Room for Improvement: People living with diabetes in Canada are not receiving guideline-recommended preventive cardiovascular care: Analyses using the National Diabetes Repository
In brief
Fewer than 1 in 10 Canadians with diabetes had lipid monitoring recorded
In 2022, among 38,901 people with diabetes in a Canadian repository, lipid monitoring was recorded for 9% and guideline-recommended HbA1c monitoring for 12%; blood pressure checks were documented for 56%, and about half had prescriptions for heart-protective medications. Records point to gaps and differences by age, sex and urban or rural residence, but may not capture care delivered outside the repository.
- Journal
- Primary care diabetes (Q1)
- Published
- 22 September 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Katharine Mackett, Nancy A Santesso, Diana Sherifali, Russell J de Souza, James M Bowen, Sylvie Dostie, et al.
- PMID
- 42827072
- DOI
- 10.1016/j.pcd.2026.09.003
Why clinicians should know about it
- Picked for Family Practice (paper of the day, 7 October 2026): Low guideline adherence for diabetes cardiovascular prevention
Abstract
BACKGROUND: To reduce cardiovascular morbidity and mortality, people living with diabetes should receive guideline-recommended care. This study aimed to determine whether people living with diabetes in Canada received cardiovascular preventive care in accordance with the 2018 Diabetes Canada Clinical Practice Guidelines, and whether this care differed by sociodemographic factors. METHODS: This retrospective cross-sectional study analyzed 83,799 records from the National Diabetes Repository in Canada, with at least one recorded outcome for the years 2021 and 2022. The percentage of individuals receiving guideline-recommended care was estimated and logistic regression were performed using R. RESULTS: Of the 38,901 individuals, 56% had their blood pressure monitored, 36% had a recorded weight measurement, 12% received guideline-recommended laboratory monitoring for hemoglobin A1c (HbA1c), and 9% monitoring for lipids in 2022. Most measurements were for individuals aged 65 + years or urban residents. Of the 2% referred to dietetic services, urban residents were more likely to have a documented referral (adjusted odds ratio (aOR) 3.02, 95% confidence interval (CI) 2.32-4.00) compared to rural residents. Alternatively, urban residents were less likely to receive blood pressure monitoring (aOR:0.49, 95%CI:0.46-0.52). Approximately half were prescribed cardio-protective medications (i.e. statins). Such prescriptions were more likely for male versus female individuals (aOR:1.42, 95%CI:1.36-1.48). Younger participants aged 18-39 were more likely to be prescribed smoking cessation medication (aOR:3.35, 95%CI:2.77-4.04) than participants aged 65 +. Findings were similar in 2021. CONCLUSIONS: In 2021 and 2022, few people living with diabetes received guideline-recommended care, with some variation based on sociodemographic characteristics. Implementation strategies to improve care for people living with diabetes at risk of cardiovascular disease are needed across Canada.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.