In This Issue

  • Report from the Chair
  • Project Update
  • ACHORD Seen & Heard
  • Recent Literature
  • ACHORD Accolades
  • Events

Previous Issues

ACHORD Seen & Heard

Recent Publications

Al Sayah F, Qiu W, Johnson JA. Health literacy and health-related quality of life in adults with type 2 diabetes: A longitudinal study. Qual Life Res 2016;25(6):1487-1494. PMID: 26603739.

Al Sayah F, Bansback N, Bryan S, Ohinmaa A, Poissant L, Pullenayegum E, Xie F, Johnson JA. Determinants of Time-Trade Off Valuations for EQ-5D-5L Health States: Data from the Canadian EQ-5D-5L Valuation Study. Qual Life Res 2016;25(7):1679-85. PMID: 26659899.

Beatty JA, Majumdar SR, Tyrrell GJ, Marrie TJ, Eurich DT. Current Smoking and Reduced Mortality in Bacteremic Pneumococcal Pneumonia: A Population-Based Cohort Study. Chest. 2016 Sep;150(3):652-60. PMID: 27151328.

Butalia S, Johnson JA, Ghali WA, Southern DA, Rabi DM. Temporal variation of diabetic ketoacidosis and hypoglycemia in adults with type 1 diabetes: A nationwide cohort study. J Diabetes. 2016;8(4):552-8. PMID: 26301804.

Chen CB, Lin M, Eurich DT, Johnson JA. Safety of concomitant metformin and proton pump inhibitor use: a population retrospective cohort study. Clin Therapeutics 2016;38(6)1392-1400. PMID: 27061884.

Gamble JM, Thomas JM, Twells LK, Midodzi WK, Majumdar SR. Comparative effectiveness of incretin-based therapies and the risk of death and cardiovascular events in 38,233 metformin monotherapy users. Medicine (Baltimore). 2016 Jun;95(26):e3995. PMID: 27368005.

Gill RS, Majumdar SR, Rueda-Clausen CF, Apte S, Birch DW, Karmali S, Sharma AM, Klarenbach S, Padwal RS. Comparative effectiveness and safety of gastric bypass, sleeve gastrectomy and adjustable gastric banding in a population-based bariatric program: prospective cohort study. Can J Surg. 2016 Aug;59(4):233-41. PMID: 27240132.

Johnson JA, Lier DA, Soprovich A, Qiu W, Al Sayah F, Majumdar SR. Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care. Am J Prev Med 2016;51(1):e13-20. PMID: 26947212.

Johnson ST, Lubans DR, Mladenovic AB, Plotnikoff RC, Karunamuni N, Johnson JA. Testing social-cognitive mediators for objective estimates of physical activity from the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study. Psychol Health Med 2016;8:945-53. PMID: 26899570.

Johnson ST, Al Sayah F, Mathe N, Johnson JA. The Relationship of Diabetes-Related Distress and Depressive Symptoms with Physical Activity and Dietary Behaviors in Adults with Type 2 Diabetes: A Cross-sectional Study. J Diabetes Complications 2016;30(5):967-70. PMID: 27083444.

Khokhar B, Jette N, Metcalfe A, Cunningham CT, Quan H, Kaplan GG, Butalia S, Rabi D. Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations. BMJ Open 2016;6(8):e009952. PMID: 27496226.

Lega IC, Wilton AS, Austin PC, Fischer H, Johnson JA, Lipscombe L. The temporal relationship between diabetes and cancer. Cancer 2016;122(17):2731-8. PMID: 27400035.

Majumdar SR. Antihypertensive treatments for adults with Type 2 Diabetes. BMJ 2016;352:i560. PMID: 26867645.

Majumdar SR, Josse RG, Lin M, Eurich DT. Does Sitagliptin Affect the Rate of Osteoporotic Fractures in Type-2 Diabetes? Population-Based Cohort Study. J Clin Endocrinol Metab 2016;101(5):1962-9. PMID: 26930183.

Mathe N, Pisa PT, Johnson JA, Johnson ST. Dietary patterns in adults with type 2 diabetes predict cardio-metabolic risk factors. Can J Diabet 2016;40(4):296-303. PMID: 26971990.

McAlister FA, Youngson E, Eurich DT. Treated glycosylated hemoglobin levels in individuals with diabetes mellitus vary little by health status: A retrospective cohort study. Medicine (Baltimore). 2016 Jun;95(24):e3894. PMID: 27310986.

Padwal R, Leslie WD, Lix LM, Majumdar SR. Relationship Among Body Fat Percentage, Body Mass Index, and All-Cause Mortality: A Cohort Study. Ann Intern Med 2016;164(8):532-41. PMID: 26954388.

Padwal R, McAlister FA, Wood PW, Boulanger P, Fradette M, Klarenbach S, Edwards AL, Holroyd-Leduc JM, Alagiakrishnan K, Rabi D, Majumdar SR. Telemonitoring and Protocolized Case Management for Hypertensive Community-Dwelling Seniors With Diabetes: Protocol of the TECHNOMED Randomized Controlled Trial. JMIR Res Protoc. 2016 Jun 24;5(2):e107. PMID: 27343147.

Padwal RS, Majumdar SR. Comparability of two commonly used automated office blood pressure devices in the severely obese. Blood Press Monit. 2016 Oct;21(5):313-5. PMID: 27100401.

Pederson JL, Warkentin LM, Majumdar SR, McAlister FA. Depressive symptoms are associated with higher rates of readmission or mortality after medical hospitalization: A systematic review and meta-analysis. J Hosp Med 2016;11(5):373-80. PMID: 26824220.

Simpson SH, Lin M, Eurich DT. Medication Adherence Affects Risk of New Diabetes Complications: A Cohort Study. Ann Pharmacother. 2016 Sep;50(9):741-6. PMID: 27307411.

Vallance JK, Eurich DT, Lynch BM, Gardiner PA, Taylor LM, Jefferis BJ, Johnson ST. Correlates of General and Domain-Specific Sitting Time among Older Adults. Am J Health Behav 2016;40(3):362-370. PMID: 27103415.

Wozniak L, Soprovich A, Rees S, Johnson ST, Majumdar SR, Johnson JA. A qualitative study examining healthcare managers and providers’ perspectives on participating in primary care implementation research. BMC Health Services Research 2016 16:316.

Xie F, Pullenayegum E, Gaebel K, Bansback N, Bryan S, Ohinmaa A, Poissant L, Johnson JA. How different are composite and traditional TTO valuations of severe EQ-5D-5L states? Qual Life Res 2016;25(8):2101-8. PMID: 26875190.

Yang S, Leslie WD, Morin SN, Majumdar SR, Lix LM. Antiresorptive therapy and newly diagnosed diabetes in women: a historical cohort study. Diabetes Obes Metab. 2016 Sep;18(9):875-81. PMID: 27097832.


14th Annual ACHORD Retreat

March 2-3, 2017
Alumni House
University of Alberta Campus
Edmonton, Alberta, Canada


2nd Annual APERSU End User Meeting

November 9-10, 2016
Matrix Hotel
Edmonton, Alberta, Canada









Location and Date Change for ACHORD Retreat 2017!!!

The ACHORD Retreat will be held on March 2 and 3, 2017, at Alumni House, University of Alberta, instead of making the trip to Banff. The original date conflicted with a EuroQol Foundation Meeting and unfortunately, alternate dates were not available at the Banff Centre.  We look forward to having the meeting in Edmonton this year, overlooking the beautiful river valley and downtown.  We anticipate returning to the Banff Centre for the ACHORD Retreat 2018.

Report from the Chair

I hope everyone had a great summer and enjoyed some time off. Despite summer vacations, everyone in ACHORD has been busy. Here is a quick update on what we have been doing since our last newsletter.

The newly established Alberta’s PROMs and EQ-5D Research and Support Unit (APERSU) continues to pick up steam as more groups register to use the EQ-5D. We held a Board of Directors teleconference in June and a Scientific Advisory Committee teleconference in mid April. We updated members on our activities and gained excellent feedback from the members of both committees. We are currently planning the second End User Meeting in November, 2016, in Edmonton. The EuroQol Foundation held a meeting in Amsterdam in July in which Arto Ohinmaa and I attended on behalf of APERSU. We have done several presentations to various audiences around the province, to both academic and non-academic stakeholders. We were fortunate to have two summer students working with us on APERSU tasks, Katelynn Crick and Shelby Huffman. Our first APERSU Newsletter went out at the end of July.

Two Masters students successfully completed their programs in June; Danielle Thiel and Chris Chen. Danielle is starting Medical School at the University of Alberta this month and Chris has found employment with Alberta Health. I was both Danielle’s and Chris’s supervisor. Travis Featherstone, Masters Student under the supervision of Scot Simpson successfully completed his program in August. Travis continues to work with Pharmacare, an Alberta-based health-service company that supports over 4000 patients daily. Congratulations to all.

This fall involved a lot of travel for me. The European Association for the Study of Diabetes had their annual meeting in Munich, Germany and the EuroQol Foundation had their annual EuroQol Plenary in Berlin, Germany, both in September. October travel includes the ISOQOL Annual Meeting in Copenhagen, Denmark, the Society for Medical Decision Making Meeting in Vancouver, BC and the Canadian Diabetes Association Annual Meeting in Ottawa. Fatima Al Sayah and Arto Ohinmaa will also be attending the EuroQol Plenary and the ISOQOL Annual Meeting, and several ACHORD members will be attending the CDA Annual Meeting.

I hope the information in our newsletter is informative, and if you have any questions about our activities, please do not hesitate to contact us. I look forward to updating you in early winter with more on ACHORD’s activities.


Project Update

HEALD-GDM: Healthy Eating & Active Living after Gestational Diabetes

By: ST Johnson, M Davenport, S Butalia, JA Johnson, N Mathe

Project Summary
Gestational diabetes mellitus (GDM) or diabetes during pregnancy, is a common complication in pregnancy that may lead to type 2 diabetes at a later stage. Increases in activities such as walking could significantly reduce the risk of type 2 diabetes. Most women who have had GDM do not meet daily physical activity recommendation. The low participation in physical activity for women who have had GDM is likely related to lack social support and childcare obligations.

The Healthy Eating and Active Living (HEALD) program is a walking program that was shown to increase physical activity in people living with type 2 diabetes in Alberta. ACHORD researchers at Athabasca University, University of Calgary and the University of Alberta collaborated to translate this program to women who have had GDM, called HEALD-GDM. To assess the effectiveness of HEALD-GDM in post-partum women who had GDM, we are conducting a pragmatic control trial funded by a grant from the Lawson foundation of Canada.

Who are the participants in HEALD-GDM trial?
Women aged 18 to 45 years and capable of sustained walking for 10 minutes, with laboratory confirmed gestational diabetes mellitus (based on Canadian Diabetes Association 2013 guideline criteria).

How does HEALD-GDM work?
The eligible women are randomly allocated to either the HEALD-GDM intervention or to a control arm. Those allocated to HEALD-GDM receive a 24-week program led by an Exercise Specialist at a local recreational facility in Calgary or Edmonton.

HEALD-GDM consists of two 12-week phases, for a total of 24 weeks. In phase one, the goal for participants is to increase their number of steps per day. Participants set their own daily step goals, initially based on their baseline average steps/day. In Phase two, participants are taught how to increase their baseline walking speed by 10% during a 30 minute walk (i.e., targeting intensity). They are asked to incorporate this faster walking pace for 30 minutes/day on three days/week until the end of the study period. In addition, participants receive dietary advice based on the glycemic index concept. Participants are encouraged to improve diet quality by swapping high glycemic index foods (e.g. white bread, white rice) for low glycemic index foods (e.g. pumpernickel bread and brown rice).

Social Support
Those in HEALD-GDM receive additional social support in the form of weekly telephone-based peer counseling. The HEALD-GDM program also provides complementary childcare for all participants.

Evaluation of HEALD-GDM
All participants are assessed at baseline, 3 months and 6 months. Data related to increase physical activity, diet and physical and clinical measures are collected.

This study was approved by the Health Research Ethics Board of the University of Alberta and participants gave written informed consent.



Twitter  @HEALD_GDM


Recent Literature from the ACHORD Journal Club

(Paper discussed Wednesday, June 1, 2016; Commentary by Max Eskin)

Dormuth CR, Filion KB, Paterson JM, James MT, Teare GF, Raymond CB, Rahme E, Tamim H, Lipscombe L. Higher potency statins and the risk of new diabetes: multicenter, observational study of administrative databases. BMJ 2014; 348:g3244 PMID: 24874977


Labels on statin medications in the United States now include information concerning glycemic effects, including diabetes and increases in Hemoglobin A1C or fasting plasma glucose. The US Food and Drug Administration approved these labelling changes based mainly on evidence drawn from two meta-analyses of randomized controlled trials. However, existing clinical trials of statins were not based on real world use, were not specifically designed to assess diabetes endpoints, and were not restricted to secondary prevention of cardiovascular events. Furthermore, many studies have not been able to ensure that diabetes cases were truly incident. Therefore, the Canadian Network for Observational Drug Effect Studies (CNODES) designed a study to evaluate the risk of new diabetes in patients who received higher potency statins as opposed to lower potency statins shortly after a cardiovascular event or procedure.


The study was conducted as a set of 8 population based cohort studies and a meta-analysis across 6 Canadian provinces and 2 international databases from the UK and US and included 136 966 participants aged ≥40 years newly treated with statins between 1 January 1997 and 31 March 2011. Within each cohort of patients with newly prescribed statin medication after hospitalization for a major cardiovascular event or procedure, the authors performed nested case-control analyses to compare diabetes incidence in users of higher potency statins with incidence in users of lower potency statins. Main outcome measures included hospitalization for new onset diabetes, or a prescription for insulin or an oral antidiabetic drug. Adjustment for confounding was achieved using high dimensional propensity scores. Meta-analytic methods were used to estimate overall effects across sites.


Study conclusion is that higher potency statin use is associated with a moderate increase in the risk of new onset diabetes compared with lower potency statins in patients treated for secondary prevention of cardiovascular disease. Therefore, clinicians should consider this risk when prescribing higher potency statins in secondary prevention patients and FDA labeling for statin medications is a legitimate step in improving patients’ safety. However, there were several points highlighted in Journal Club Discussion regarding study methodology. Firstly, overall number of participants reported by the authors (136,966) is lower than the actual number of participants used for matching of cases and controls in nested case control analysis (61,686). Secondly, nested case control analysis is used in the study due to its good computational efficiency for analyzing rare events in large databases; however an availability of highly efficient computers nowadays allows fast performance of complex calculations for large databases and therefore using Cox regression would be more appropriate. Last, diabetes diagnosis was detected using only hospital discharge data, regardless family physicians diagnoses that may potentially affect the overall number of outcomes.


Recent Presentations

Eurich DT. Improving diabetes care for Alberta’s First Nations communities through technology, Alberta Innovates Health Solutions, 2016. AIHS e-newsletter, Vol. 2, Iss. 7

Lee A, Eurich, DT, Mah D, Hanstock C, Seres, P, Kalra S. Advanced MRI in a Multicenter Study: Assessing the Reliability of Candidate Biomarkers in ALS. ALS Canada Research Forum – Toronto Ontario May 1-4, 2016.

Eurich DT. Past, Present and Future of SPOR in Alberta – Patient Orientated Summer Institute, Calgary, Alberta, 2016, May 3rd, 2016.

Butalia S, Donovan LE, Savu A, Edwards A, Johnson JA, and Kaul P. Rates and Types of Postpartum Diabetes Testing in Women with Gestational Diabetes Mellitus: A Population-based Study in Alberta, Canada. 76th Scientific Sessions of the American Diabetes Association Meeting, New Orleans, Louisiana, June 2016 – Abstract #2343.

Samii L, Kallas-Koeman M, Donovan L, Lodha A, Crawford S, and Butalia S. The Association between Vascular Complications of Type 1 Diabetes Mellitus during Pregnancy and Congenital Malformations. 76th Scientific Sessions of the American Diabetes Association Meeting, New Orleans, Louisiana, June 2016 – Abstract #1362-P.

Mendez A, Eurich DT. Patient Centered Outcomes in Head and Neck Oncology Patients. Poliquin Resident Research Competition of the 70th CSOHNS Annual Meeting in Charlottetown, PEI, June 13, 2016.

Eurich DT. Academic CVs: Ten Irritating Mistakes to Avoid – Undergraduate Student Summer Series: Launchpad to Research, University of Alberta, June 22, 2016.

ACHORD Accolades

Congratulations to:

Danielle Thiel on successfully completing her Master of Science Oral Exam

Chris Chen on successfully completing his Master of Science Oral Exam

Travis Featherstone on successfully completing his Master of Science Oral Exam

Candace Necyk on being awarded the Queen Elizabeth II Graduate Doctoral Scholarship


Other ACHORD News

Welcome to Donna Pressick, our new Receptionist and Administrative Assistant.

Congratulations to the Travis, Kelly and Scarlett Featherstone on the addition of Theia Elyn to their family in September.

Welcome to Fizza Gilani, a 2012 Graduate of the FoPPS and community pharmacist who will be working towards her MSc with Scot Simpson. Her research interest is in the area of pnemococcal vaccination for people with diabetes.

ACHORD Contact Information

Phone Numbers: General Inquiries: 780-248-1010 | Fax : 780-492-7455
University of Alberta | 2-040 Li Ka Shing Centre for Health Research Innovation | Edmonton, AB, T6G 2E1