Related Posts Plugin for WordPress, Blogger...

New 2018 Diabetes Canada Guidelines - Weight Management

>> Monday, April 30, 2018




As an author of the Weight Management chapter of the new 2018 Diabetes Canada Clinical Practice Guidelines, I'm thrilled to share with you some key points and exciting changes!

So what is new since the last guidelines in 2013?

1.  People first language.  We have made an important change in the entire 2018 Diabetes Canada guidelines in the way we talk about obesity.  Obesity is a diagnosis, and not a way to describe a person.  Thus, instead of the terminology 'overweight or obese people', the correct terminology is 'people with overweight or obesity'.  This is a critical step in breaking down the stigma against obesity!


2.  New information on medications for weight management in type 2 diabetes.  Liraglutide (Saxenda) is a new medication available for weight management in Canada since the last guidelines.

(note: Naltrexone/Bupropion (Contrave) is now approved in Canada as well, but this approval occurred after the literature reviews for the Guidelines were completed, so is not included in this iteration)

Medications for weight management have not been adequately studied in people with type 1 diabetes.


3.  Updates on bariatric surgery:

  • Gastric banding is not as effective as other bariatric procedures for type 2 diabetes control or remission.  
  • Predictors of who is more likely to enjoy type 2 diabetes remission after bariatric surgery include a shorter duration of diabetes, younger age, not needing insulin preoperatively, and higher preoperative serum C-peptide (a marker of insulin production). 
  • An update on the effect of bariatric surgery on complications of diabetes is discussed as well.
  • The BMI criteria for bariatric surgery remain unchanged.  Evidence of risk and outcomes of bariatric surgery for people with a BMI of 30-35 is limited and cannot be recommended at this time. 
  • Bariatric surgery has not been adequately studied in people with type 1 diabetes. 



KEY MESSAGES: 

1. Sustained weight loss of 5% or more can improve diabetes control and cardiovascular risk factors.

2.  In people with diabetes and obesity, weight loss and improvement in diabetes control can be achieved with healthy behaviour interventions.  Weight management medications can improve diabetes and metabolic control.

3.  Bariatric surgery may be considered appropriate for people with diabetes and obesity.

4.  When selecting the most appropriate diabetes medications, the effect on body weight should be considered.



KEY MESSAGES FOR PEOPLE WITH DIABETES: 

1. When you have diabetes, having overweight or obesity increases your risk for complications.

2.  Healthy behaviour modifications, including regular physical activity and eating well can help with your blood sugar control, and reduce your risk for other health problems associated with diabetes.

3.  Your diabetes health care team can help you with weight management.  For some people with diabetes, weight management medications and bariatric surgery may be helpful.



Follow me on twitter! @drsuepedersen


www.drsue.ca © 2018

0 comments:

A HEARTFELT WELCOME!

I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!


Are you ready to change your life? Let's begin our journey together, towards a healthier, happier you!!




  © Blogger templates Palm by Ourblogtemplates.com 2008

Back to TOP