Pharmacy U

How to help your patients with diabetes achieve better health outcomes


by Pavithra Ravinatarajan MPharm RPh


Statistics show that 1 in 3 Canadians suffer from diabetes or pre-diabetes. Astonishingly less than 50% of Canadians can identify the early signs of diabetes which can result in disease progression and complex disease state management. Awareness and education of patients who may be at risk or who have been diagnosed with diabetes are key.


Diabetes Canada has numerous tools available on their website to support patients. You can also utilize the CANRISK assessment tool to screen patients and better describe their risk of diabetes.


Insulin plays a key role in diabetes. Insulin resistance is often caused by diet seen through an increase in inflammation leading to metabolic syndrome. If diet control remains unaddressed, this added stress to the beta cells in the pancreas can lead to fatigue and reduction/elimination of insulin production.


Highlighting the importance of blood sugar monitoring can be a core component in diabetes management and patient accountability.  Blood sugar monitoring plays a key role in understanding how treatment is affecting a patient, the impact of diet changes, how and when to exercise, pregnancy, and “sick” days. A main area that many patients are not aware of is how severely dietary changes can impact diabetes. Both for the good and the bad. Diets can help regulate glucose intake, control peaks and troughs of insulin, provide potential risk of low blood sugar and even ketoacidosis. Understanding the impact of fad diets as opposed to structured diets can help provide patients with better guidance as to what they can and cannot try.


Exercise can also play a role in ketoacidosis or low blood sugar. Numerous patients are unaware of the dangers in exercising without knowing their current blood sugar. Levels lower the 5.6 mmol/L require a patient to eat a small snack and wait 15-20 and retest before exercising. Low levels and exercising can lead to hypoglycemia. Similarly, if blood sugar levels are above 13.9 mmol/L exercising can pose the risk of ketoacidosis to the patient. Understanding your patients’ needs and providing the right monitoring system is vital, along with the education of when and where to use blood sugar monitoring.


Counselling your patients may often not be enough to engage them in ownership of their condition. For patients with diabetes, help set actionable goals with blood sugar reading that relate to personal targets, whether this be playing with their grandchildren, fitting into a dress, or running a 5K.


Pharmacists are among the most accessible healthcare providers playing a primary role in supporting patient disease state management. Providing clear, digestible information, with shared participation from the patient, patient’s family, and healthcare team can help to motivate and encourage our patients along their health journey.



Pavithra Ravinatarajan RPh is the founder and principal consultant of Pavithra Consulting Inc. She spoke recently about diabetes management at Pharmacy U.