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Review ArticleClinical Review

Shared decision-making approach to type 2 diabetes management

Blair J. MacDonald, James P. McCormack and Ricky D. Turgeon
Canadian Family Physician May 2024; 70 (5) 310-315; DOI: https://doi.org/10.46747/cfp.7005310
Blair J. MacDonald
Doctoral candidate in the Faculty of Pharmaceutical Sciences at the University of British Columbia in Vancouver.
PharmD
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James P. McCormack
Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia.
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Ricky D. Turgeon
Assistant Professor at the University of British Columbia and Clinical Pharmacy Specialist at St Paul’s Hospital in Vancouver.
ACPR PharmD
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  • For correspondence: ricky.turgeon@ubc.ca
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    Figure 1.

    Diabetes-related outcome 10-y risk estimates for patient D.K.

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    Table 1.

    Excerpt from the decision aid’s FAQ section* outlining the evidence for medication options that reduce the risk of adverse kidney outcomes in patients with T2DM

    TREATMENTRR FOR OUTCOMES IN PATIENTS WITH T2DM
    DEATHASCVDHEART FAILUREKIDNEY FAILURESEVERE VISION LOSSNEUROPATHY
    ACE inhibitors or ARBs0.750.750.80No albuminuric CKD: NA
    Albuminuric CKD: 0.60
    NANA
    Finerenone0.90 (RR=1.00 if eGFR ≥60 mL/min/1.73 m2 and ACR ≤30 mg/mmol)1.000.80 (RR=1.00 if eGFR ≥60 mL/min/1.73 m2 and ACR ≤30 mg/mmol)0.85 (RR=1.00 if eGFR ≥60 mL/min/1.73 m2 and ACR ≤30 mg/mmol)NANA
    GLP1 receptor agonists0.900.901.000.85NA1.00
    SGLT2 inhibitors0.900.900.65No albuminuric CKD: 0.70
    Albuminuric CKD: 0.65
    NA1.00
    • ACE—angiotensin-converting enzyme, ACR—albumin-creatinine ratio, ARB—angiotensin receptor blocker, ASCVD—atherosclerotic cardiovascular disease, CKD—chronic kidney disease, eGFR—estimated glomerular filtration rate, FAQ—frequently asked questions, GLP1—glucagonlike peptide-1, NA—not applicable (owing to absence of evidence), RR—relative risk, SGLT2—sodium-glucose cotransporter-2, T2DM—type 2 diabetes mellitus.

    • ↵* See the FAQ section for an up-to-date list of references: https://decisionaid.ca/diabetes/faq.html.

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Canadian Family Physician: 70 (5)
Canadian Family Physician
Vol. 70, Issue 5
1 May 2024
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Shared decision-making approach to type 2 diabetes management
Blair J. MacDonald, James P. McCormack, Ricky D. Turgeon
Canadian Family Physician May 2024, 70 (5) 310-315; DOI: 10.46747/cfp.7005310

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Shared decision-making approach to type 2 diabetes management
Blair J. MacDonald, James P. McCormack, Ricky D. Turgeon
Canadian Family Physician May 2024, 70 (5) 310-315; DOI: 10.46747/cfp.7005310
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