BackgroundSpecialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes.This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work.MethodData from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators’ reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software.ResultsFour major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange.ConclusionsOur findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.

This study shows that gender inequities in health exist in all countries, regardless of income level. Economic development seemed to confer advantages in the availability of such indicators; however, this finding was not consistent and needs to be further explored. Future initiatives should include identifying health system factors and risk factors associated with disparities as well as assessing the cost-effectiveness of including the routine monitoring of gender inequities in health.

Because situating diabetes teams in primary care currently involves using existing healthcare structures and human resources, pragmatic methods of fostering successful implementation of this model of practice are required. The utility of this model was perceived as being viable, and benefits were visible to all study participants. Strategies to facilitate implementation include outlining roles and expectations by educators and the primary care providers' team in the beginning, investment in the intervention by all stakeholders, and clear channels of communication that allow educators to perform their roles and leverage opportunities for team collaboration in patient care. Further evaluation of implementation processes can serve to expand this model of practice, which has proven so far to be favourable to the players involved.

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ood insecurity (FI) is consistently more prevalent among households of people living with diabetes than families or adults without chronic disease (1-4), and it is particularly high among households of children with diabetes (5). With healthy eating at the cornerstone of all diabetes care strategies for both adults and children, FI can have a significant negative impact on diabetes management. Current evidence indicates that people with diabetes and FI are at increased risk for poor glycemic control (A1C >7%), hypoglycemia (6), hyperglycemia (7), and chronic diseases related to diabetes complications (8). In children, poor glycemic control can have severe consequences such as hypoglycemia and ketoacidosis, leading to hospital admissions (5), as well as various chronic complications later in life (9). The importance of routine screening for FI in the diabetes population is