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July 22, 2019 Recognize

The 5 Rs for all patients with diabetes

Recognize is your reminder to consider diabetes risk factors for all of your patients, and screen appropriately for type 2 diabetes.

Does this mean…

I have to do a bloodtest on everyone? NO

OR, that I have to look for type 2 diabetes risk factors in everyone? YES

View risk factors

Who should I screen?

Screen every 3 years in individuals > 40 years of age or in individuals at high risk using a risk calculator. Screen earlier and/or more frequently in people with additional risk factors for diabetes or for those at very high risk using a risk calculator.

What are the numbers?

Test Result Dysglycemia category
FPG (mmol/L) No caloric intake for at least 8 hours 6.1 - 6.9 IFG
≥7.0 Diabetes
2hPG in a 75 g OGTT (mmol/L) 7.8 - 11.0 IGT
≥11.1 Diabetes
A1C (%) Standardized, validated assay, in the absence of factors that affect the accuracy of A1C and not for suspected type 1 diabetes 6.0 - 6.4 Prediabetes
≥6.5 Diabetes
Random PG (mmol/L) ≥11.1 Diabetes

If asymptomatic, a repeat confirmatory test (FPG, A1C, or a 2hrPG in a 75 g OGTT) must be done. If symptomatic, diagnosis made, and begin treatment. 

But, how do I actually do this in my practice?

  • If you have an Electronic Medical Record (EMR), program alerts to remind you to screen your patients for type 2 diabetes, or,
  • Populate this registry template with your patients
    • And stay tuned as we develop more EMR templates to facilitate diabetes care
  • No EMR? No problem…
    • Ask your patients to complete a CANRISK questionnaire while they are waiting for their appointment with you, and ask them about their result when they see you
    • Keep this quick reference for screening and diagnosis posted where you will see it in your examination room