (CCM) because evidence shows that the structure of care is just as important as the medication prescribed.

Why this chapter matters for the CDE Exam:

The guidelines explicitly state that a “proactive, interprofessional team” is superior to standard care. You need to know the specific definitions of strategies like Case Management and Facilitated Relay of Information, as the exam may present a clinical scenario and ask you to identify which Quality Improvement (QI) strategy is being used.

High-Yield Exam Themes:

  1. The Shift to Proactive Care: Moving from acute, reactive care to planned, population-based care.
  2. The 6 Components of the CCM: You should be able to identify examples of Delivery System Design vs. Decision Support vs. Clinical Information Systems.
  3. Telehealth: Know that it is a proven tool for reducing A1C and improving access, particularly when it allows for medication adjustment.

Below is your study guide to mastering the organizational frameworks that underpin effective diabetes management in Canada.

1. Chapter Overview

This chapter addresses the “Care Gap”—the difference between evidence-based goals and actual clinical practice. It argues that to close this gap, we must redesign primary care using the Expanded Chronic Care Model (CCM). The goal is to transform care from “acute and reactive” to “proactive, planned, and population-based”.

 

2. Key Messages (The "Gold Nuggets")

  • Patient-Centred: Care must be organized around the person living with diabetes, who is the most important member of the team.

  • Proactive Team: Care should be facilitated by an interprofessional team that provides ongoing self-management education and support.

  • The Framework: Care should be delivered using the components of the Chronic Care Model (CCM).

  • Data-Driven: Structured care must be supported by clinical information systems (registries, reminders, audits).

3. The Chronic Care Model (CCM)

The CCM is the evidence-based framework for this chapter. It includes 6 essential components that work together. For the exam, memorize the examples for each component found in Table 1 in the guidelines.

A. Delivery System Design (How we structure the visit/team)

  • Team-Based Care: Multidisciplinary team with specific diabetes training.

  • Case Management: A structured intervention (often by a nurse, pharmacist, or dietitian) involving medication adjustment, monitoring, and care coordination. Note: Case management with medication adjustment has the greatest impact on lowering A1C.

  • Shared Care: Joint participation of primary care and specialists.

B. Self-Management Support (Empowering the patient)

  • Activities that support the patient in managing their disease (education, coaching, peer support).

  • This is the cornerstone of diabetes care in the CCM.

C. Decision Support (Helping the provider make the right choice)

  • Evidence-Based Guidelines: Embedding guidelines into EMRs.

  • Audit and Feedback: Summarizing provider performance to increase awareness.

  • Benchmarking: Comparing performance against a peer group.

D. Clinical Information Systems (The data backbone)

  • Patient Registries: A list of all patients with diabetes to track care (preventing patients from “falling through the cracks”).

  • Clinician/Patient Reminders: Prompts to recall patients or perform tasks (e.g., foot exam reminders).

  • Facilitated Relay of Information: Collection of patient data (e.g., home glucose logs) sent to the clinician, ideally one who can adjust meds.

E. The Community

  • Building healthy public policy and supportive environments.

F. Health Systems

  • Leadership and organization of healthcare.

4. Quality Improvement (QI) Strategies

  • Multi-component is Best: Interventions targeting the system (e.g., team changes + registries + case management) produce the greatest effect.

  • Effectiveness: The more CCM components used, the better the outcomes.

  • Rural Areas: Using 3 or more QI strategies significantly increases the impact on self-management compared to using a single strategy.

5. Telehealth

Telehealth is defined as the provision of healthcare remotely (telephone, video, web-based).

  • Evidence: It is one of the few QI strategies with consistent evidence for improving glycemia and cardiovascular risk factors.

  • A1C Impact: Improvement is most likely when the system allows for medication adjustment.

  • Target: A1C improvement is greater when the baseline A1C is higher (>8.0%).

6. Clinical Decision Algorithm

While this chapter is less “algorithmic” than others, visualize the workflow of an Optimized Practice:

  1. Register: Create a patient registry to identify everyone with diabetes.

  2. Recall: Use the registry to generate reminders for overdue labs/visits.

  3. Resource: Assign an interprofessional team (Nurse, Dietitian, Pharmacist) to the patient.

  4. Relay: Establish a system for the patient to send data (glucose data from CGM on CBG) to the team.

  5. Review: Use decision support tools (guidelines, flow sheets) during the visit.

7. Diabetes Canada Clinical Practice Guidelines Recommendations

Key Recommendations to Memorize:

  1. Team Care: Care should be facilitated by a proactive, interprofessional team with specific training in diabetes. 

  2. QI Strategies: The following strategies should be used to reduce A1C and improve adherence:

    • Promotion of self-management.

    • Team changes.

    • Case management.

    • Electronic patient registries.

    • Facilitated relay of clinical information.

  3. Case Manager Role: The role of the diabetes case manager should be enhanced to include interventions led by a nurse, pharmacist, or dietitian to improve coordination and facilitate timely changes to management.

  4. Telehealth: Telehealth technologies may be used to:

    • Improve self-management in underserviced communities.

    • Improve clinical outcomes (A1C, guideline adherence) in Type 2 diabetes.

Reference:

Clement M, Filteau P, Harvey B, et al. Organization of Diabetes Care. Canadian Journal of Diabetes. 2018;42:S27-S35. doi:10.1016/j.jcjd.2017.10.005
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CDE Diabetes

Flash Cards: Reducing the Risk of Developing Diabetes (Chapter 5)

Master the key concepts of diabetes prevention with these rapid-review flashcards.

With the rising prevalence of diabetes, implementing safe and cost-effective interventions is urgent to decrease the burden on individuals and the healthcare system. These flashcards are designed to help pharmacists and healthcare professionals quickly recall the evidence-based recommendations for preventing or delaying the onset of type 2 diabetes and understanding the current landscape for type 1 diabetes prevention.

 
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CDE Diabetes

Practice Exam: Reducing the Risk of Developing Diabetes (Chapter 5)

Welcome to the practice exam for Chapter 5 of the Diabetes Canada Clinical Practice Guidelines.

Welcome to the practice exam for Chapter 5 of the Diabetes Canada Clinical Practice Guidelines.

With the increasing incidence and prevalence of diabetes, the development of safe and cost-effective interventions to reduce risk is urgently needed to decrease the burden on individuals and the healthcare system. Ideally, prevention strategies should range from efforts focused on high-risk individuals to broader population-based strategies.

This practice exam focuses on the evidence-based recommendations for preventing or delaying the onset of type 2 diabetes, as well as the current status of interventions for type 1 diabetes.

Key Concepts Covered in This Exam:

  • Type 1 Diabetes Prevention: Understanding the distinction that current attempts to prevent type 1 diabetes should be undertaken only within formal research protocols.

  • Healthy Behaviour Interventions: The critical role of intensive, structured lifestyle modifications—specifically targeting a sustained weight loss of approximately 5% and regular physical activity—in reducing the risk of progression from prediabetes to type 2 diabetes by nearly 60%.

  • Dietary Patterns: Identifying evidence-based dietary patterns that reduce risk, including the Mediterranean diet, DASH diet, and the Alternate Healthy Eating Index (AHEI).

  • Pharmacotherapy: Indications for the use of pharmacologic therapy, specifically metformin, in individuals with prediabetes to delay or prevent type 2 diabetes.

  • Risk Stratification: Differentiating interventions based on risk profiles, such as Impaired Fasting Glucose (IFG), Impaired Glucose Tolerance (IGT), and elevated A1C.

Please go to Practice Exam: Reducing the Risk of Developing Diabetes (Chapter 5) to view this quiz
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CDE Diabetes

Study Guide: Reducing the Risk of Developing Diabetes (Chapter 5)

Reducing the Risk of Developing Diabetes

Welcome to the next installment of our CDE Exam Study Guide series. Now that we have covered how to identify individuals at risk in Chapter 4: Screening, we move to the crucial next step: Prevention.

Chapter 5, “Reducing the Risk of Developing Diabetes,” is a high-yield topic for the Canadian Certified Diabetes Educator (CDE) exam. As educators, we are often the first point of contact for patients diagnosed with prediabetes. Understanding the hierarchy of interventions—and specifically where pharmacotherapy fits in—is essential for both clinical practice and exam success.

Why this chapter matters for the CDE Exam:

The guidelines are very specific about the efficacy of lifestyle versus medication. A key “gold nugget” to remember is that intensive healthy behaviour interventions are the gold standard, capable of reducing the risk of type 2 diabetes by nearly 60%. In comparison, metformin reduces this risk by approximately 30%.

For the exam, focus your attention on these three areas:
  1. The “5% Rule”: The target for weight loss in prediabetes is approximately 5% of initial body weight.
  2. The Candidates for Metformin: While lifestyle is for everyone, metformin is specifically considered for those with IGT, IFG, or an A1C of 6.0%–6.4%, particularly if they are younger (<60 years), have a BMI >35 kg/m², or have a history of gestational diabetes.
  3. Type 1 vs. Type 2: Remember that while we have actionable strategies for Type 2, prevention of Type 1 diabetes is currently restricted to formal research protocols only.

Below is a summarized study guide to help you navigate the evidence, the dietary patterns (Mediterranean, DASH, AHEI), and the clinical decision flow.

 

1. Chapter Overview

This chapter focuses on interventions to prevent or delay the onset of type 2 diabetes in high-risk individuals and the current status of prevention strategies for type 1 diabetes. For the CDE exam, focus heavily on the hierarchy of interventions (Lifestyle > Metformin) and the specific dietary patterns recommended.

2. Key Messages (The "Gold Nuggets")

  • Type 1 Diabetes: As safe and effective preventive therapies have not yet been identified, prevention attempts should be undertaken only within the confines of formal research protocols.
  • Lifestyle Efficacy: Intensive healthy behaviour interventions, ideally resulting in a loss of ~5% of initial body weight, can reduce the risk of type 2 diabetes by almost 60%.
  • Durability: When initiated early, the effects of healthy behaviour interventions are long-lasting (more than 20 years).
  • Pharmacotherapy: Metformin reduces the risk of progression to type 2 diabetes by approximately 30%, with persistent benefits observed after stopping treatment.
  • Role of Dietitians: A registered dietitian can educate patients about dietary changes to reduce diabetes risk.

3. Prevention of Type 1 Diabetes

  • Current Status: Interventions such as nicotinamide (ENDIT trial), insulin injections (DPT-1), and elimination of cow’s milk protein (TRIGR) have not shown success in preventing Type 1 diabetes in general populations.
  • Clinical Rule: Attempts to prevent type 1 diabetes should be restricted to formal research protocols.

4. Prevention of Type 2 Diabetes: Interventions

A. Healthy Behaviour Interventions (First Line)

  • Target: Weight loss of approximately 5% of initial body weight.
  • Physical Activity: Moderate-intensity activity of at least 150 minutes per week.
  • Evidence:
    • DPP & DPS Trials: Showed a 58% risk reduction at 4 years.
    • Da Qing Study: 23-year follow-up showed reduced all-cause and cardiovascular mortality.

B. Dietary Patterns

There is strong evidence to support specific dietary patterns.

  • Mediterranean Diet:
    • High adherence reduces the risk of future diabetes by 19% to 23%.
    • Supplementation with Extra Virgin Olive Oil (EVOO) or mixed nuts reduced diabetes risk by 40% and 18% respectively in the PREDIMED trial.
  • DASH Diet: (Dietary Approaches to Stop Hypertension) is consistently associated with a reduced risk of type 2 diabetes.
  • AHEI: (Alternate Healthy Eating Index) is consistently associated with a reduced risk of type 2 diabetes.
  • Specific Foods:
    • Whole Grains: Consuming more than 2 servings per day is associated with a 43% reduced risk.
    • Dairy: An inverse association (more dairy = less diabetes) exists for total dairy up to 300–400 g/day.
    • Sugar-Sweetened Beverages: Higher intake is associated with higher risk, independent of body weight.

C. Pharmacotherapy

  • Metformin:
    • Efficacy: Decreased progression to diabetes by 31% compared to placebo.
    • Best Candidates: Metformin may be considered for people with Impaired Glucose Tolerance (IGT), especially if they also have Impaired Fasting Glucose (IFG) or an A1C of 6.0%–6.4%. It is most effective in younger individuals (<60 years), those with significant obesity (BMI >35 kg/m²), and women with a history of Gestational Diabetes (GDM).
  • Other Agents (Not First Line/Specific Contexts):
    • Thiazolidinediones (TZDs): Rosiglitazone and Pioglitazone reduce risk significantly (60-72%) but are not recommended for widespread use due to adverse effects like weight gain and edema.
    • Acarbose: Reduced risk by 25%, but the effect did not persist after discontinuation.
    • Liraglutide: Shown to prevent conversion to diabetes and induce weight loss, but cost and long-term safety remain considerations.
    • Orlistat: Reduced incidence by 37% but had a high dropout rate due to side effects.
    • Vitamin D: Has no significant effects on insulin resistance or prevention in trials to date.

D. Bariatric Surgery

  • Shows a drastic risk reduction (Odds Ratio 0.10).
  • Limitations: The cost-benefit analysis for primary prevention is unclear, so it is not routinely recommended solely for prevention.

5. Clinical Decision Algorithm

For the exam, visualize the flow of treatment for a patient with Prediabetes:

  1. START: Diagnose Prediabetes.
  2. INTERVENTION:
    • Healthy Behaviour Interventions (Goal: ≥5% weight loss).
    • AND/OR Dietary Patterns (Mediterranean, DASH, AHEI).
    • Consider Metformin in addition to lifestyle (esp. if high risk).
  3. MONITOR: Check A1C/FPG in 3 to 6 months.
  4. DECISION:
    • Stable/Improved? -> Maintain current strategy, follow up every 6 months.
    • Not Improved? -> Intensify healthy behaviour, consider adding/increasing Metformin.

6. 2018 Clinical Practice Guidelines Recommendations

These are the “Must Memorize” graded recommendations for the exam.

  1. Healthy Behaviour: In individuals with prediabetes, a structured program of healthy behaviour interventions that includes moderate weight loss and regular physical activity of a minimum of 150 minutes per week should be implemented to reduce the risk of type 2 diabetes.
  2. Dietary Patterns: In individuals at risk for type 2 diabetes, dietary patterns may be used to reduce the risk of diabetes, specifically:
    • Mediterranean-style.
    • DASH (Dietary Approaches to Stop Hypertension).
    • AHEI (Alternate Healthy Eating Index).
  3. Metformin: In individuals with prediabetes, pharmacologic therapy with metformin may be used to reduce the risk of type 2 diabetes.

Reference:

Prebtani APH, Bajaj HS, Goldenberg R, Mullan Y. Reducing the Risk of Developing Diabetes. Canadian Journal of Diabetes. 2018;42:S20-S26. doi:10.1016/j.jcjd.2017.10.033
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CDE Diabetes

Flashcards: Screening for Diabetes in Adults (Chapter 4)

Who needs screening? When? And how often?

Welcome to the Interactive Flashcard Deck for Chapter 4 of the Diabetes Canada Clinical Practice Guidelines.

While Chapter 3 was about diagnosing the disease, Chapter 4 is about finding it. For the CDE exam, you need to be able to look at a patient profile and instantly decide: “Do I screen them now, or can they wait?”

This chapter requires you to memorize a long list of risk factors and master the specific Screening Algorithm.

Ready to practice your risk assessment skills? Click the cards below to start.

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CDE Diabetes

Practice Exam: Screening for Diabetes in Adults (Chapter 4)

Based on the Diabetes Canada Clinical Practice Guidelines

Welcome to the Chapter 4 Practice Exam. This assessment is tailored for Canadian healthcare professionals preparing for the Certified Diabetes Educator (CDE) examination.

While Chapter 3 covers how to diagnose diabetes, Chapter 4 focuses on the critical public health question: Who needs to be tested, and when?

With an estimated 20% to 40% of diabetes cases remaining undiagnosed, your ability to identify high-risk individuals and implement appropriate screening intervals is a core competency for any diabetes educator. This exam will test your ability to apply the “Screening Algorithm” to diverse patient scenarios.

Competency Alignment

This exam is designed to map directly to the CDECB Competencies:

  • 1.G: Describes the impact of lifestyle, genetics, and body composition (Risk Factors).

  • 5.E: Describes the recommendations for screening for microvascular and macrovascular complications (and underlying diabetes).

Key Concepts to Review

Before starting, ensure you are familiar with:

  1. The “Rule of 40”: The baseline recommendation for everyone 40 years old.

  2. The Risk Factor List: Specific conditions that mandate earlier screening (e.g., PCOS, Acanthosis Nigricans, Schizophrenia).
  3. Screening Intervals: The difference between the standard 3-year interval and the 6–12 month interval for high-risk or “At Risk” results.
Please go to Practice Exam: Screening for Diabetes in Adults (Chapter 4) to view this quiz
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Study Guide: Screening for Diabetes in Adults (Chapter 4)

Based on the Diabetes Canada Clinical Practice Guidelines Competency Focus: 5.E (Screening), 1.G (Risk Factors) Exam Weight: Moderate

1. Screening for Type 1 Diabetes

The Rule: Routine screening for Type 1 diabetes is not recommended.

  • Reasoning: There is currently no evidence for effective interventions to prevent or delay Type 1 diabetes in the general population.

  • Limitations: Antibody screening (GAD, IA-2) is not universally available and has variable sensitivity (identifying only ~60% of future cases in some studies).

2. Screening for Type 2 Diabetes: The “Who” and “When”

Competency: Identifies the recommendations for screening.

Unlike the US guidelines (which target age 40-70 with obesity), Diabetes Canada recommends broader screening to catch the 20-40% of cases that are undiagnosed.

General Recommendation

  • Who: Everyone ≥ 40 years of age.

  • Frequency: Every 3 years.

  • Tool: Fasting Plasma Glucose (FPG) and/or A1C.

Earlier/More Frequent Screening

Screening should be done earlier (before age 40) and/or more frequently (every 6 to 12 months) in people with risk factors.

  • Use a risk calculator (like CANRISK) to assess risk.

  • High risk is defined as a 33% chance of developing diabetes over 10 years.

3. Risk Factors (Memorization List)

Competency: Identifies risk factors contributing to complications and diabetes development.

You must recognize these factors in case scenarios. If a patient has these, they need screening regardless of age.

Demographics & History

  • Age ≥ 40 years.

  • First-degree relative with Type 2 diabetes.

  • Member of a high-risk population (African, Arab, Asian, Hispanic, Indigenous, or South Asian descent; low socioeconomic status).

  • History of prediabetes (IFG, IGT, or A1C 6.0-6.4%).

  • History of Gestational Diabetes (GDM).

  • History of delivery of a macrosomic infant.

Vascular Risk Factors

  • HDL-C: <1.0 mmol/L (males) or <1.3 mmol/L (females).

  • Triglycerides: ≥1.7 mmol/L.

  • Hypertension.

  • Overweight or Abdominal Obesity.

  • Smoking.

Associated Diseases & Conditions

  • Polycystic Ovary Syndrome (PCOS).

  • Acanthosis Nigricans (sign of insulin resistance).

  • History of Pancreatitis.

  • Hyperuricemia / Gout.

  • Non-alcoholic steatohepatitis (NASH).

  • Cystic Fibrosis.

  • Obstructive Sleep Apnea (OSA).

  • Psychiatric disorders (Bipolar, Depression, Schizophrenia).

  • HIV infection.

Medications Associated with Diabetes

  • Glucocorticoids.

  • Atypical Antipsychotics.

  • Statins.

  • HAART (Highly Active Antiretroviral Therapy).

  • Anti-rejection drugs.

4. The Screening Algorithm: What do the numbers mean?

Competency: Interpreting screening results.

When you screen with FPG or A1C, the result determines the follow-up interval. 

Result: Normal

  • Values: FPG <5.6 mmol/L AND A1C <5.5%.

  • Action: Rescreen as recommended (usually every 3 years).

Result: At Risk

  • Values: FPG 5.6 – 6.0 mmol/L OR A1C 5.5% – 5.9%.

  • Action: Rescreen more often.

  • Consider: A 75g OGTT if suspicious of T2D or high risk factors.

Result: Prediabetes

  • Values: FPG 6.1 – 6.9 mmol/L OR A1C 6.0% – 6.4%.

  • Action: Rescreen more often.

  • Consider: A 75g OGTT should be considered to check for Impaired Glucose Tolerance.

Result: Diabetes

  • Values: FPG ≥ 7.0 mmol/L OR A1C ≥ 6.5%.

  • Action: Confirm diagnosis (repeat test).

5. Special Clinical Notes

Schizophrenia

  • The incidence of T2D is 3 times higher in people with schizophrenia.

  • Antipsychotic medications further increase this risk.

Discordant Results

  • If you perform both FPG and A1C and they disagree (e.g., FPG is Normal but A1C is Prediabetes), treat the patient according to the test that is furthest to the right (the more severe result) on the algorithm.

The Role of OGTT (Oral Glucose Tolerance Test)

  • While FPG and A1C are the primary screening tools, the OGTT is not obsolete.

  • When to use: It is considered when FPG is 6.1–6.9 mmol/L or A1C is 6.0–6.4% to clarify the diagnosis.

  • Why: A1C misses approximately 50% of people who have prediabetes defined by an OGTT.

Reference:

Ekoe JM, Goldenberg R, Katz P. Screening for Diabetes in Adults. Canadian Journal of Diabetes. 2018;42:S16-S19. doi:10.1016/j.jcjd.2017.10.004
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CDE Diabetes

Flashcards: Definition, Classification & Diagnosis (Chapter 3)

Master the Numbers. Ace the Exam.

Welcome to the Interactive Flashcard Deck for Chapter 3 of the Diabetes Canada Clinical Practice Guidelines.

This chapter is heavily focused on memorization. To pass the CDE exam, you cannot just “understand” the concepts; you need to instantly recall specific diagnostic thresholds (down to the decimal point) and differentiate between similar-sounding conditions like Impaired Fasting Glucose and Metabolic Syndrome.

Ready to test your recall? Click the cards below to flip them.