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www.dmscan.ca. The DM-SCAN program has been made possible through the support of Merck Canada Inc. The opinions expressed in this material are those of the authors and do not necessarily reflect the views of Merck Canada Inc . Steering Committee Members Western Canada:

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www.dmscan.ca

The DM-SCAN program has been made possible through the support of Merck Canada Inc.

The opinions expressed in this material are those of the authors and do not necessarily reflect the views of Merck Canada Inc.


  • Steering Committee Members

  • Western Canada:

    • Lori Berard, RN, CDE – Nurse and Certified Diabetes Educator – Winnipeg, MB

    • Keith Bowering, MD – Endocrinologist – Edmonton, AB

    • Keith Dawson, MD – Endocrinologist – Vancouver, BC

    • Ross Tsuyuki, PharmD – Academic Pharmacist – Calgary AB

    • Vincent Woo, MD – Endocrinologist – Winnipeg, MB

  • Ontario:

    • Alice Cheng, MD – Endocrinologist – Toronto, ON

    • Stewart Harris, MD – Primary Care Physician/Diabetes Expert – London, ON

    • Anatoly Langer MD – Cardiologist – Toronto, ON

    • Lawrence Leiter, MD (Chair) – Endocrinologist – Toronto, ON

    • Peter Lin, MD – Primary Care Physician – Toronto, ON

    • Dana Whitham, RD, MSc, CDE – Dietitian and Certified Diabetes Educator – Toronto, ON

  • Quebec:

    • Jean-Marie Ekoé, MD – Endocrinologist – Montreal, QC

    • Carl Fournier, MD – Primary Care Physician – Montreal, QC

    • Jean-Francois Yale, MD – Endocrinologist – Montreal, QC

  • Atlantic Canada:

    • Thomas Ransom, MD – Endocrinologist – Halifax, NS


Program objectives
Program Objectives

  • To evaluate and gain insight into the current status and management of patients with Type 2 Diabetes in Canada in the primary care setting

  • To highlight the public health burden of Type 2 Diabetes

  • To identify management gaps to help design educational programs of practical value to primary care physicians


Program overview
Program Overview

Assess the current management of patients with type 2 diabetes by completing a simple one-page Data Collection Form on ALL patients seen as part of routine clinical practice on or as close as possible to World Diabetes Day (November 14, 2012)


National Physician and Patient Representation

MDs – N = 479

DCFs – N = 5123

  • Avg. number of DCF*s/MD - 11

NL

MDs – n=17

DCFs – n=208

BC

MDs – n=41

DCFs – n=365

AB

MDs – n=29

DCFs – n=233

SK

MDs – n=3

DCFs – n=21

MB

MDs – n=19

DCFs – n=249

QC

MDs – n =45

DCFs – n=400

ON

MDs – n=270

DCFs – n=2990

NS

MDs – n=28

DCFs – n=295

NB-PEI

MDs – n=27

DCFs – n=362

* DCF – Data Collection Form


Practice setting
Practice Setting

50% of the physician participants identified being a part of a Family Health Team


Physician practice geographic setting
Physician Practice – Geographic Setting


Practice survey question on average how many patients with type 2 diabetes do you see in a week
Practice Survey Question:On average, how many patients with Type 2 Diabetes do you see in a week?


Practice Survey Question:Approximately what proportion of your patients have their type 2 diabetes co-managed by an allied health care professional (in your office or local diabetes education centre)?


Practice survey question please identify the greatest barriers to managing patients with diabetes
Practice Survey Question:Please identify the greatest barriers to managing patients with diabetes:

Top Five Responses:

Patient non-compliance

Patient resistance

Constraints on physician’s time

Financial barriers

Lack of support for the physician


Patient demographics
Patient Demographics

Female Sex: n=2353 Available Records 4707

Age: n=5090

Duration of T2DM: n=5062

* Data presented as mean (SD)

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Patient ethnicity
Patient Ethnicity

N = 4971

152 records unavailable

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Summary of patient bmi categories
Summary of Patient BMI Categories

N = 5123*

N for each category was variable due to missing values, <10% in each case.

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Health behaviours
Health Behaviours

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Glycemic and renal profile
Glycemic and Renal Profile

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Insulin use by number of injections per day
Insulin Use by Number of Injections per Day

% of patients

* NIAHA – Non Insulin Antihyperglycemic Agent

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Glycemic management
Glycemic Management

N = 4477

* NIAHA - non-insulin antihyperglycemic agent

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


A1c values achieved
A1C Values Achieved

N = 5103

% of patients

A1C (%)

In 81% of patients, the A1C goal set by the physicians was ≤7%.

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


A1c 7 attainment rates based on duration of diabetes
A1C <7% Attainment Rates based on Duration of Diabetes

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Lipid profile
Lipid Profile

N = 5069

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Lipid management
Lipid Management

N = 4153

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Ldl c values achieved
LDL-C Values Achieved

N = 5069

% of patients

LDL-C (mmol/L)

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Ldl c values achieved presence and absence of vascular disease
LDL-C Values Achieved – Presence and Absence of Vascular Disease

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Lipid control and management of dm scan patients
Lipid Control and Management of DM-SCAN Patients

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Blood pressure profile
Blood Pressure Profile

Systolic Blood Pressure: N = 5103, Diastolic Blood Pressure: N = 5099

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Blood pressure management
Blood Pressure Management

N = 4946

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Blood pressure values achieved
Blood Pressure Values Achieved

N = 5099

% of patients

SBP / DBP (mm Hg)

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Distribution of Antihypertensive Therapy Strategies Prescribed to Patients with Blood Pressure >130/80 mmHg

N = 1494

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Guideline targets achieved for a1c ldl c and blood pressure
Guideline Targets Achieved for A1C, LDL-C and Blood Pressure

% of patients

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Patient comorbidities
Patient Comorbidities LDL-C and Blood Pressure

% of patients

L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89


Has glycemic management improved over the last decade
Has glycemic management improved over the last decade? LDL-C and Blood Pressure

Note: All data reported as mean

1Harris S, et al. Diabetes Res Clin Prac. 2005;70(1):90-97.

2Braga M, et al. Can J Cardiol. 2010;26(6):297-302.


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