Diabetes Topics Catalogue

To search this Diabetes Topics Catalogue, hold "Ctrl" + "f" (PC) or "Cmd" + "f" (Mac) and type in your search word. 

Consider giving all your patients the short list of Diabetes Resources for Patients (diabetes phone-lines, classes, urgent help, routine 1:1 help).

AHS - Misc Documents & Sites


Assessment Tools and Safety

Carbohydrate Counting

The following are some of the many tools available for determining the carbohydrate content of foods. Not all sources of carbohyrate content may be acccurate (particularly for apps).

CHO Counting Handouts

Other CHO Info and Resources

  • Labels: Subtract grams of fibre from the grams of carbohydrate for the portion on the label.
  • Restaurant websites: Many fast food and other restaurants have nutrient analysis posted online for their products.
  • Diabetes Canada Educator Resource: Helpful hints for educators using Beyond the Basic
  • Ordering Beyond the Basics
  • Nutrient Analysis Apps: Through smart phones' app stores or AppCrawlr .
  • General carbohydrate estimates. One carbohydrate choice contains 15 grams of carbohydrate (after the fibre is subtracted).A general guideline for the number of carbohydrate choices to eat per meal is 2-4 for most women and 4-6 for most men. For snacks: 0-1 for women and 0-2 carb choices for men.
    ​One Carb Choice (15g) equals:
    • 1 slice of bread
    • 1/2 cup (125 mL) cooked pasta/potato/other starch
    • 1 medium piece of fruit
    • 1 cup (250 mL) of milk
    • 1 tbsp (15 mL) of sugar, jam or honey.

Nutrient Analysis Websites (we cannot verify accuracy of data):


Classes for Diabetes (for patients)

Client Centered Counseling (Motivational Interviewing)

Complications

Continuous Glucose Monitors (CGM)

Diabetes Canada Clinical Practice Guidelines

Diabetes Services (AHS) - Calgary Zone

  • See Diabetes Services Calgary page for referral documents as well as links to rural and indigenous (Siksika, Morley) diabetes services and endocinrologist consults. 

Diabetes in Pregnancy

General Pregnancy Resources: 

 Gestational Diabetes (GDM) Resources:

Diabetes in Pregnancy Resources: 

Diabetes-Type 1

Diabetes Updates 

  Donating Supplies

Driving

Emergency Wait Room Times

Exercise

  • See heading for Physical Activity 

Foot Care

Health Care Provider Foot Care Assessments and Resources

Footcare Handouts and Patient Resources

Calgary Foot Care Services: Low - Moderate Risk 

Calgary Foot Care Services: High Risk 

Gastroparesis 

  • Patient handout: Gastroparesis (AHS)
  • If you suspect your patient may have gastroparesis, you can advise they discuss with their endocrinologist or primary care physician. 
  • Physicians can consult Specialist Link with patient related gastroenterology questions. 
  • Patients may be interested in volunteering for a research study involving gastroparesis. See Research Opportunies below. 

Glucose Meters


HbA1c - Hemoglobin A1c

Healthcare Provider Education

Homecare

  • Calgary area clients and staff may call 403-943-1920 to inquire about eligibility for homecare services.

Hypoglycemia (Low Blood Sugar)

Inpatient Diabetes Resources (Alberta Hospitals)

Patient Handout: Visit the top of this page for the handout Diabetes Resources for Patients (AHS) Diabetes Resources for Patients (AHS) 

Inpatient AHS Glycemic Policy: Glycemic Management Policy Suite (includes inpatient Hypoglycemia and Hyperglycemia Policies) 

Inpatient Diabetes Educator Triage (for AHS, Calgary zone only): Inpatient Diabetes Educator Triage and Referral Guidelines; Updated February 2019 

Inpatient Provider Resources:

Insulin Adjustment

Insulin Allergy 

Insulin allergies were more common with bovine and porcine insulins. As technology has improved with recombinant and analogue insulins, the reported prevalence of insulin allergy is 0.1-0.3%.
If your patient lets you know about a reaction to their insulin, it is important to gather appropriate history and inform the patient’s family physician or diabetes specialist. Assessment considerations: 

  • Type of reaction? *A diffuse, systemic response requires prompt assessment and treatment*
    -local (immediately around injection site) or diffuse (covering large area of body)?
    -skin only, or systemic (airway/breathing)?
    -Does it resolve, or worsen over time?
  • Relationship to insulin administration? 
    -immediately -1 hour after injection
    -delayed- 2-24 hours after injection
  • Type of insulin?
  • Changes or interruptions to insulin?
  • History of other allergies? (many needles use silicon or lubricants)
  • Any other triggers such as change to medications, diet, cosmetics, detergents or other autoimmune diseases?

Treatment considerations to be discussed with physician or diabetes specialist, depending on severity of reaction:

  • Observe and optimize patient’s injection technique to avoid any possible site irritations (i.e. proper site rotation, not injecting where clothes/belts rub, not massaging after injection, not using alcohol wipes)
  • Cool site before and after injection
  • Possible use of insulin port devices if allergy to pen needles
  • Avoid insulin if possible
  • Switch to a different type or brand of insulin
  • Use of anti-histamines for symptom relief
  • Rapid desensitization protocol – complex protocol that involves starting insulin at very low doses in an intensive care setting

Insulin Pump

  • Roche Accu-Chek Combo or Spirit (No longer for sale in Canada)
    • IMPORTANT NOTICE Roche insulin pumps are no longer sold in Canada: For support of existing Roche pumps call 1-800-688-4578 or email This email address is being protected from spambots. You need JavaScript enabled to view it.
    • User Guide for Spirit pump. 
  • Tandem t:slim X2
  • YpsoPump by YpsoMed Canada 
  • Support Group: Calgary Insulin Pumpers

Insulin Safety - AHS Provincial

Insulin Senstivity Factor (ISF)

Insulin Starts and Injectables

  • Useful Healthcare Provider Actions
    • Explaining insulin benefits
    • Demonstrating the injection process
    • Collaborating (collaborative style)
    • The LEAST useful was an authorative style

A study identified the healthcare provider actions (above) that helped patients who didn't want to start insulin change their mind and start insuiln. Reference: William H. Polonsky et. al. Identifying solutions to psychological insulin resistance: An international study. Journal of Diabetes and its Complications. Available online 17 January 2019. https://doi.org/10.1016/j.jdiacomp.2019.01.001

Marijuana (Cannabis) and Diabetes 


  • Impact of Marijuana use on Diabetes Management:
    • No current conclusive evidence exists to suggest significant or consistent direct impact of marijuana on glycemic management in diabetes (as of 2018). More research is needed to investigate the role of cannabinoids in glycemic control.
    • Marijuana may indirectly impact diabetes management through its negative effects on self-care practices, decision making, appetite, judgement, memory or other effects.
  • Health Effects of Marijuana: The two main cannabinoids in marijuana are THC and CBD. Health effects of cannabis apart from recreational use for the THC (“high” or relaxed) or medicinal use of TCH and/or CBD (reduced nausea, vomiting, pain, spasticity, seizures) can include the following:

Medical Procedures

Medication Resources

Nutrition Resources

Obesity Resources

Physical Activity (Exercise)

Primary Care Networks (PCNs)

Psychosocial Resources 

  • Mental Health
    • Calgary Distress Line: 403-266-4357 (403-266-HELP) Delivers 24-hour support, free crisis counseling and resource referral services to Calgary and the surrounding area.​
    • Access Mental Health: 403-943-1500 helps direct people to the most appropriate mental health services in the Calgary zone.
    • Patient handout: Diabetes Canada Diabetes and Mental Health
    • See Stress topics below
  • General Social Services
  • Diabetes Supplies
    • Compassionate diabetes supplies: Family doctors can call the 1-800 number of insulin or medication companies to discuss and request forms for compassionate care supplies. Many companies offer this, but not all.
    • Emergency support to help purchase medications is available to those who qualify. Patients can call Alberta Works Income Support 1-866-644-5135 (press 0).
    • The Government of Canada offers a Disability Tax Credit for those who qualify. This requires physician help in completing forms. Income taxes must be completed prior to sending into the federal government.
    • Also view the section on Alberta resources in the Diabetes Canada's PDF called Diabetes Resource Manual (or view other province's resources).

Research Opportunities - Studies Recruiting Patients

  • REMIT: This trial is researching the effectiveness of a new approach to diabetes treatment, with the intention of inducing a remission of type 2 diabetes. The study involves 12 weeks of intensive lifestyle interventions, oral and injectable diabetes medications. The REMIT Criteria are here. Posted Feb 2019.
  • SCORED: This trial is a randomized, double blind, placebo controlled study to demonstrate the effects of sotagliflozin, an SGLT2 and SGLT1 inhibitor, on cardiovascular and renal events in patients with T2DM who also have cardiovascular risk factors and moderately impaired renal function. This study is a Phase 3, CV outcomes trial. The SCORED Criteria are here. An office poster for SCORED is here. Posted Feb 2019. 
  • Gastroparesis and Diabetes: If your patient has diabetes and symptoms of nausea/vomiting, abdominal pain, bloating or early fullness after meals they may qualify for this study. Particpants must be over 18, have diabetes for at least 5 years, have the symptoms listed or diagnosed with gastoparesis for at least 3 months. Those who qualify will receive study-related exams, evaluations and study drug at no cost. For more information please contact Lynn at 403-592-5045 or This email address is being protected from spambots. You need JavaScript enabled to view it. 

Renal Disease (Chronic Kidney Disease - CKD)

Retinopathy 

Safety Checklist 

Sick Days (Illness)

Skin Care 

  • See the Skin Care page for products for CGM, insulin pumps and infusion sets.

Smoking Cessation

Stress

Support Groups

Please note that most of these supportive groups or organizations are not managed, reviewed or endorsed by Alberta Health Services (AHS).

  • Alberta Healthy Living Program (AHS) “Better Choices, Better Health groups for type 2 diabetes. 403-943-2584
  • Calgary Neuropathy Association
  • Calgary Insulin Pumpers
  • Diabetes Canada Calgary 403-266-0620 ask about events, groups (all types of diabetes)
  • Transitioning Youth with Diabetes in Calgary (AHS) Twitter: @TYDcalgary; Facebook:TYP Calgary 
  • Connected in Motion (type 1 diabetes)
  • JDRF Southern Alberta - type 1 diabetes. Contact Chelsie 403.255.7100 This email address is being protected from spambots. You need JavaScript enabled to view it.
  • I Challenge Diabetes

Translated Diabetes Materials (Language, Ethnic/Cultural Resources) 

Travel

  • Patient handout: Travel and Diabetes (AHS)
  • Medication Adjustment Flowchart (AHS) with Timeline worksheet
  • Fillable Timeline Worksheet for Travel (downloads as .doc; doesn't open in browser)
  • Frio Insulin Cooling Cases may be ordered through their Canadian website. Please see the brochure for 10% discount code. Rep: This email address is being protected from spambots. You need JavaScript enabled to view it. 

Vascular Risk

Websites and Directories

 

Handout Key:

AHS: Alberta Health Services

DCC: Diabetes Centre Calgary, AHS

DC: Diabetes Canada (previouslyCanadian Diabetes Association - CDA)