www.dmscan.ca

1. 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.

3. 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

4. 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

5. 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)

7. 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

8. Practice Setting 50% of the physician participants identified being a part of a Family Health Team

9. Physician Practice – Geographic Setting

10. Practice Survey Question:On average, how many patients with Type 2 Diabetes do you see in a week?

11. 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)?

12. 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

13. 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

14. Patient Ethnicity N = 4971 152 records unavailable L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

15. 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

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

17. Glycemic and Renal Profile L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

18. 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

19. Glycemic Management N = 4477 * NIAHA - non-insulin antihyperglycemic agent L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

20. 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

21. A1C <7% Attainment Rates based on Duration of Diabetes L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

22. Lipid Profile N = 5069 L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

23. Lipid Management N = 4153 L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

24. LDL-C Values Achieved N = 5069 % of patients LDL-C (mmol/L) L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

25. LDL-C Values Achieved – Presence and Absence of Vascular Disease L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

26. Lipid Control and Management of DM-SCAN Patients L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

27. 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

28. Blood Pressure Management N = 4946 L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

29. Blood Pressure Values Achieved N = 5099 % of patients SBP / DBP (mm Hg) L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

30. 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

31. Guideline Targets Achieved for A1C, LDL-C and Blood Pressure % of patients L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

32. Patient Comorbidities % of patients L.A. Leiter et al. / Can J Diabetes 37 (2013) 82-89

33. Has glycemic management improved over the last decade? 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.