To search this Diabetes Topics Catalogue, hold "Ctrl" + "f" (PC) or "Cmd" + "f" (Mac) and type in your search word. If problem opening PDFs, right click on the document, "save as" and save to desktop.
Consider giving all your patients the short list of Diabetes Resources for Patients.PDF (diabetes phone-lines, classes, urgent help, routine 1:1 help).
AHS - Misc Documents & Sites
- Consent-Authorizing a Representative
- DON SCN Documents & Resources
- MyHealth Records Portal for patients to review lab results and other information
- Patient and Caregiver Journal can be found on this AHS page. (Includes checklists of questions for patients to ask when referred to specialists).
Numerous apps are available to assist those with diabetes. See the heading COMPUTER below if your patient needs help accessing the internet, has no internet or no computer. These include apps from companies for specific glucose meters, sensors, insulin pumps as well as third party apps. Most allow patients to view data and/or send reports from the app or from an online cloud service directly to their clinicians. It's important for eduators to direct patients to send reports, since not all health authorities have the approval to use "Clinic" clouds (e.g. an online server for the clinician/program that stores the glucose data of just their patients.)
Forgotten App Passwords for Glucose Data:
- If on iPhone under phone settings > passwords > search the app name, tap to review the username & password. (There is no one location in Android phones to access all passwords.)
- Or open the specific app, then settings > user account, to learn the email account used to set it up. Use this email address to log into the corresponding cloud service ( Carelink, Clarity, Libreview, OneTouchReveal etc). Click "forgot password" to reset it if can't recall. The email used to set up the app must be used to sign into the online cloud service. Connect with the company IT or rep for help if needed.
- Additionally, although not ideal for the depth of data, a screenshot can be taken and emailed to a clinician.
Apps for "Bolus Calculators" or "Insulin on Board". We cannot endorse the accuracy of these apps.
- Ypsomed App: This app is intended to pair with the Ypsomed pump, but the option exists to choose MDI and see Insulin on Board.
- Lifescan Insulin Mentor has a bolus calculator that can be used independently from their meters, if desired. See the meters page and use <Ctrl + f> to search for ‘Mentor’.
See Carbohydrate Counting Heading below for related apps.
See the Diabetes Canada Quick Reference Guide for a short summary of screening, targets, glycemic therapies, cardiovascular protection, preventing hypoglycemia and goal seting.
- Assess Diabetes Risk/Screening:
- Assess Agenda:
- Assess Safety:
- Assess Targets and Complications:
- See our Diabetes Targets and Priorities page
- Assess if vascular protection medication required- See Diabetes Canada Interactive Tools
- Diabetes care flow sheet and targets (Diabetes Canada)
- Assess Patient Knowledge:
- If problems opening PDFs, right click, "save as", save to your desktop.
- Carbohydrate Counting Quiz - pdf, AHS
- MDI patient knowledge quiz (ICR, ISF, managing DKA, hypo)- pdf, AHS
- Managing Your Blood Sugars Worksheet -pdf, AHS
- Pump Annual Review: IPTP Self Assessment Questionnaire - pdf, AHS
- Pump: DKA Prevention in Pump - Practice Cases for Patient- pdf, AHS
- Pump: Intro to Pump Patient Questionnaire -pdf, AHS
A biosimilar insulin is highly similar to another insulin (with an expired patent). No differences in clinical performance are expected from the biosimilar in comparison to the original medication. Government drug plans, such as those in Alberta, often promote the use of biosimilars as they are frequently lower in cost. For use of biosimilar insulins in insulin pump brands, see here.
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). For suggested nutrient intakes in diabetes, see Diabetes Canada Guidelines Chapter 11 - Nutrition Therapy. Also see section under Nutrition heading below for Low Carbohyrate Diets.
Carb Counting Handouts
- Healthy Meal Planning for Diabetes (lists 15g carb choices). See the NFS Online Database in Nutrition Resources below. (AHS)
- Matching Insulin to Carbohydrates Handout under Diabetes -Type 1 heading below. (AHS-DCC)
- Basic Carbohydrate Counting (Diabetes Canada)
Other Carb 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 Basics
- 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.
We cannot verify accuracy of data. Some apps or websites have customers input data. Please advise patients to carefully consider options. Some may require subscriptions. The product manufacturer or label is always the best resource for processed foods.
- Canadian Nutrient File
- MyFitnessPal Recipe Calculator
- Self Nutrition Data
- Calorie King
- Sushi nutrient analysis
- Canadian Nutrient File (downloadable file)
- USDA Nutrient Database (online use)
- Alberta Healthy Living Program
Patients may self-register for Calgary AHLP Classes Online. If difficulties, call Calgary Zone Telephone: 1-844-527-1160 or visit their website. Those who need services in Cantonese, Mandarin, Hindi or Punjabi can state their language of choice when they call and an interpreter will be happy to assist them.
- Diabetes Canada Type 2 Live Virtual Classes
Diabetes Canada Type 2 Virtual Classes as well as their toll-free phone & email support.
- Diabetes Canada Type 1 Video Education Series
- Primary Care Networks (PCNs)
Encourage patients to contact their Primary Care Network (PCN) regarding classes. PCN information can be accessed through mypcn.ca
- Also see Diabetes Prevention
- Diabetes Canada
- Our resources:
- Read: Tips for Instructing Groups
- Read: 3 Minute Empowerment - Dr. Jacques Bedard
- Read: Motivational Interviewing in the Prevention and Management of Chronic Disease: Improving Physical Activity and Exercise in Line with Choice Theory.International Journal of Reality Therapy, 2008: 27(2):26-29.
- Read: Welch G, Rose G, Ernst D. Motivational Interviewing and Diabetes: What Is It, How Is It Used, and Does It Work? Diabetes Spectrum January 2006 Vol 19 (1): 5-11
- Visit and browse your PCN Learning Resources (ABSORB) for courses
- Visit and browse My Learning Link for AHS staff for courses
- See heading for Assessment Tools and Safety above
- Staying Healthy with Diabetes - Diabetes Canada handout
- See our Complicatons page
Some patients do not have access to a computer and/or internet or do not have adequate skills to help them navigate online. Unfortunately, they cannot benefit from servers that upload glucose or other data into reports or even from haing an email account. Please note the possible resources to help these patients.
- All Calgary Public Library (CPL) locations (except for Rocky Ridge) have computers with internet access and printers available for members to use.
- These computers don’t need to be booked. People need either a Calgary Public Library card (free if live in the city; can sign up by calling 403-260-2600 or in-person) or to connect with a staff member to get a guest internet-only card.
- CPL regularly has introductory technology programs. These can be booked online or by calling the library. Details are here. Usually these sessions are in person with safety measures per local COVID protocols.
- CPL has a volunteer-led program called Tech Mentors which assists members one-on-one with specific inquiries (e.g. setting up a gmail account) or assists members who need more individual help. This help is available either online or in person (but not at all sites, so members need to call to ask.)
- The Alex may have computer access, although it may be discontinued during COVID. Patients can call to ask 403-520-2260.
- Targets for CGM. See the relevant link in Diabetes Targets, A1c and Glucose Levels here.
- How to Analyze the AGP (type1better.com)
- Continuous Glucose Monitoring (CGM): The Basics (AHS)
- Glucose Sensors: Suggested Practices
- Dexcom Trend Arrows: Preventing High & Low Readings by Adjusting
- Libre Arrows: Scanning Frequency & Adjusting Insulin Using Trend Arrows
- Related pages:
- Cost Coverage Heading on this page, just scroll.
- Dexcom Clarity cloud server at https://clarity.dexcom.eu/
- LibreView cloud server
- Medtronic Guardian Connect CareLink cloud server
- CGM Brand Information page - for company contacts and more
- Skin Care Products
- Continuous Glucose Monitoring Home page.
- Benefits and Challenges of CGM
Patients are encouraged to meet with psychosocial services in their PCN or diabetes centre to review potential additional options available to help assist with the costs of managing diabetes. If there is nothing specific listed further down, patients could also consider approaching alternate groups such as:
- Lions/Lioness Clubs
- Royal Purple organization
- Larger companies/business as sometime either the business or employees may have funds they collect for community types of goodwill funding
Below are some resources for the cost of strips and medications in Alberta.
- Alberta 211 patients can call or visit https://www.ab.211.ca/ to find community resources and financial supports for other concerns including tax preparation services
- Income Support Contact Centre: Emergency support to help purchase medications is available to those who qualify. Patients can call Income Support Contact Centre 1-866-644-5135 (press 0) or fill in forms online
- Alberta Blue Cross Private – Patients are encouraged to ask their pharmacist if their private coverage allows for glucose test strips and/or sensors. Sensors may be included under different headings e.g. blood glucose meter or medical device.
- Alberta Blue Cross Formulary of Covered Medications: Interactive Drug Benefit List . The form for Special Authorization of GLP-1, DPP-4 or SGLT is here. All other SA forms: Blue Cross Forms page.
- Alberta Insulin Pump Therapy Program (IPTP)Those in the IPTP can receive up to 700 strips per 100 days, plus infusion sets or pods.
- Alberta Adult Health Benefit
- CALGARY: ACCESS to FOOD RESOURCES
- Dispensing Fees: Patients may investigate switching to pharmacies with lower dispensing fees e.g. Walmart and Costco
- GLUCOSE MONITORING SUPPLIES
- Alberta Government Sponsored Drug Programs
- Starting July 2021, Alberta Government Sponsored Drug Programs including SENIORS Alberta Blue Cross have changed their coverage for blood glucose test strips. See the Pharmacy Benefact Notice sent to Pharmacies from Alberta Blue Cross.
- Alberta Works Income Support
1-866-644-5135. They may be able provide emergency support for test strips to those who qualify.
- Abbott (Libre sensors) ...also see NIHB below.
Have the prescriber and patient fill in the Libre Compassionate Supplies Request. It must be filled in by a physician and involves verification of income. We've learned that a Blue Cross or Insurance Letter that declines coverage is also required. Short term, consider "Libre: Getting Started" program if available as provides one free sensor. See CGM Brand Information, Libre, Website/Company. Additionally, a Libre 2 STI Card (physical sample card) may permit some savings with each purchase re: dispensing or co-pay. For email versions of the card, contact your local Libre rep.
- Ascensia (Contour Meters) Compassionate Program
For patients in critical need, have them call 1-800-268-7200 to be assessed for a free meter and limited test strips on a one-time basis (e.g. 25 strips, although we are told amounts may vary). English and French customer service available.
- Brands with less expensive strips: Have patients investigate brands with less costly strips at their pharmacy, including GE200 meter which also has reductions though Innovicares Card.
- Dexcom does not have a compassionate program at this time. Note the information about NIHB, below. Select private insurance companies provide coverage (patients can call Dexcom Insurance Specialists at 1-844-832-1810 ext.2 for assistance in determining if they are covered.)
- Medtronic CGM
Medtronic CGM Access Program is for those on 670G or 770G with no CGM coverage. Those who qualify will receive sensors for $99 per month and free transmitter.
- NIHB (Non-Insured Health Benefits Program)
Libre and Dexcom sensors are covered under NIHB, for all First Nations and Inuit people with type 1 diabetes of any age and additionally, those 2-19 on any insulin. See this link for more details. or NIHB directly.
Steps for Coverage:
- Send prescription to pharmacy
- Pharmacy calls NIHB Exception Line at 1-800-580-0950
- Pharmacist to provide Patient NIHB #, DIN# (Dexcom DIN # 3-pack sensors 97799136, Dexcom Transmitter 97799135 or Libre2 Sensor 97799075), Prescriber Lic. #, Pharmacy #
- NIHB verifies they are on Insulin
Main Roche Webpage has link to obtain free meter with 10 strips. Also check clinic supply rooms for coupons to mail patients for 100 free lancets. These are redeemed online by patient and lancets are mailed.
- Benefits may be available through Alberta Government Sponsored Drug Programs
- Medications: Novo Nordisk Insulins NovoRapid, Tresiba, Glucagon
- Note: NovoRapid is only provided in 10 mL vials; the client must be taught syringe use.
- Clients without insurance can see if they are eligible for NovoRapid and/or Tresiba through the Novo Nordisk Diabetes Care Program online at https://nncare.ca/ or over the phone 1-833-595-1899.
- There are some eligibility questions (household income, number of dependents, province, and patient must have no insurance).
- To repeat, clinicians are to obtain a physical or a virtual NovoNordisk Diabetes Care Program Card (client ID) for their patient first (no patient information is required) before having the patient apply.
- Compassionate Glucagon is via the distributer. Click here to visit the NovoNordisk glucagon section of the Complete Medications Table.
- Medications: Sanofi
- Sanoficares.ca Medication Certificates: Patients visit, Sanoficares.ca , click "Download a certificate" (no personal information is required). They show the certificate via phone photo (or can print it) to the pharmacist to receive a free box. Once only. (1 box= 5 disposable pens of Apidra, Toujeo, Soliqua or 3 disposable pens of Toujeo Doublestar). The patient must have a prescription. When the patient needs more of the medication, they download another new certificate. Works best on mobile, and we've also used easily and quickly on MS Edge desktop browser.
- Prescribers may also request 6 month supply through a new online program (paper compassionate request forms no longer accepted). Program can be accessed through the website:www.innomarstart.com/sanofi (Access Code : SANOFI)
- Medications: Viatris
- 25% off copay certificate
- Cost reduction of 25% off either dispensing fee or purchase fee if paying out of pocket. No expiration date as of this time.
- Innovicares Card
- Government of Canada Disability Tax Credit – some people with type 1 diabetes may apply and be successful in receiving this tax benefit, which could assist with funds for glucose monitoring supplies.
- Psychosocial Resources - (links to heading below0
- Consider reviewing the costs (before addition of dispensing fees) for similar medications on the Complete Medication Table.
- Diabetes Canada Interactive Tools
- Clinical Practice Guidelines - online version
- Appendices: Diabetes Canada Flowsheets etc
- Managing type 2 diabetes during COVID-19: a guide for primary care providers
- Diabetes Education Line or 1-800-BANTING where a volunteer certified diabetes educator provides individualized answers and support.
- Webinars for those with diabetes
- Virtual diabetes education classes for those with type 2 diabetes.
COVID-19 and Pregnancy
- COVID-19: Pregnancy, Birth, Postpartum, Breastfeeding - Information for Expectant and New Parents (handout)
General Pregnancy Resources:
- Antenatal resources for healthcare providers (updated July 2019): Alberta Antenatal Pathway
- Resource provided to patients by their primary care team when pregnant or planning pregnancy: Healthy Parents, Healthy Children (healthy weight gain, exercise, etc.)
- Best Beginnings Program: Best Beginnings Referral Form
- Nutrition Guidelines for Pregnancy (Nutrition Services) - (see diabetes specific guidelines below)
Gestational Diabetes (GDM) Resources:
- Patient Video: Gestational Diabetes - How to manage with healthy eating and activity(DCC)
- Patient Video: Starting Insulin in Diabetes in Pregnancy (DCC)
- Patient Handout: Gestational Diabetes (Diabetes Canada)
- Patient Handout: After Gestational Diabetes (Diabetes Canada)
- Patient Handout: Metformin Use in GDM
- Fillable Food Record
- Fillable Blood Sugar Log with comments
- Fillable Blood Sugar Log with medications
Diabetes in Pregnancy Resources:
- Website resource for patients with GDM, type 1 or type 2 diabetes in pregnancy: diabetes-pregnancy.ca
- Nutrition Guidelines for Diabetes in Pregnancy (Nutrition Services- updated 2018)
- Forum for Injection Technique (FIT): Guidelines for insulin injection in pregnancy.
- Patient Handout:Pregnancy and Type 1 or Type 2 Diabetes
- Patient Handout:Type 1 and type 2 diabetes After Pregnancy
- Nutrition handouts for diabetes in pregnancy see Nutrition Resources below.
- AHS Virtual Diabetes Prevention Program:
Diabetes Services (AHS) & Referrals - Calgary Zone
- See Diabetes Services Calgary page for referral documents as well as links to rural and indigenous (Siksika, Morley) diabetes services, Diabetes in Pregnancy Programs (DIP) and endocinrologist consults.
- Type 1 diabetes: the basics PDF (Diabetes Canada)
- Type 1 Diabetes Education Review (Diabetes Canada and AHS documents in one PDF download)
- Diabetes Canada YouTube Videos for type 1 (see Classes heading above)
- Basic nutrition guidelines for type 1 diabetes (AHS)
- Activity and type 1 diabetes (AHS)
- How to Manage Illness in Type 1 Diabetes and Prevent DKA (sick days) (AHS)
- Glucagon and diabetes handout (AHS). See the Complete Medications Table for glucagon information (including Baqsimi).
- Matching carbohydrate to insulin (and using ISF - correction factors) - patient handout
- Low blood sugar: go to heading Hypoglycemia
- Diabetes and Driving (AHS)
- To search AHS Nutrition Database for handouts, see Nutrition Resources below.
- See Glucose Meters heading for logbooks and blank record books.
- See Lipohypertrophy webpage
- Type 2 Diabetes - The Basics (Diabetes Canada Handout)
- Search this page or Diabetes Canada's patient resources for more handouts
- Sign up for periodic emails reivewing new meds, gadgets, etc in diabetes (for heathcare providers)
- View archives
- Pumps & Pump Supplies:
- The Calgary Insulin Pumpers group (contact page is here) may accept them as their members may not all have insurance or Alberta Insulin Pump Therapy Program coverage.
- Richmond Square Pharmacy in Calgary may accept unused pump supplies. (403) 249-4346
- Medtronic pumps: Medtronic may help someone donate a Medtronic pump to someone they specifically know. It's possible the person receiving the pump pays $500 to have the warranty transferred. Medtronic takes the pump back and provides a new one. If this is someone in Alberta, it is preferred for them to go through the Alberta Insulin Pump Therapy Program (IPTP) for funding of supplies and pump.
- Insulin for LIfe no longer has their donation service.
- CUPS primary care clinic will accept diabetes supplies and unused insulin that has not expired. Supplies can be brought to the CUPS clinic. Please call first (403-221-8780 dial 1 to talk with primary care clinic) and they will instruct re: drop off.
- Patient Handout: Diabetes and Driving (AHS)
- Patient Handout: Drive Safe with Diabetes (Diabetes Canada)
- Diabetes Canada Guidelines Chapter on Driving
- Note that Physicians adhere to the CCMTA Drivers Medical Standards [Canadian Council of Motor Transport Administrators]. Any questions about interpretation should be directed to the CCMTA and the Alberta Ministry of Transportation. People using insulin will be required to submit a Medical Examination for Motor Vehicle Operators.
- Visit our Ucalgary Patient Website at www.endometab.ca for all Endocrinology & Metabolism Program, Calgary services as well as patient resources
- Or view just our diabetes services
- See heading for Physical Activity
Health Care Provider Foot Care Assessments and Resources
- Also see our Foot Care webpage
- The Diabetes Foot Health Self-Screening Tool: This tool has been developed to support patients in screening their feet at home, identify their overall risk of developing foot problems, and the actions to take depending on the risk level.
- Why a Proper Foot Assessment is Important- DON SCN Video
- Specialist Link Diabetes Foot Care Primary Care Pathway (One pager!)
- Foot Care Pathway: Alberta Diabetes Foot Care Clinical Pathway (DON SCN) Assessment Tools and Resources
- Additional reading: The American Podiatric Association's Guidelines
- Monofilaments - Reusable (with cleaning, appropriate for use on multiple patients):
- Monofilaments - Disposable (not for use on more than one patient):
Footcare Handouts and Patient Resources
- Encourage patients to ask their PCN about services. e.g. Mosaic PCN offers those living in their catchment area classes and individual appointments for foot care.
- Alberta Aids to Daily Living may provide therapeutic footwear or orthotics for those who qualify and who are prescribed this by a physician in one of Alberta's High Risk Foot Teams. In Calgary the clinic that can prescribe is the Zivot Limb Preservation Centre at PLC.
- DON SCN Alberta Foot Care Patient Handouts & Online Education
- Diabetes Canada Patient Handouts:
- Alberta Foot Care (previously Victoria Order of Nurses)
- College of Podiatric Physicians of Alberta website to find a current list of podiatrists and clinics in Calgary.
- Kerby Centre for Seniors Foot Clinics
- If finances are a concern, suggest patients call local podiatry services and ask what is charged for initial assessement and ongoing footcare appointments.
If patient has a wound refer to the Sheldon Chumir wound clinic.
- The Sheldon Chumir Wound Clinic information.
Fax Referrals to Community Care Access 403-943-1602
Fax both the Foot Risk Assessment Form together with the Wound Clinic referral form.
- Peter Lougheed Centre: Zivot Limb Preservation Centre information.
- Fax number: 403-943-6423.
- Fax both the Foot Risk Assessment Form together with the PLC referral form.
- IMPORTANT: Educators MUST include the name and info of the MD who referred to DCC (GP or Endo). Zivot will send the report back to that physician. You can include your name in the signature as an educator from Diabetes Centre Calgary and add "for Dr. ...(referring doctor)." As per usual charting standards, please inform the referring physician of the action you've taken.
- Serum fructosamine may be used as an alternative to Hemoglobin A1c. It indicates average glucose level over the previous 2-3 weeks.
- According to Medscape (https://emedicine.medscape.com/article/2089070-overview#showall) updated October 2019, the formula for comparing HbA1c to fructosamine is:
- HbA1c = 0.017 X fructosamine level (µmol/L) + 1.61
- Detailed infomation on serum fructosamine available in this review by Dr. Ghaznavi and Dr. McKeen.
- If you suspect your patient may have gastroparesis, you can advise they discuss with their endocrinologist or primary care physician.
- A patient handout is available on the AHS Nutrition Education handouts page here. Use the search box to search "gastroparesis". Refer to a dietitian.
- Physicians can consult Specialist Link with patient related gastroenterology questions.
- Glucagon and diabetes handout (AHS). See the Complete Medications Table for glucagon information (including Baqsimi).
- Simply put, GMI replaces the terms "Estimated A1c"and 'eA1c' that were used in glucose sensor reports. Eventually eA1c will be removed from most sensor reports. GMI estimates the A1c using average sensor glucose data of ideally ≥ 14 days. GMI may be reported in % or mmol/mol (as is A1c).
- GMI and A1c are not the same and may differ for various reasons including individual’s biology or a short-term fluctuation in glucose control.
- Convert GMI mmol/mol to GMI% (A1c conversion chart)
- Convert average sensor glucose to GMI% (Calculator)
- For GMI use in Medtronic reports, see here.
- Accuracy of blood glucose meters
- Glucose Meter Summary Sheet for Health Educators 2021 (Includes steps to manually access results etc)
- CGM- See CGM Heading for continuous glucose monitoring
- Cloud accounts and clinic upload boxes
- Diasend portal . The Diasend Professional Clinic box will upload Libre handheld scanners, glucose meters, most CGM cloud server data, most insulin pumps (Omnipod, Tandem, Ypsomed) and merge glucose and pump data. See the Diasend document: Interpretting Charts and Graphs.
- Glooko portal to access professional & personal accounts. (The clinic Glooko box currently doesn't upload Libre - Oct 2019.)
- In many cases, patient data is accessible via company specific cloud services or apps. See specific meter brand websites listed on Glucose Meters page or CGM Brands page. e.g Libre phone app users can view their data by signing into their cloud account on Libreview, Dexcom on Clarity.
- Diabetes Canada Interactive Tools for glucose monitoring frequency
- Glucose Meters page. Also includes link to the Genteel lancing device.
- Health Canada: Approved medical devices.
- Patient Handout: Managing your blood glucose (testing blood sugar, sick days (Diabetes Canada)
- DOWNLOADABLE LOGBOOKS / RECORD SHEETS
- 4 Day Food, Insulin and Blood Sugar Worksheet (AHS)
- Fillable food and glucose record sheet
- Your Blood Sugar Log Fillable PDF Versions:
- English: Your blood sugar log-Fillable PDF (AHS)
- French: Your blood sugar log-Fillable PDF (AHS)
- Spanish: Your blood sugar log-Fillable PDF (AHS)
- Arabic: Your blood sugar log-Fillable PDF (AHS)
- Urdu: Your blood sugar log-Fillable PDF (AHS)
- Tigrinya: Your blood sugar log - Fillable PDF (AHS)
- Traditional Chinese: Your blood sugar log - Fillable PDF (AHS)
- Vietnamese: Your blood sugar log-Fillable PDF (AHS
- Blank glucose record book (AHS)
- Glucose Log Book (Diabetes Canada)
- Pump records: 5 days: Glucose & insulin records for pump and 3 days: Blood glucose and insulin record for pump therapy
- Patient handout: A1c Testing for Adults - handout (AHS)
- Visit our A1c page for why A1c matters (research summaries) and what A1c is
- Diabetes Canada Interactive Tool - Individualizing A1c
- Video: Diabetes Canada's What, When, Why? Understanding A1c
- Glucose Wands (Canadian Orders, see page 72) or (U.S. orders).
Healthcare Provider Education
- Calgary area clients and staff may call 403-943-1920 to inquire about eligibility for homecare services.
- Homecare staff are not permitted to take insuiln orders or adjustments from educators. DCC educators please refer to their Medication Adjustment Policy for options (e.g. if familiy is adjusting instead, a certain consent is required).
- Patient PICTORIAL handouts:
- Patient handout: Hypoglycemia unawareness: When you don't feel your low blood sugar (AHS)
- Patient handout: Glucagon and diabetes (AHS)
- Educator reference: Troubleshooting Hypoglycemia (with and without insulin pump therapy)
Indiginous Health Services
- Indigenous Support Line: 1-844-944-4744: Support for issues related to referrals, culture, primary care, addictions mental health, and other general concerns. Poster is available here.
- NIHB (Non-Insured Health Benefits Program): Libre and Dexcom sensors are covered under NIHB. Patients to connect with their pharmacists once they have a prescription.
- AHS Clinical Policies & Procedures page is searchable. Click here.
- AHS Clinical Knowledge Topic Viewer - under "D" for diabetes. e.g. for DKA treatment and under "P" for Perioperative Management of Patients wiht Diabetes
- Provincial Diabetes Medication Adjustment Protocol (Adults) - e.g. AHS adjustment protocol for AHS educators
- Provincial Inpatient AHS Glycemic Policy: Glycemic Management Policy Suite (includes inpatient Hypoglycemia and Hyperglycemia Policies)
- Provincial in-hosptial insulin pump guidelines at www.ipumpit.ca
- Provincial AHS Insulin Safety & Diabetes Management for Health Care Professionals includes:
- General Diabetes Information
- Nutrition Information for Patients with Diabetes
- Basal Bolus Insulin Therapy (BBIT)
- Insulin Pump Therapy (IPT) – Safe Management in Acute Care
- Provincial Glycemic Management Policy Suite
- General Information on Insulin Safety
- Insulin Pen Information
- AHS Insulin Formulary Information
- Provincial: myLearningLink > Courses and Registration>Basic Diabetes Education - this is designed for inpatient staff.
- Provincial BBIT
- Basal Bolus Insulin Therapy (BBIT) in Hospital Self Study Guide (AHS - Provincial)
- Basal Bolus Insulin Therapy (BBIT): AHS educational materials for professionals
- Insulin Pump Therapy In Hospital: AHS processes and documents
- Provincial: Checking your blood glucose (sugar) level while you’re in the hospital
- BD AutoShield Duo Safety Pen Needle Video
- Calgary Zone Inpatient Diabetes Nurse Navigator: Click here for summary sheet of our role.
- Diabetes Services Search Engines, when referring to AB Clinics:
- Edmonton Zone Diabetes Services 780-735-2824 referral is here. Visit their site for referral criteria here.
- Inpatient foot care options: Inpatient units may consult geriatric untis (e.g. Units 57 & 58 Acute Geriatrics at RGH) to learn their local practices for inpatient nail/foot care. Different options may be used in the province, some including long term stay clinics contracting a foot care nurse whereas others inviting families to hire a private foot care nurse. General resources: www.ahs.ca/footcare and https://www.albertapodiatry.com/
- Please see related headings on this page:
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
- Alberta Health Services Pump Resources
- Alberta Health: Alberta Insulin PumpTherapy (IPT) Program Site
- AHS Approved Specialist Physicians for Alberta IPT program
- Insulin Pump Therapy Patient Learning Module for Patients (online) and accompanying questionnaire.
- Guidelines for safe management of insulin pump therapy in hospital (AHS)
- Troubleshooting Hypo and Hyperglycemia in insulin pump therapy
- Skin care products for infusion site management
- Patient Handouts & Forms:
- Assessment Quizzes (DKA, MDI, Carb, Annual Review click to go to Assess)
- Basal testing worksheet- Checking and adjusting basal rates in insulin pump therapy (AHS)
- Coming off the pump (AHS)
- DKA- Prevention of Diabetic Ketoacidosis (DKA) in Insulin Pump Therapy (AHS)
- DKA prevention in insulin pump: Practice Cases (pdf)
- Emergency / Urgent Care Insulin Pump Document
- IPTP Patient Responsibility Agreement
- PATIENT INFORMATION- INSULIN PUMP PROGRAM - DIABETES CENTRE CALGARY
- Records: Blank pump glucose/insulin records
- See the patient website for pump brand contacts as well as hands-on for pump and CGM brands monthly at the Carriage House Inn in Calgary.
- Support Group: Calgary Insulin Pumpers
- Other: Comparison of AID pump systems Canadian and Comparison of Automated Insulin Delivery US devices (pumps).
- Other: Commentary on Automated Insulin Delivery: Six Universal Observations and Understandings
Periodically, consider reviewing the following with those using insulin. In practice, glucose levels are frequently impacted by one or more of the following. Perhaps consider an annual "Insulin Review" with patients to touch base on:
- role of insulin
- type and action(s) of insulin(s) prescribed and carbohydrate requirements
- use of insulin delivery device and accessories
- time that insulin is administered (e.g. before or after meals etc)
- storage (in the fridge, no freezing) and expiry of insulin (see Complete Medication Table for duration at room temperature)
- injection sites and rotation
- pen needle length (e.g. not 12 mm, to avoid intramuscular injections)
- barriers to giving all injections, if any
- impact of missed or late injections
- travel (e.g. 2x supply in carry-on)
- basics of how and when to self-adjust bolus and basal insulin if appropriate (use of ICR and ISF; targets used with ISF)
- when and how to seek help (Consider giving the handout: Diabetes Resources for Patients. It contains a list of urgent concerns.)
- hypoglycemia (prevention, symptoms, treatment)
- hyperglycemia/DKA (prevention - ketone testing, symptoms, treatment)
Insulin Safety - AHS Provincial
- 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 insulin. 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
- Diabetes Canada Resources
- Getting started with insulin handout;
- DCC staff also to print Medication Supply Checklist to provide patient.
- Insulin Pen Start Checklist for Healthcare Professionals
- Traditional Chinese: Getting started with insulin (handout)
- Video: How to Inject Insulin Step by Step Guide length 7m:39s
- Video: Insulin Pen, What You Need to Know length 2m:22s
- Video: Introduction to Insulin length 2m:45s
- Alberta Health Services (AHS) Resources
- Insulin start formulas
- Low Blood Sugar (handouts - link to heading)
- Diabetes and Driving (handout)
- Average Insulin Action Time (handout)
- Inpatient hospital staff resources (AHS login is required): Insulin Safety & Diabetes Management Toolkit for Health Care Professionals
- Patient Video: Starting Insulin in Diabetes in Pregnancy (DCC)
- Forum for Injection Technique (FIT): FIT teaching handouts
- List of usermanuals for injection devices (pens) and injection aids
- For more detailed information on insulin visit the Complete Medication Table.
- Also see Inpatient Diabetes Resources
- Rarely, patients prefer syringes. There are numerous videos on how to prep and administer insulin via syringe. This link is but one.
Ketone Testing Supplies
Patients testing ketones have access in Alberta to:
- Urine ketone test strips
- Abbott Blood ketone test strips used in the appropriate device e.g. Libre 1 or Libre 2 hand held reader. Although these readers are intended to "scan" Libre glucose sensors, they can also be used to manually measure blood ketones and blood glucose, when using the appropriate Abbott blood test strips for each. Unfortunately, the product boxes do not indicate that these handheld readers can also be used for blood ketone measurement and blood glucose measurement.
Knowledge Resource Services (KRS - AHS "Library")
- Knowledge Resource Services provides AHS employees access to journals, Lexicomp and other resources.
- KRS Learning How to Use Resources (sign up for live session or click associated link for video e.g. Finding Full Text Articles)
- Impact of Marijuana use on Diabetes Management:
- Review Diabetes Canada Position Statement on Recreational Cannabis Use in Adults and Adolescents With Type 1 and Type 2 Diabetes (2019)
- Marijuana may also indirectly impact diabetes management through its negative effects on self-care practices, decision making, appetite, judgement, memory or other effects.
- Review Diabetes Canada Position Statement on Recreational Cannabis Use in Adults and Adolescents With Type 1 and Type 2 Diabetes (2019)
- 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:
- Decreased: Memory, concentration, reaction time, coordination, decision-making abilities, ability to judge distances
- Increased: Heart rate, sleepiness, anxiety, fear, panic, paranoia, delusions, hallucinations, mood disturbances, psychotic symptoms and appetite
- ( Health Effects of Cannabis Factsheet Canada.ca; and Nat. Inst. of Drug Abuse U.S, )
- Duration of Cannabis Impairment and Side Effects:
- “Cannabis Impairment: There is no standard waiting time to drive after using cannabis. If you are using cannabis, do not drive. Find an alternative.” (Cannabis Impairment- Canada)
- The effects of smoked cannabis may last 6 hours or longer, ingested cannabis 12 hours or longer (Health Effects of Cannabis Factsheet, Canada) and medicinal cannabis up to 48-72 hours (e.g. nabilone for treatment of nausea in chemotherapy. (product monograph)
- For more information visit:
- Cannabis in Canada: Get the Facts (Government of Canada)
- www.drugcocktails.ca (enter a prescription medication ie. Insulin, search and it will list interactions with alcohol, illicit drugs, tobacco or marijuana.)
- Alberta Health Services's
- Medic Alert offers a subscription service with their medical alert bracelets. The bracelets are engraved with key health concerns and a phone number. This allows first responders to call a centralized Medic Alert phone number 24/7 to receive health and family contact information about the person wearing the I.D.
- Various jewellers may offer medical identification bracelets with custom engraving. There is no service fee attached if not associated with Medic Alert.
Generalized Summary: (scroll a few inches for more options for pump)
- Basal Insulin:
20% reduction in basal insulin the night before and morning of a procedure. Tresiba (degludec) may need to be reduced 2-3 days prior. (No reduction is suggested for fasting labwork unless individually required for safety.)
- Bolus Insulin:
The day(s) of clear fluid preparation, consider reducing meal bolus by 20%.
The morning of the procedure, hold bolus insulin until eating after the procedure.
For hydrogen breath test for small intestine bacterial overgrowth, consider reducing the bolus by 20% for the75g glucose required for the test.
- Meds other than insulin:
The morning of the procedure, hold other diabetes meds until eating after the procedure. Consider holding SGLT-2 two days before colonoscopy prep to reduce the risk of DKA.
- Individualization and more:
These suggestions need to be individualized according to the patient's current glucose values, risk for hypoglycemia and other factors. See handouts below for additional instructions for specific tests.
Patient Education for Medical Procedures (AHS myHealthAB):
- Adjusting Your Diabetes Medicine & Diet for Fasting Blood Tests
- Adjusting Your Diabetes Medicine & Diet for a Hydrogen Breath Test (HBT) for Lactose intolerance
- Adjusting Your Diabetes Medicine & Diet for a Hydrogen Breath Test (HBT) for Small Bowel Overgrowth
- Adjusting Your Diabetes Medicine & Diet for a Gastroscopy or EGD
- Adjusting Your Diabetes Medicine & Diet for a Barium Enema or Colonoscopy
Algorithm for the Safe Use of Insulin Pump during Procedures and Surgery
There are resources for the safe use of insulin pump therapy in hospital. Some of these guidelines may also apply to outpatient procedures requiring local anesthesia or conscious sedation, in particular this resource: Algorithm for the Safe Use of Insulin Pump during Procedures and Surgery. Alternately, click the image below to enlarge.
For patients that come off pump for procedures and have insulin replaced by IV or manual BBIT, please instruct on how to safely resume basal insulin in pump and automated delivery of correction or basal insulin if being used (AutoMode, Control IQ, Loop, APS etc). This will vary depending on how insulin was replaced when the pump was removed, how much of that replacement will still be active and for how long.
- AHS Medication Policies. Use a keyword to search policies by clicking here.
- Adjustment Guidelines
- Cost Coverage information: See heading Cost Coverage heading above
- Detailed diabetes medication information:
- Medication Intro page
- Complete Medication Table.
- Choosing Next Line Agents: Diabetes Canada Interactive Tools.
- NOTE 2020 Diabetes Canada Updates Type 2 Pharmacologic Glycemic Management of Type 2 Diabetes in Adults: 2020 Update PDF (or via DOI or webpage) as well as The User Guide FAQ.
- Choosing Next Line Agents: Summary Table for Medication Class Benefits (CKD, HF, CVD, Weight)
- Therapeutic Considerations for Renal Impairment (click for heading below)
- Indications: Health Canada Drug Product Database for product monographs
- AHS Lexicomp... Insite>Teams>Pharmacy>Drug information (on left)>Popular Drug Info (on right, scroll down).
- Inpatient Providers: See Inpatient Diabetes Resources heading above
- Patient Medication Handouts:
- Also visit AHS Lexicomp... Insite>Teams>Pharmacy>Drug information (on left)>Popular Drug Info (on right, scroll down). Search the drug name, Then scroll for patient education handouts. Ctrl +P (choose Microsoft Print to PDF and save).
- Alpha-glucosidase inhibitor
- Biguanide (metformin)
- DPP-4 inhibitor
- GLP-1 receptor agonist
- Sulfonylurea insulin secretagogue
- Non-sulfonylurea insulin secretagogue
- SGLT-2 inhibitor
- SGLT-2 STOP DKA in Type 1
- See Hypoglycemia Heading above
- SADMANS Sick Day Medication List (Diabetes Canada)
- Medication & Herbal Advice Line 24 hrs/day (AHS) 1-888-944-1012
- For SGLT see Hyperglycemia (DKA, HHNS) in Safety Checklist and SADMANS in bullet above and "SGLT-2 STOP DKA in Type 1" under patient medication handouts (here).
- www.drugcocktails.ca - Enter a prescription medication (ie. Insulin) and search and it will list any interactions with alcohol, illicit drugs, tobacco or marijuana. (It also gives the street names of the substances listed.)
- Related heading Marijuana and Diabetes
- Alberta Health Services Nutrition and Food Services (AHS NFS).
- Nutrition guidelines for all clinicians are available at AHS Nutrition Guidelines for Healthcare Providers .
- Publicly Available AHS Nutrition Education Materials (Click on Diabetes).
- Calgary: Access to Food Resources
- Canada's Food Guide (Health Canada)
- Diabetes Canada Nutrition Handouts - click "management". For HCP professional guidelines, see Diabetes Canada Guidelines Chapter 11 - Nutrition Therapy. Click here to order the poster "Beyond the Basics". They also have a separate Position Statement on Low Carbohydrate Diets for Adults wtih Diabetes (2020). (The statement does not look at diabetes in pregnancy. For all others consider: addressing an agreement to treat hypoglycemia appropriately and discussing differences between DKA and dietary ketosis.)
- Natural Medicines Comprehensive Database
- PEN: Practice Based Evidence in Nutrition for healthcare professionals.(This link is for access from AHS server computers only). Or visit PEN's home site for subscription information.
- Diabetes Canada Position Statement on Low Carbohydrate Diets for Adults wtih Diabetes (2020) The statement does not look at diabetes in pregnancy. For all others consider: addressing an agreement to treat hypoglycemia appropriately and discussing differences between DKA and dietary ketosis.
- For a short summary of considerations for people asking about ketogenic diets, please see this page.
- Diabetes Canada more detail: Diabetes Canada Position Statement on Low-Carbohydrate Diets for Adults With Diabetes: A Rapid Review
- Obesity Canada
- Dr. Sharma's Obesity Notes
- Calgary Adult Bariatric Speciality Clinic
- Alberta Obesity Centre
- For quick access to Calgary area pharmacy phone and fax numbers, click on this link from the Calgary Region Pharmacists webpage.
- Patient's pharmacy and pharmacy phone number are usually available on Netcare when viewing medications.
- Alberta Healthy Living Program's supervised exercise classes (AHS) Calgary Zone 403-9-Health (403-943-2584)
- Prescription to Get Active (no cost or low cost access to physical activity programs in the community)
- Patient handout: Physical Activity and Type 1 Diabetes
- Diabetes Canada Exercise Resources for Patients
- Calgary Family Medicine Physician Directory identifies the PCN a family doctor is attached to. If not in the directory, the GP is likely not part of a PCN.
- MyPCN.ca shows Calgary PCN coverage maps and websites
- https://albertafindadoctor.ca/ to find a family doctor.
- Patients from any PCN can refer themselves for (or units can call to arrange) an individual appointment for diabetes with a CFPCN RD, RN, pharmacist, SW or Behavioral Health Consultant. They can visit https://cfpcn.ca/ , click Services, choose the health professional and follow the instructions on that page (soon, those instructions will include online booking!)
- Mosaic PCN
- Patients from Mosaic PCN can refer themselves for an individual diabetes appointment with a Mosaic RD, RN, pharmacist, SW or Behavioral Health Consultant. They can visit http://mosaicpcn.ca/, click Programs & Services, choose either Primary Health Care Team or other service (Social work, mental health etc) and follow the instructions on that page.
- Key Mental Health Resources
- MENTAL HEALTH HOTLINE 1-877-303-2642. Translation services available.
- 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.
- Alberta 211 (call or text 211) or https://ab.211.ca/ . This is Alberta’s online directory to help you navigate to resources for mental health, finances, addiction, crisis, disability, employment, food, housing, indigenous peoples, legal & more.
- Alberta Supports 1-877-644-9992 province-wide (TTY: 1-800-232-7215) https://www.alberta.ca/alberta-supports.aspx Alberta Supports can help you access more than 30 programs and 120 services for seniors, people with disabilities, job seekers, parents and families, homelessness, financial assistance, abuse, and family violence prevention.
- Access Mental Health 403-943-1500 or The Distress Centre distresscentre.com to help you find the right resource.
- Diabetes Canada Handouts: Diabetes and Mental Health; Steps to Stress Management; Understanding the Stress Response
- Educator Tool: Diabetes Distress Scale
- See Stress topics below
- AHS: Help in Tough Times
- AHS: COVID-19 and Your Mental Health
- AHS: Coping & Connection for Children & Families during COVID-19
- Canadian Psychological Association: Managing COVID-19 Anxiety Resources
- The Wellness Society: Coronavirus Anxiety Workbook
- AHS Staff: Wellness And Mental Health Guide
- AHS - CAMHC COVID-19 Toolkit
- AHS Self-Care Tip Sheets: COVID-19 worker supports
- Supporting Your Mental Health: COVID-19 worker supports
- Wellness Check-in Overview during COVID-19- Employee Family Assistance Program
- Canada Together Wellness Portal: The federal government provides Canadians access to free supports and counselling for mental health and substance use. This includes counselling via phone, videoconference and text. They offer access to immediate crisis support via text for adults and a separate number for front-line workers. A counselling session can be accessed immediately via 1-866-585-0445.
- Also see Community Connect YYC below under General Social Services.
- General Social Services
- Community Connect YYC connects Calgary communities with low or no-cost and barrier free access to virtual or in-person counselling services. If individuals are looking to access a counselling session rapidly, they can click on “Rapid Access Counselling” on the homepage.This initiative is supported by the City of Calgary, and seeks to create a “one-stop shop” for community members who are in need of affordable counselling supports, or other social service including basic needs help.
- Grocery Resources - See Nutrition Heading above
- Social worker services are available for clients of the Diabetes Centre Calgary. They may also be available for clients of Calgary Area Primary Care Networks (PCNs).
- Visit or Call 211: Free, confidential, multilingual, 24 hour information on government and community based health and social services, including tax preparation services!
- Supports and Services for People with Diabetes - Diabetes Canada list
- Diabetes Supplies
- Also see the heading above for Cost Coverage
- 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).
- Stress and Your Health, click to visit "Stress" heading above
- 2022 Ramadan starts the evening of April 2.
- Diabetes Canada: Ramadan Guidelines
- The International Diabetes Federation (IDF): 'Diabetes and Ramadan Practical Guidelines'
- Notes from the 2014 educator rounds session on Ramadan. Presenters were Dr. Hanan Bassyouni, Ali Chatour, Raman Virk, Satvir Malhi and Ruchi Chopra.
- See the University of Calgary's Diabetes Clinical Trials Unit
- Predispose Study - Aims to Assess if CGM use immediately after delivery in people with Gestational Diabetes can predict the future development of Type 2 Diabetes.
- Diabetes Canada Renal Dosing Chart (click the chart to enlarge)
- Product monographs may be more up to date for eGFR levels and SGLT-2i as research advances. See Canada's Drug Product Database. Remember that SGLT-2’s may not be as effective for glucose lowering with lower GFR’s but may be initiated for cardiac/renal protective effects.
- Alberta Chronic Kidney Disease Clinical Pathway
- Alberta Kidney Care Programs (previously SARP) and the AKC-S Renal Diabetes Nurse
- Jump to
- Diabetes Considerations in Stages 4-5 Renal Disease (DCC older and shorter summary document).
- For Diabetes Centre Calgary staff (interim process):
- Stage 4 (GFR 15 - 30): Check if the nephrologist or endocrinologist is adjusting insulin doses. If not, use the guidelines for Stages 4-5 directly above.
- Stage 5 (GFR <15): If patient is on hemodialysis or peritoneal dialysis, insulin adjustment is the responsibility of the nephrologist or the endocrinologist. Defer to them. For patients on conservative management (no dialysis) insulin adjustment may be done by the nephrologist/endocrinologist, or the educator if that is the preference of the specialist physicians. Use the guidelines above.
- See our Retinopathy page for information and resources.
- Canadian National Institute for the Blind (CNIB)
- Staying Safe with Diabetes When Sick or Dehyrated (Diabetes Canada)
- See heading Diabetes - Type 1 for How to Manage Illness in Type 1 Diabetes and Prevent DKA
- SADMANS Sick Day Medication List (Diabetes Canada)
- See the Skin Care page for products for CGM, insulin pumps and infusion sets.
- Becoming Tabacoo Free - AHS list of resources
- AHS list of resources (provider and patient) for tobacco intervention
- Alberta Quits - patient resources
- Consider directing clients to their family doctor, PCN and pharmacist to ask if they have in-house classes or programs for quitting smoking.
Steroids & Glucorticosteroids (GC)
- See page 29, section 13b. Suggestions for Patients Receiving Corticosteroid Therapy under BBIT.CA > Education & Resources > How to BBIT for Prescribers.
- General guidelines:
- As the dose of the glucocorticoid is being modified, the dose of
antihyperglycemic needs to be modified
- Insulin dose can be adjusted by half the percentage of the GC dose change. For example, when GCs are increased or reduced by 50%, insulin dose is suggested to be increased or reduced by 25%, respectively.
- As the dose of the glucocorticoid is being modified, the dose of
- Prednisone impact on glycemia
- Given in morning, hyperglycemia occurs in afternoon and evening (duration 16-18 hours)
- Peak about 4-8 hours after administration
- Hyperglycemic effect diminishes by morning
- If administered in multiple doses, hyperglycemia may be present throughout the day (mostly post prandial)
- IV hydrocortisone (multiple doses) and Dexamethasone impact on glycemia
- Levels expected to peak about 5 hours after IV administration
- May cause increased glycemic effect through 24 hour period
- May have slight decline in overnight fast
- If patients have blood glucoses equal or greater than 10.0 mmol/L,
- blood glucose lowering therapy should be started.
- Suggested blood glucose lowering therapies: see page 29 of section 13b. Suggestions for Patients Receiving Corticosteroid Therapy under BBIT.CA > Education & Resources > How to BBIT for Prescribers.
- Reduction or Cessation of Steroid
- Reduce insulin or sulfonylurea dose with reduction of steroid dose
- Significant risk of hypoglycemia if insulin dose or sulfonylurea not reduced in line with blood glucose monitoring and anticipated dose tapering
- With once daily steroid especially, there is a high risk of hypoglycemia in the evening,as steroid effect tends to wear off overnight
- Also click to view COVID specific resources above, under Psychosocial Resources
- The Diabetes Distress Scale] -Diabetes Canada (and Using the Diabetes Distress Scale)
- Steps to Stress Management Diabetes Canada
- "ABATE" the Stress: Understanding the Stress Response - Diabetes Canada
- Stress and Your Health - video, AHS
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 may also involve groups with 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)
- No longer available: Transitioning Youth with Diabetes in Calgary (AHS) Twitter: @TYDcalgary; Facebook:TYP Calgary
- Connected in Motion (type 1 diabetes)
- I Challenge Diabetes
- Roche offers Accu-chek Engage - an online behavioral change support program, for patients who are using the Accu-chek meter. Sign up information is here. Note that patients can register without linking their account to a clinic.
- Canada Virtual: Support Group for 14-24 year olds with type 1 diabetes
- Search notes:
- Use all of these with caution. They have not been reviewed by Health Canada and do not direct patients to local Canadian resources.
- The best way to search for resources is to use"ctrl"+F (pc) or command+F (mac) and type in the language (e.g Punjabi), then hit enter to take you to each listing on this page with that language in its name
- You can also browse the items below
- You may also find possible translated materials under topic headings above e.g. Starting Insulin, Hypoglycemia
- Diabetes Canada's Ressources Françaises webpage.
- Diabetes Canada's Chinese Handouts and Resources
- Quebec Diabetes Association , specifically the page on Living with Diabetes, The 4 Pillars of Balance . Suggestion: Once on website, click English in the top right of desktop brower. Find the page/handout you want. Then check French for the corresponiding French versions. E.g. consider this English Hypoglycemia page and the pdfs on right of it; then click French in top right of webpage (NOT google services) and you should be viewing their corresponding French version of hypo page with all the French PDFs.
- Diabetes Toolbox (French site)- an online diabetes resource for health care professionals: www.schalifouxdiabete.com
- Canada's Food Guide (French and 19 other languages)
- Tagalog (Filipino):
The Mosaic Primary Care Network and the Filipino Healthcare Providers Group of Calgary provided these handouts. The English resource documents from which these were adapted are in brackets.
- Just the Basics - Mahalagang Pamumuhay Para sa Diabetes Tagalog/Filipino (English resource doc is here)
- What is Diabetes - Ano ang Dyabetes Tagalog (English resource doc is here)
- Carbohydrate in Foods Tagalog (no portions included; the English resource doc is here)
- Managing Your Diabetes Tagalog - Paano Manatiling Malusog Kahit may Diabetes (English resource doc is here)
- Driving and Hypoglycemia Tagalog
- Driving Guidelines and Diabetes Tagalog
- Hypoglycemia Tagalog
- Sadmans Tagalog
- Filipino Plate
- AHS staff visit Lexicomp (insite>pharmacy services>Lexicomp (right hand side) --Type in medication or disease condition, scroll to click patient education, English shows as default choose "select language" in upper right.
- www.ethnomed.org: Diabetes information with pictures in a variety of languages (Amharic, Somali, Vietnamese, Khmer, Oromo, Tigrinya, etc.)
- BC Fraser Health Region: South Asian Nutrition Resources (Punjabi)
- Canada's Food Guide is available in over 20 languages
- Dietitians of Canada: Picture list of common South Asian snacks, carbohydrates, proteins, side dishes, desserts and beverages
- Diabetes Canada: Just the Basics South Asian (in English)
- Carbohydrate counts of common ethnic foods: Asian, Chinese, Japanese, Indian, Korean, Filipino
- Carbohydrate guide for common Somali foods
- Carb counting- Adapted for African and Caribbean communities (PEN)
- Enhancing Cultural Competency - A Resource Kit for Health Care Professionals (Note that this resource is from 2009 and may contain outdated material. Educators are encouraged to view pages 108 and 109 for the ETHNIC and LEARN models of asking culturally sensitive questions).
- National Diabetes Service Scheme - Australian Government Initiative: (if using any patient handouts please inform patients not to call the contact #'s listed) Many language handouts and videos including resources for Diabetes in Pregnancy. Languages include: Arabic, Bengali, Chinese (simplified and traditional), Dari, Farsi, Greek, Hindi, Italian, Karen, Khmer, Korean, Macadonian, Nepali, Punjabi, Samoan, Sinhalese, Somali, Spanish, Tagalog, Tamil, Thai, Tongan, Turkish, Urdu and Vietnamese.
- Other Punjabi resources (also search Punjabi on this Topics Catalogue): National Diabetes Services Australia; How To Use Insulin Injection (Punjabi) Dr. Nikhil Gupta M ; MyWayDiabetes; Fraser Health - On the Road to Diabetes Health (Type 1 or Type 2) booklet;
- One Touch Reveal App is available in the following languages: Czech, French, German, Italian, Japanese, Polish, Portuguese, Slovenian, Spanish, Vietnamese. In order for the user to benefit from these languages, they would need to surf into the phone settings menu, then select the app (OneTouch) then they will find a section (Language) from there they can change to any language they want.
- See our Travel page for advice regarding preparation, medication adjustments, and links to patient handouts
- See Diabetes Canada Interactive Tools for Vascular Risk Assessment Tool
- AHS list of cardiovascular resources for healthcare providers
- Canadian Cardiovascular Society Resources (apps, pocket guides, guidelines etc)
- Heart and Stroke Foundation of Canada
- Patient handout: Understanding and Managing Your Blood Pressure - Hypertension Canada
- Patient handout: Healthy Eating for Healthy Blood Pressure - Hypertension Canada
- Hypertension Canada home site Canada home site
- Hypertension Canada patient resources (how to measure blood pressure at home)
- See Nutrition Resources above
- Canadian Diabetes Educator Certification Board (CDECB) and the Essentials Diabetes study guides (you can purchase monthly access and discontinue when not needed) https://essentialsdiabetes.com/pricing/
- Diabetes Canada
- Diabetes Toolbox (online Diabetes resource for health care professionals sponsored by Diabetes Quebec, AstraZeneca and Roche).
- Find a family doctor - Calgary Zone
- Health Link call 811
- International Diabetes Federation
- Inform Alberta
- National Aboriginal Diabetes Association (NADA)
AHS: Alberta Health Services
DCC: Diabetes Centre Calgary, AHS
DC: Diabetes Canada (previously Canadian Diabetes Association - CDA)