Diabetes

Rationale

Diabetes is an increasingly common multisystem 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
3. Insulin resistance (e.g., obesity)
4. Insulin deficiency
5. Gestational diabetes
6. Other specific types (e.g., genetic defects, medications associated to other diseases like endocrinopathies, infections, or diseases of the pancreas)

Key Objectives

Given a patient with diabetes, the candidate will diagnose the cause, severity, and complications and will initiate an appropriate management plan. Early detection of the disease and recognition of medical emergencies are particularly important.

Enabling Objectives

Given a patient with diabetes, the candidate will

1. list and interpret medical history, clinical findings, and results of investigations aimed at identifying
   1. risk factors;
   2. diagnosis;
   3. secondary causes; and
   4. complications;
2. construct an effective management plan, including
   1. education and counselling (e.g., lifestyle modifications, management of risk factors, intensive glycemic control, pharmacologic treatments);
   2. prevention and management of emergent situations (e.g., hypoglycemia, diabetic ketoacidosis, hyperosmolar nonketotic coma);
   3. prevention and management of complications (e.g., microvascular and macrovascular); and
   4. determining whether the patient requires specialized care and/or referral to other health care professionals.