Advanced Diabetes Management: Addressing Medical & Social Complexity

January 07, 2019

Program Overview
This advanced level course in diabetes is specifically designed to help participants support people with diabetes living with medical complexity (e.g. medical comorbidities and complications) and/or sociodemographic complexity (e.g. income and immigration related barriers).    Participants will be guided through in-class exercises and case studies designed to bridge principles of evidence-based medicine, quality, safety and person-centered care.  Group discussion will continuously be focused around questions arising from the clinical and educational experiences of participants and facilitators. 

This new program, consisting of five, two-hour sessions, will meet the needs of health care clinicians and educators with Certified Diabetes Educator (CDE) designation, who have attended introductory courses on diabetes, and who are currently involved in the clinical care and/or education of people living with diabetes. Each session will build on the previous, culminating in a final session to put it all together. There will be little or no mandatory homework/readings for this program, although case studies will be circulated to participants prior to each session.

The registration fee for the entire course (5 x 2 h sessions) is $150.   To maximize small group discussion and ensure that the learning needs of every participant are met, we are limiting enrollment to 10 participants on a first-come, first serve basis.

Learning goals:
The goals of this program are:

1.     To discuss the latest diabetes clinical evidence, specifically in regard to the pharmacologic treatment of hyperglycemia and the prevention of diabetes-related complications
2.     To develop advanced skills in the treatment of diabetes
3.     To integrate principles of evidence-based medicine, quality improvement, patient-safety, and person-centeredness in the context of patient care
4.     To foster a community of practice among participants and members of the Banting and Best Diabetes Center

Learning objectives:
By the end of the course, participants will be able to:

1.     Interpret results from capillary blood glucose monitoring and flash glucose monitoring systems
2.     Individualize use of glucose-lowering therapies, including newer therapies, in the context of a patient’s preferences, comorbidities and socioeconomic status
3.     Adjust antihyperglycemic therapy based on the presence of acute and chronic medical comorbidities (including use of glucocorticoids, kidney disease and heart disease)
4.     Identify and address social inequities in marginalized populations that may be preventing quality and safe diabetes care
5.     Identify system-related factors in their local sites that may facilitate or impede quality and safety in diabetes
6.     Practice compassionate diabetes care

Target audience:
Healthcare practitioners, with Certified Diabetes Educator (CDE) designation, who are currently working people with diabetes in a clinical and/or educational environment.

Participants should:

1.     Already be aware of the available pharmacologic treatment options for glucose lowering, as recommended in clinical practice guidelines
2.     Have developed competency to support insulin initiation and dose adjustment
3.     Be prepared to actively engage in small group discussion around patient cases.

Schedule & Location:
Each session will be held at the Endocrine Conference Room, Endocrine Clinic Toronto General Hospital, 12th Floor, Room 12-N-1276)

Session 1 (March 27, 2019 at 4:30-6:30 p.m.):  Course introduction & Clinical updates 
In the introductory session we will provide a clinical update on the newest available pharmacologic options and glucose monitoring systems for diabetes, and discuss their benefits and risks in the context of specific patient scenarios. 

Session 2 (April 17, 2019 at 4:30-6:30 p.m.):   Ensuring patient safety in at-risk patients
Building off the previous session, this session will focus on acting at the level of the patient and health care system level to provide evidence-based care while ensuring safety.  Case scenarios are designed to discuss strategies relating to the frail elderly, and patients whose occupations and/or medical conditions put them at risk for hypoglycemia.

Session 3 (May 15, 2019 at 4:30-6:30 p.m.):  Medical complexity:  Diabetes treatment in the setting of acute & chronic medical comorbidities
This session will be themed around the effects of other medical comorbidities on diabetes, and how to predict the need to adjust diabetes treatments based on the stability of acute and chronic medical comorbidities.  Case scenarios are designed to discuss treatment strategies in patients with diabetes and evolving kidney disease, coronary artery disease, heart failure; patients on steroids, and patients undergoing medical procedures.

Session 4 (May 29, 2019 at 4:30-6:30 p.m.): Social complexity: Diabetes treatment in individuals living with sociodemographic related barriers to health
This session will be themed around the social inequities experienced by marginalized populations with diabetes.  Case scenarios are structured to discuss the complexities of providing quality and safe care in patients with diabetes and mental illness, those with socioeconomic barriers to health and those who have recently immigrated.

Session 5 (June 19, 2019 at 4:30-6:30 p.m.):  Summary: Putting it all together
In this concluding session, we will aim to bring together the themes from the previous sessions, to provide participants with an opportunity to practice integrating the concepts learned throughout the program into new cases.

Attendance policy:
This program is short with only 5 total sessions and missing sessions will impact the learning experience. Certificates of attendance will be provided to those who attend at least 4 of the 5 sessions.  If unable to attend at least four of the sessions, please contact us to explore how we might be able to support your learning needs.

: If the course becomes full and you would like to be put on a waiting list in the event of cancellations, send your request along with the course number BDC1903 to .   


This course has been designed and been facilitated by Dr. Rene Wong, Assistant Professor, Faculty of Medicine, University of Toronto, Endocrinologist, Toronto General Hospital.


Please contact: Sanam Tajadod
Administrative Assistant and Event Coordinator
Banting & Best Diabetes Centre, University of Toronto
T: 416-978-3498

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