Medical Council of Canada

Medical expert

Diabetes Mellitus - 37-2

Rationale

Diabetes mellitus is an increasingly common multi-system disease associated with a relative or absolute impairment of insulin secretion together with varying degrees of peripheral resistance to the action of insulin.

Causal Conditions

(list not exhaustive)
  1. Type 1
    1. Autoimmunity
    2. Idiopathic
  2. Type 2
    1. Obesity
    2. Other (e.g., genetic predisposition, medications)
  3. Gestational diabetes mellitus

Key Objectives

Given a patient with diabetes mellitus, the candidate will diagnose the cause, severity and complications, and will initiate an appropriate management plan. Particularly important are early detection of the disease, and recognition of medical emergencies such as acute hypoglycemia, diabetic ketoacidosis, and hyperosmolar nonketotic coma.

Enabling Objectives

Given a patient with diabetes mellitus, the candidate will

  1. list and interpret critical clinical findings, including
    1. history and physical examination aimed at identifying
      1. long-term complications;
      2. secondary causes;
      3. risk factors;
  2. list and interpret critical investigations, including
    1. laboratory and radiological for monitoring and emergent situations;
  3. construct an effective management plan, including
    1. education and counselling (e.g., lifestyle modifications, management of risk factors, intensive glycemic control);
    2. prevention and management of emergent situations (e.g., hypoglycemia);
    3. prevention and management of complications (e.g., diabetic nephropathy, retinopathy);
    4. determining whether the patient requires specialized care and/or referral to other health care professionals.
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