Grant: CIHR Fellowship

Since 2000, the population of patients with diabetes in the province of Quebec is on the rise; almost 1 individual out of 10 was living with diabetes in 2016. Diabetes is associated with multiple complications such as lower-extremity amputations, which impose an important burden on Quebec's healthcare system. Management of diabetes and its complications requires the involvement of different healthcare specialists, which is also known as healthcare trajectories; yet, the accessibility to optimal care is not necessarily the reality for all patients with diabetes in light of their status of deprivation, location, treating physician specialities or sex. In other words, in the province of Quebec, optimal healthcare trajectories for patients with diabetes and related complications are still largely unexplored. Also, many gaps remain regarding the balance between benefices and risks of drugs used to treat diabetes. Objective: To evaluate the temporal trends of diabetes and to identify optimal healthcare trajectories in diabetes management and its complications, considering deprivation status, physician specialties, location, sex and drugs used to treat diabetes within patients newly diagnosed with diabetes in the province of Quebec. Methods: Using linked data from provincial health administrative databases, we will identify different patterns in healthcare utilization among patients with diabetes and we will study the relationship between these patterns and the incidence of complications, like lower-extremity amputations, and mortality. Relevance: This project will ensure a better understanding of the population of patients with diabetes, incidence of complications, healthcare trajectories and drugs used to treat diabetes within the Quebec's healthcare system and will propose new strategies to optimize healthcare. Ultimately, this project will allow the development of future programs/approaches that will help better prevent and treat diabetes-related complications.