Grant: Project Grant

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 diabetes and early-stage mild diabetes. It is important to know whether treating people with prediabetes and mild diabetes with medications helps them avoid the complications of diabetes or exposes them to potential harms of over-diagnosis and over-treatment. We have completed interviews of people with lived experience of prediabetes and mild diabetes, and healthcare providers to understand how this condition is currently managed and identified that there exists variability in the management of this condition. In this study, we propose to better understand how people with prediabetes and mild diabetes are currently treated, and if starting medications earlier helps reduce the complications of diabetes. We will use data sets from Alberta, British Columbia and Ontario to identify newly diagnosed adults with prediabetes and mild diabetes and evaluate their health outcomes over the course of 8 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, healthcare providers and health systems. Prevention of diabetes-related complications with medications in the prediabetes or mild diabetes stage could be promising, however the evidence has to be strengthened to avoid the risk of over-treating people with medications. Our study will help inform decisions around initiation of treatment in this group of people.