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Clinical Guidelines and Best Practice

Essential guidelines and best practices for effective clinical decision-making

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British Columbia Diabetes Guidelines
 

This guideline, updated in 2024, outlines care objectives for preventing, diagnosing, and managing diabetes in adults aged 19 and older. It emphasizes systems and approaches to improve care for most people, most of the time.

2024 Canadian Clinical Practice Guidelines 

Now updated in 2024, the quick reference guide to the Diabetes Canada Clinical Practice Guidelines for managing Type 2 Diabetes - essential recommendations for optimal care.

2018 Diabetes Canada Clinical Practice Guidelines

Note, this guideline has been updated and should be used for reference only. In 2018, Diabetes Canada Clinical Practice Guidelines Expert Committee have compiled a comprehensive clinical practice guideline for the prevention and management of diabetes in Canada.

Diabetes Canada Clinical Practice Guidelines VIDEOS

If you prefer to watch the Diabetes Canada Clinical Practice Guidelines in video format, this series of 38 videos covers it all.

Type 2 Diabetes Diagnosis Guidelines British Columbia

Diagnosis guidelines for Type 2 diabetes, presented in an easy-to-follow table format for clear, practical application.

Screening, Diagnosis & Targets Quick Ref Guide

Quick reference guide for the screening, diagnosis, and A1C% targets of Type 2 diabetes, providing essential steps for early detection and effective management.

Algorithm - Screening for Type 2 Diabetes

Screening algorithm for Type 2 diabetes in British Columbia, adapted from Diabetes Canada guidelines, ensures timely detection and care.

Algorithm -Management of Type 2 Diabetes

Diabetes Canada has developed an algorithm for managing Type 2 diabetes (Figure 1) for streamlining personalized treatment decisions for optimal patient care.

Algorithm - Reviewing, Adjusting Therapy

Diabetes Canada has developed an algorithm (Figure 2) for reviewing, adjusting, and advancing therapy in Type 2 diabetes—streamlining personalized treatment decisions for optimal patient care.

A1C% Targets for Glycemic Control    
 

Adapted from Diabetes Canada, this table of A1C% glycemic targets provides clear, practical goals for effective diabetes management and monitoring.

Algorithm - Starting or Advancing Insulin Therapy

Diabetes Canada has developed an algorithm for starting or advancing Type 2 diabetes therapy —streamlining personalized treatment decisions for optimal patient care.

Insulin Prescription Tool - Initiation & Titration Guide

Comprehensive insulin prescribing tool to guide optimal treatment decisions and streamline diabetes management. Please note that Levemir is anticipated to be discontinued at the end of 2025 - and this tool will need to be updated by Diabetes Canada.

Diabetes Eye Care Pathway Toolkit
 

The Pathway Toolkit, created by the Diabetes, Obesity, and Nutrition SCN, provides comprehensive resources for implementing the Diabetic Foot Care Clinical Pathway, including tools for eye care, pharmacists, and patients.

Retinopathy Screening Guidelines

For individuals aged 15 and older with type 1 diabetes, annual retinopathy screening by a vision care professional should start 5 years after diagnosis; for type 2 diabetes, screening should begin at diagnosis, with follow-up based on severity. Effective blood glucose and blood pressure control, along with appropriate interventions, are crucial for managing and preventing retinopathy.

Inlow's 60-second Diabetic Foot Screening

Inlow's 60-second foot screening, provided by Wounds Canada, provides a rapid and effective assessment of foot health in just one minute. This tool allows healthcare professionals to quickly identify potential issues and take early action to prevent serious complications.

Consider the ABCDESSS for Vascular Protection

Use the “ABCDESSS” mnemonic as a handy tool for remembering key vascular protection strategies.

Renal Dosing Chart for Antihyperglycemics

The renal dosing chart for antihyperglycemic agents provides critical guidance on adjusting medication dosages based on kidney function, ensuring safe and effective treatment for patients with varying levels of renal function.

Canadian Adult Obesity Canada Guidelines

Find all Clinical Practice Guidelines for adults on obesity, including assessment, management, prevention, nutrition, physical activity, psychological interventions, pharmacotherapy, bariatric surgery, and emerging technologies.

College of Physicians and Surgeons

The College of Physicians and Surgeons of BC establishes practice standards, professional guidelines, and legislative guidance to help physicians and surgeons uphold exceptional medical practice and conduct. These resources cover specific, relevant issues in medical practice and are regularly updated to reflect current standards. Registrants are encouraged to familiarize themselves with these documents and review them frequently to ensure they stay aligned with best practices.

Lifetime Prevention Schedule  Guide 2023

The Lifetime Prevention Schedule (LPS) Practice Guide 2023 by the British Columbia government is a guideline for health professionals to prioritize preventive healthcare measures across a patient’s lifespan. It includes recommendations on screenings, behavioral interventions, and preventive medications tailored by age and sex. The guide emphasizes clinically effective and cost-efficient interventions that impact public health positively. The LPS is updated regularly to reflect current health needs and priorities in British Columbia.

Canadian Task Force  Preventive Health Guide

Provides clinical prevention guidelines for primary care professionals across Canada, including several related to Type 2 diabetes.

GLP‑1 Therapy Guidelines & Resources

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ADA Standards of Medical Care in Diabetes – 2026

The American Diabetes Association’s annual Standards of Care is the gold‑standard, evidence‑based guideline for T2D management. It includes comprehensive recommendations on when and how to use GLP‑1 receptor agonists

Lifestyle + GLP‑1 Therapy Benefits
 

A large meta‑analysis found that combining GLP‑1 receptor agonists with lifestyle modification led to significantly greater weight loss, improved waist circumference, better HbA1c, and favorable changes in blood lipids and blood pressure compared to lifestyle changes alone.

Practical Nutrition & Activity Tips
 

Experts emphasize protein intake (20–30 g per meal) to preserve lean mass, smaller regular meals to manage appetite and GI side effects, and a balanced, nutrient‑dense diet (whole grains, fiber, healthy fats). Hydration and gradual exercise progression support overall wellbeing on GLP‑1 therapies.

Lifestyle + GLP‑1 for Heart Health

Preliminary data presented at the American Heart Association Scientific Sessions 2025 shows that people with Type 2 Diabetes who combine GLP‑1 therapy with lifestyle improvements (healthy eating, activity) see greater reductions in cardiovascular risk compared to medication alone.

Practical Exercise Guidance

Peer‑reviewed research supports combining exercise with GLP‑1 medication to enhance metabolic benefits, preserve lean muscle, and improve body composition beyond what medications can do on their own.

WHO GLP‑1 Use & Lifestyle Integration

World Health Organization guideline on GLP‑1 therapies - emphasizes that GLP‑1 medications should be used as part of a comprehensive treatment plan including healthy diet and physical activity, not as standalone treatment.

GLP‑1 RAs & Cardiovascular Outcomes

This review summarizes cardiovascular outcome trials demonstrating that several GLP‑1 receptor agonists reduce major adverse cardiovascular events, which informs guideline recommendations on therapy choice.

Pharmacologic Approaches to Glycemic Treatment

The ADA Standards outlines the stepwise pharmacologic approach to glucose lowering including GLP‑1 RAs, SGLT2 inhibitors, metformin, and when combination therapy is appropriate. It’s updated annually.

2023 AACE Consensus Statement

The American Association of Clinical Endocrinology / American College of Endocrinology consensus algorithm provides a comprehensive therapeutic framework for T2D, including the positioning of GLP‑1 receptor agonists within dual and triple therapy regimens and comorbidity‑based pathways.

Gastrointestinal Side Effect Management

This multidisciplinary expert guideline outlines practical strategies to reduce nausea, vomiting, diarrhea, and constipation that often occur during GLP‑1 therapy—especially during dose increases. It includes recommendations on dose escalation and symptom mitigation for patients.

Managing Common GLP-1 Side Effects 

Many people experience nausea, vomiting, diarrhea, or constipation when starting GLP‑1 or combination therapies. Simple strategies can help: eat small, frequent meals and avoid greasy or spicy foods to reduce nausea; stay well hydrated and adjust food quality to manage vomiting.

GLP-1 Diet Guidance
 

Cleveland Clinic: GLP‑1 medications help control blood sugar and support weight loss by slowing digestion and reducing appetite. Because they can also cause nausea, constipation, or other digestive side effects, it’s important to choose foods carefully.

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