Let’s Focus on Prevention of Type 2 Diabetes

November is Diabetes Awareness Month.  As a pharmacist, I am often asked how to best optimize medications for patient with Type 2 diabetes. There are many medications already available on the market, and there will be many more to be developed. But what I find odd, is that we haven’t spent enough time to focus on prevention, when we know Type 2 diabetes can be preventable.

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Who is at risk of B12 Deficiency?

It isn’t uncommon that I see a patient admitted to nursing home with advanced dementia and a very low level of vitamin B12. I always wonder how much of vitamin B12 deficiency may be contributing to the progression of dementia, even though it isn’t the cause. I am not a big fan of any vitamin supplements but Vitamin B12 is one where I would advocate supplementation where indicated.

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How to become a Certified Diabetes Educator (CDE)?

What a relief to pass my CDE exam again! I am now a certified diabetes educator for another 5 years. When I wrote my last exam five years ago, all costs and expenses were paid for by my previous employer. I had no idea how much everything would add up. This time around, I have to pay everything up front, hoping the amount will be fully or partially reimbursed by the Allied Health Professional Development Fund. Here’s a brief account of my financial investment as well as some thoughts around the journey.

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Canagliflozin – Results of the CANVAS Program

I am so excited to see that the results of the CANVAS program is finally released in the New England Journal of Medicine this week.  Click here for the article. The results were also shared at last week’s 77th Scientific Sessions of the American Diabetes Association in San Diego, California. So what do they say? What do they mean? How do these results translate into clinical practice?

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Carb Counting should be taught to everyone.

I am currently studying for the exam to be re-certified as a Canadian Diabetes Educator. One of the agonizing parts of the journey is to memorize the carbohydrate contents of the common food items.  It may be a breeze to the dietitians but not so easy for me. I only memorize the information for the exam.

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Safety Concerns of Sodium Glucose Cotransporter Inhibitor

Sodium Glucose Co-transporter inhibitor is a new class of medication for treatment of Type 2 Diabetes. The following three medications belong to this class:

  • Canagliflozin (Invokana)
  • Empagliflozin (Jardiance)
  • Dapagliflozin (Forxiga)

Recently, there have been FDA reports of safety concerns ranging from acute kidney injury to increased risk of bone fracture risks.  Given this class of medication is still relatively new and experience is limited in real life setting, we are still learning about the safety concerns as we speak.  Below is a quick summary of what has been reported by FDA:

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Healthy Eating on the Go

It can be hectic to be chauffeur for my kids, driving them to different extracurricular activities and to feed them healthy food on the go. Instead of the boring peanut butter sandwich or the unhealthy McDonald meals, I try to ensure there is some healthy food for my kids to eat on the go.

Lately, my girls like sushi but they only eat cucumber rolls.  So I decided to make some cucumber roll with sushi rice and quinoa to see how they turn out.

I think they turn out ok.


Sadly, my girls don’t like the sushi with quinoa.  When I get a chance to socialize with other parents, the hot topic that we always discuss is “what to feed our kids”, or sometimes I call it “how to provide healthy food with sanity”. It seems that kids always gravitate towards unhealthy food – is it our society, our culture or somehow we are missing the right ingredient to ensure a healthy eating habit? It is so important and it does set the stage for how Type 2 Diabetes may develop later in life.

It is a mystery to me. Do you have any wisdom to share?

Thank you for reading my post!