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<br /> FOCUS ON<br /> DIABETES<br /> from<br /> RESEARCH<br /> Glucose-responsive insulin and glucagon delivery<br /> improves short-term glucose control and reduces<br /> the risk of hypoglycemia in type 1 diabetes<br /> REVIEW<br /> Risks and bene ts of intensive blood<br /> lowering in patients with type 2 diabetes<br /> PRACTICE<br /> A purulent foot ulcer in a man<br /> with diabetes<br /> COMMENTARY<br /> Choosing the right<br /> angiotensin-receptor blocker:<br /> still controversial<br /> Brought to you by an unrestricted educational grant from<br /> Q: Why should patients get only<br /> a number when they can also<br /> get helpful information?<br /> A:<br /> New<br /> Over 90% of patients said:<br /> “It's easy to use and makes<br /> results simple to understand.” 1 Colour-coded indicators for<br /> low, high and <a title="CMAJ - Focus on Diabetes page 1" href="http://viewer.zmags.com/publication/69a152e6?page=1"> FOCUS ON DIABETES from RESEARCH Glucose-responsiv</a> <a title="CMAJ - Focus on Diabetes page 2" href="http://viewer.zmags.com/publication/69a152e6?page=2"> Q: Why should patients get only a number </a> <a title="CMAJ - Focus on Diabetes page 3" href="http://viewer.zmags.com/publication/69a152e6?page=3"> FOCUS ON DIABETES Editorial from 51 Approac</a> <a title="CMAJ - Focus on Diabetes page 4" href="http://viewer.zmags.com/publication/69a152e6?page=4"> Q : Pourquoi les patients devraient- il</a> <a title="CMAJ - Focus on Diabetes page 5" href="http://viewer.zmags.com/publication/69a152e6?page=5"> CMAJ JAMC Medical knowledge that matters Foc</a> <a title="CMAJ - Focus on Diabetes page 6" href="http://viewer.zmags.com/publication/69a152e6?page=6"> Q: Why should patients get only a number </a> <a title="CMAJ - Focus on Diabetes page 7" href="http://viewer.zmags.com/publication/69a152e6?page=7"> CMAJ Editorial Diabetes: diagnosis and treatment</a> <a title="CMAJ - Focus on Diabetes page 8" href="http://viewer.zmags.com/publication/69a152e6?page=8"> Q : Pourquoi les patients devraient- il</a> <a title="CMAJ - Focus on Diabetes page 9" href="http://viewer.zmags.com/publication/69a152e6?page=9"> CMAJ Research Comparative effectiveness of angio</a> <a title="CMAJ - Focus on Diabetes page 10" href="http://viewer.zmags.com/publication/69a152e6?page=10"> Research telmisartan-mediated activation of PPA</a> <a title="CMAJ - Focus on Diabetes page 11" href="http://viewer.zmags.com/publication/69a152e6?page=11"> diabetes aged 66 years and older who started trea</a> <a title="CMAJ - Focus on Diabetes page 12" href="http://viewer.zmags.com/publication/69a152e6?page=12"> Research sis and procedure codes. We used the O</a> <a title="CMAJ - Focus on Diabetes page 13" href="http://viewer.zmags.com/publication/69a152e6?page=13"> blockers to be time-dependent covariables, using </a> <a title="CMAJ - Focus on Diabetes page 14" href="http://viewer.zmags.com/publication/69a152e6?page=14"> Research common structural features, important </a> <a title="CMAJ - Focus on Diabetes page 15" href="http://viewer.zmags.com/publication/69a152e6?page=15"> 10. Derosa G, Fogari E, D'Angelo A, et al. Meta</a> <a title="CMAJ - Focus on Diabetes page 16" href="http://viewer.zmags.com/publication/69a152e6?page=16"> Research CMAJ Glucose-responsive insulin and gl</a> <a title="CMAJ - Focus on Diabetes page 17" href="http://viewer.zmags.com/publication/69a152e6?page=17"> period, with 47% of those nights involving at lea</a> <a title="CMAJ - Focus on Diabetes page 18" href="http://viewer.zmags.com/publication/69a152e6?page=18"> Research During visits involving dual-hormo</a> <a title="CMAJ - Focus on Diabetes page 19" href="http://viewer.zmags.com/publication/69a152e6?page=19"> Research A 14 12 10 8 Concentration, </a> <a title="CMAJ - Focus on Diabetes page 20" href="http://viewer.zmags.com/publication/69a152e6?page=20"> Research During control visits, participants</a> <a title="CMAJ - Focus on Diabetes page 21" href="http://viewer.zmags.com/publication/69a152e6?page=21"> characteristics of the participants are listed in</a> <a title="CMAJ - Focus on Diabetes page 22" href="http://viewer.zmags.com/publication/69a152e6?page=22"> Research at the time of glucagon delivery, and </a> <a title="CMAJ - Focus on Diabetes page 23" href="http://viewer.zmags.com/publication/69a152e6?page=23"> Mean plasma glucose levels did not differ betw</a> <a title="CMAJ - Focus on Diabetes page 24" href="http://viewer.zmags.com/publication/69a152e6?page=24"> Research 18. Atlas E, Nimri R, Miller S, et </a> <a title="CMAJ - Focus on Diabetes page 25" href="http://viewer.zmags.com/publication/69a152e6?page=25"> CMAJ Research Differential mortality and the exc</a> <a title="CMAJ - Focus on Diabetes page 26" href="http://viewer.zmags.com/publication/69a152e6?page=26"> Research Methods Study populations In this retr</a> <a title="CMAJ - Focus on Diabetes page 27" href="http://viewer.zmags.com/publication/69a152e6?page=27"> predictors shown to be signi cant in the univari</a> <a title="CMAJ - Focus on Diabetes page 28" href="http://viewer.zmags.com/publication/69a152e6?page=28"> Research the time of diabetes diagnosis and mal</a> <a title="CMAJ - Focus on Diabetes page 29" href="http://viewer.zmags.com/publication/69a152e6?page=29"> ronmental factors such as glycemic and blood pres</a> <a title="CMAJ - Focus on Diabetes page 30" href="http://viewer.zmags.com/publication/69a152e6?page=30"> Research particular attention to diabetes in pr</a> <a title="CMAJ - Focus on Diabetes page 31" href="http://viewer.zmags.com/publication/69a152e6?page=31"> Conclusion In this competing-risks analysis, Firs</a> <a title="CMAJ - Focus on Diabetes page 32" href="http://viewer.zmags.com/publication/69a152e6?page=32"> Research CMAJ Effectiveness of group medical vi</a> <a title="CMAJ - Focus on Diabetes page 33" href="http://viewer.zmags.com/publication/69a152e6?page=33"> Methods We used the PICO (population, interventi</a> <a title="CMAJ - Focus on Diabetes page 34" href="http://viewer.zmags.com/publication/69a152e6?page=34"> Research value by dividing the number of appoin</a> <a title="CMAJ - Focus on Diabetes page 35" href="http://viewer.zmags.com/publication/69a152e6?page=35"> Research Target systolic BP (< 130 mm Hg) reach</a> <a title="CMAJ - Focus on Diabetes page 36" href="http://viewer.zmags.com/publication/69a152e6?page=36"> Research BP outcome Not measured </a> <a title="CMAJ - Focus on Diabetes page 37" href="http://viewer.zmags.com/publication/69a152e6?page=37"> BP outcome Not measured Not measured </a> <a title="CMAJ - Focus on Diabetes page 38" href="http://viewer.zmags.com/publication/69a152e6?page=38"> Research ments attended per year. We did not an</a> <a title="CMAJ - Focus on Diabetes page 39" href="http://viewer.zmags.com/publication/69a152e6?page=39"> 2 mm Hg in diastolic blood pressure has been asso</a> <a title="CMAJ - Focus on Diabetes page 40" href="http://viewer.zmags.com/publication/69a152e6?page=40"> Research References </a> <a title="CMAJ - Focus on Diabetes page 41" href="http://viewer.zmags.com/publication/69a152e6?page=41"> Af liations: School of Nursing (Housden, Wong), </a> <a title="CMAJ - Focus on Diabetes page 42" href="http://viewer.zmags.com/publication/69a152e6?page=42"> Commentary CMAJ Choosing the right angiotensin-</a> <a title="CMAJ - Focus on Diabetes page 43" href="http://viewer.zmags.com/publication/69a152e6?page=43"> metabolic pro le, as shown by lower glucose leve</a> <a title="CMAJ - Focus on Diabetes page 44" href="http://viewer.zmags.com/publication/69a152e6?page=44"> Commentary CMAJ The future of care for type 1 d</a> <a title="CMAJ - Focus on Diabetes page 45" href="http://viewer.zmags.com/publication/69a152e6?page=45"> els in the physiologic range. Glucagon opposes th</a> <a title="CMAJ - Focus on Diabetes page 46" href="http://viewer.zmags.com/publication/69a152e6?page=46"> Review CMAJ CME Risks and bene ts of intensive</a> <a title="CMAJ - Focus on Diabetes page 47" href="http://viewer.zmags.com/publication/69a152e6?page=47"> of 90 mm Hg or lower (45 events) compared with a </a> <a title="CMAJ - Focus on Diabetes page 48" href="http://viewer.zmags.com/publication/69a152e6?page=48"> Review trials.16 Thus, the potential for intera</a> <a title="CMAJ - Focus on Diabetes page 49" href="http://viewer.zmags.com/publication/69a152e6?page=49"> those at highest global risk (i.e., with multiple</a> <a title="CMAJ - Focus on Diabetes page 50" href="http://viewer.zmags.com/publication/69a152e6?page=50"> Review management of hypertension: blood</a> <a title="CMAJ - Focus on Diabetes page 51" href="http://viewer.zmags.com/publication/69a152e6?page=51"> CME CMAJ Review Approach to the patient with at</a> <a title="CMAJ - Focus on Diabetes page 52" href="http://viewer.zmags.com/publication/69a152e6?page=52"> Review of the condition itself has become appar</a> <a title="CMAJ - Focus on Diabetes page 53" href="http://viewer.zmags.com/publication/69a152e6?page=53"> enzymes involved in β cell glucose sensing and me</a> <a title="CMAJ - Focus on Diabetes page 54" href="http://viewer.zmags.com/publication/69a152e6?page=54"> Review expensive genetic testing.3 Where availa</a> <a title="CMAJ - Focus on Diabetes page 55" href="http://viewer.zmags.com/publication/69a152e6?page=55"> discerned only with careful follow-up. Ketoacid- </a> <a title="CMAJ - Focus on Diabetes page 56" href="http://viewer.zmags.com/publication/69a152e6?page=56"> Review therapy. β cell recovery is not easy to </a> <a title="CMAJ - Focus on Diabetes page 57" href="http://viewer.zmags.com/publication/69a152e6?page=57"> Thus, insulin treatment may be introduced earlier</a> <a title="CMAJ - Focus on Diabetes page 58" href="http://viewer.zmags.com/publication/69a152e6?page=58"> Guideli ne CMAJ Reco</a> <a title="CMAJ - Focus on Diabetes page 59" href="http://viewer.zmags.com/publication/69a152e6?page=59"> Guideline 1,400,000 6 1,200,000 5 1,000,</a> <a title="CMAJ - Focus on Diabetes page 60" href="http://viewer.zmags.com/publication/69a152e6?page=60"> Guideline Recommendations A summary of the reco</a> <a title="CMAJ - Focus on Diabetes page 61" href="http://viewer.zmags.com/publication/69a152e6?page=61"> recommend routinely screening every 3–5 years wit</a> <a title="CMAJ - Focus on Diabetes page 62" href="http://viewer.zmags.com/publication/69a152e6?page=62"> Guideline Design Randomized Table 2: Summa</a> <a title="CMAJ - Focus on Diabetes page 63" href="http://viewer.zmags.com/publication/69a152e6?page=63"> were extended using a new effectiveness model tha</a> <a title="CMAJ - Focus on Diabetes page 64" href="http://viewer.zmags.com/publication/69a152e6?page=64"> Guideline been validated only in a cross-sectio</a> <a title="CMAJ - Focus on Diabetes page 65" href="http://viewer.zmags.com/publication/69a152e6?page=65"> nomic costs. However, no studies were found that </a> <a title="CMAJ - Focus on Diabetes page 66" href="http://viewer.zmags.com/publication/69a152e6?page=66"> Guideline guidelines recommend starting with ri</a> <a title="CMAJ - Focus on Diabetes page 67" href="http://viewer.zmags.com/publication/69a152e6?page=67"> 25. Feig DS, Zinman B, Wang X, et al. Risk of d</a> <a title="CMAJ - Focus on Diabetes page 68" href="http://viewer.zmags.com/publication/69a152e6?page=68"> CME Practice CMAJ Decisions Impaired awarenes</a> <a title="CMAJ - Focus on Diabetes page 69" href="http://viewer.zmags.com/publication/69a152e6?page=69"> Practice Box 1: Factors in the diagnosis and man</a> <a title="CMAJ - Focus on Diabetes page 70" href="http://viewer.zmags.com/publication/69a152e6?page=70"> CME Practice CMAJ CME Decisions A purulent fo</a> <a title="CMAJ - Focus on Diabetes page 71" href="http://viewer.zmags.com/publication/69a152e6?page=71"> Practice Table 1: Classification of severity and</a> <a title="CMAJ - Focus on Diabetes page 72" href="http://viewer.zmags.com/publication/69a152e6?page=72"> Practice CMAJ Decisions Diabetes in an older </a> <a title="CMAJ - Focus on Diabetes page 73" href="http://viewer.zmags.com/publication/69a152e6?page=73"> be cautious about recommending weight loss when f</a> <a title="CMAJ - Focus on Diabetes page 74" href="http://viewer.zmags.com/publication/69a152e6?page=74"> Practice prognostic importance of diagn</a> <a title="CMAJ - Focus on Diabetes page 75" href="http://viewer.zmags.com/publication/69a152e6?page=75"> CMAJ Practice Clinical images Massive gastric</a> <a title="CMAJ - Focus on Diabetes page 76" href="http://viewer.zmags.com/publication/69a152e6?page=76"> Salon CMAJ Questioning the assumptions about ty</a>