Grant: Project Grant - PA: Patient-Oriented Research: Early-Career Investigator

Diabetes is a chronic medical condition that leads to higher-than-normal blood glucose levels in the body. This may lead to several complications including heart attacks, strokes, kidney damage, vision loss, and loss of limb. The rates of diabetes are rising globally and in Canada. With more advanced diagnostic tests we are now able to identify people with prediabetes and mild stages of diabetes. However, it is not clear if treating people with prediabetes and mild diabetes with medications reduces their risk of worse outcomes related to diabetes. It is important to know if treating people with prediabetes and mild diabetes helps them avoid the complications of diabetes, or exposes them to more medication side-effects and psychological harms associated with over-diagnosis. In this study we propose to understand better how people with prediabetes and mild diabetes should be treated. We will interview people with lived experience of prediabetes and mild diabetes, and health care providers to understand how the diagnosis is made, managed, and the impacts of the diagnosis and associated additional monitoring. We will use data sets from Alberta, British Columbia and Ontario to identify newly diagnosed adult individuals with prediabetes and mild diabetes and evaluate their health outcomes over the course of seven years. We will seek to understand how those outcomes were impacted or not by the initiation of medications. The findings from our study will shed light on an important question facing patients, health care providers and health systems. Prevention of diabetes related complications with early treatment is promising, however, there are risks of over-treating people with medications. Our study will help inform decisions around initiation of treatment in this group of people. This will lead to the formation of a unique cohort of people that can be followed for longer-term outcomes