Building Competency in Diabetes Education THE ESSENTIALS

PATHOPHYSIOLOGY| 3-31

Use of drugs associated with diabetes: o Glucocorticoids o Atypical antipsychotics o Statins o

•

Highly active antiretroviral therapy ⱡ

Anti-rejection drugs

o o

Other (see Appendix 2)

• Other secondary causes (see Appendix 2) A1C, glycated hemoglobin; CV , cardiovascular; GDM , gestational diabetes; HDL-C , high-density lipoprotein cholesterol; HIV , human immunodeficiency virus-1; IFG , impaired fasting glucose; IGT , impaired glucose tolerance. *Associated with insulin resistance. Ɨ The incidence of type 2 diabetes is at least three times higher in people with schizophrenia than in the general population. Using data collected in 1991, the prevalence of diabetes was assessed in >20,000 individuals diagnosed with schizophrenia. The rate of diagnosed diabetes was 9% to 14%, exceeding rates for the general population prior to the widespread use of new antipsychotic drugs. ‡ ⱡ HIV and HAART increase the risk of prediabetes (lGT) and type 2 diabetes by 1.5- to four-fold compared to the general population. § Obstructive sleep apnea is an independent risk factor for diabetes (hazard ratio 1.43). Reprinted from Diabetes Canada 2018 Clinical Practice Guidelines (1) Screening for type 2 diabetes involves informal assessment of risk factors or the individuals at risk can be encouraged to use validated tools, such as CANRISK, available on the Internet. The following comprehensive algorithm summarizes different methods for screening for diabetes risk factor assessment and laboratory tests. Its practical application increases timely and accurate detection of prediabetes and diabetes through appropriate diagnostic tests. To yield the maximum benefit, the specific sequence of different laboratory tests, their correct interpretation, and communication to the person, need to be ensured.