Podcasts about american diabetes association ada

Video Version Only on HCPLive! In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss the top-line results from the ACHIEVE-1 trial evaluating orforglipron—an investigational, once-daily oral glucagon-like peptide-1 receptor agonist (GLP-1 RA) developed by Eli Lilly—for adults with type 2 diabetes (T2D) inadequately controlled by diet and exercise. Isaacs and Bellini emphasized the clinical significance of orforglipron's Phase 3 data in the ACHIEVE-1 trial, which demonstrated substantial reductions in A1c (1.3–1.6%) from a baseline of 8.0% and notable weight loss averaging 16 pounds (7.9%) at the highest dose over 40 weeks. Impressively, more than 65% of participants achieved an A1c below 6.5%, meeting the American Diabetes Association (ADA)'s target for diabetes control. The hosts highlighted the convenience advantage of orforglipron compared to oral semaglutide, which has strict dosing requirements. Oral orforglipron can be taken without food or water restrictions, potentially increasing adherence and reducing treatment burden. They also noted the drug's favorable safety profile, with gastrointestinal side effects similar in type and incidence to existing GLP-1 RAs, and no hepatic safety signals observed in the trial. Beyond glycemic control, Isaacs and Bellini discussed the broader implications for obesity treatment, pointing to the drug's potential utility in weight management, pending regulatory submission. They explored the possibility of using injectable GLP-1 RAs for initial weight loss followed by oral maintenance with orforglipron—potentially lowering costs and improving access. The conversation touched on the upcoming ACHIEVE trial series, which will explore orforglipron in head-to-head comparisons with other agents, its use in insulin-treated T2D, and future indications including cardiovascular risk and kidney disease. While optimistic, the hosts stressed the need for cardiovascular outcomes data to confirm orforglipron's safety and potential benefits in this domain. If confirmed, they suggested orforglipron could become a cornerstone oral therapy for T2D and obesity. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Key Episode Timestamps 00:00:01 Discussion on OR for GLP-1 Receptor Agonist 00:02:13 Potential Impact and Patient Preferences 00:03:59 Safety and Market Potential 00:05:13 Cost and Transition Options 00:06:32 Future Trials and Side Effects 00:08:55 Cardiovascular Outcome Data and Conclusion

Are the 2025 American Diabetes Association (ADA) guidelines helping people with type 2 diabetes and prediabetes—or are they falling behind the science? In this episode, we take a critical look at the latest updates, uncovering what's helpful, what's missing, and where outdated thinking might be holding people back. From the confusion surrounding carbohydrate recommendations to the surprising shift in guidance on fats and protein, we'll dive into what you really need to know to manage your health effectively.You'll discover why low carbohydrate diets remain the most effective strategy for improving blood sugar, how digital health programs like the T2Diet Program are changing the game, and why monitoring your B12 levels is critical if you take metformin. Plus, learn why sleep is now firmly in the spotlight as a key factor for diabetes prevention and management. CHAPTERS1:16 ADA Standards of Medical Care overview4:34 Digital programs outperform in-person care6:37 Importance of sleep and monitoring B12 in prediabetes8:46 Eating patterns and the totality of what you eat11:52 FAIL: No clear carbohydrate recommendations18:02 FAIL: No evidence that plant protein is better than animal protein20:15 FAIL: Guidelines on fats regressed, not progressedFor show notes and resources, please visit: https://Type2DiabetesTalk.comTo share your questions and suggestions, leave us a voice message or email at: https://Type2DiabetesTalk.com/messageExplore our proven programs and services, visit: https://Type2DiabetesTalk.com/programsSubscribe to our free weekly newsletter for podcast updates, valuable nutrition tips and more: https://Type2DiabetesTalk.com/subscribe

Video Version Only on HCPLive! In this episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, explore recent advancements in incretin-based therapies, highlighting their transformative potential for diabetes management and weight loss. The episode opens with a detailed discussion on Amgen's maridebart cafraglutide (MariTide; AMG-133), an investigational antibody peptide conjugate offering remarkable efficacy for obesity and overweight in Phase 2 trial data. At 52 weeks, participants without type 2 diabetes (T2D) experienced an average weight loss of ~20% with MariTide treatment without a weight loss plateau, while those with T2D achieved up to a ~17% average reduction without a plateau. The hosts underscored the potential impact of this type of therapy, particularly in addressing adherence challenges posed by the more frequent dosing schedules of current options. Hosts cited the potential safety concerns, but noted that AMG-133 could represent a significant step forward in managing obesity and related metabolic disorders. The conversation then shifted to a head-to-head comparison of two leading incretin therapies for obesity: tirzepatide (Zepbound) and semaglutide (Wegovy). Tirzepatide emerged as a frontrunner in the SURMOUNT-5 trial, contributing to a mean body weight reduction of 20.2% versus 13.7% achieved with semaglutide. Isaacs and Bellini discuss how these findings might influence clinical decision-making, emphasizing the importance of tailoring treatment plans to individual patient needs. They also touch on the practical implications of these therapies in both obesity and diabetes care, given the growing prevalence of these conditions. In the final segment, Isaacs and Bellini addressed a critical safety issue: the proliferation of non-FDA-approved compounded glucgaon-like peptide-1 (GLP-1) receptor agonists. The American Diabetes Association (ADA) released a statement warning against these unregulated formulations due to concerns over safety, quality control, and potential adverse effects. Despite the growing popularity of compounded versions as a lower-cost alternative, the hosts stressed the importance of prioritizing patient safety. They advised clinicians to steer patients toward evidence-based, FDA-approved therapies that have undergone rigorous testing and demonstrated consistent efficacy and safety profiles. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-403 Overview: Recorded live at Pri-Med East! - The American Diabetes Association (ADA) has updated their standards of care for patients with diabetes. In this episode, we discuss some of the changes in the initial selection of glucose-lowering medications for type 2 diabetes mellitus (T2DM), including when alternatives to metformin may be appropriate. Hear strategies for making personalized, guideline-recommended choices that enhance care for patients with T2DM. Episode resource links: Pharmacologic Approaches to Glycemic Treatment. In: American Diabetes Association. Standardsof Care in Diabetes2024 - DiabetesCare 2024 Jan 1;47(Suppl 1):S1-S321 Guest: Alan M. Ehrlich, MD, FAAFP  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

Credits: 0.25 AMA PRA Category 1 Credit™   CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-403 Overview: Recorded live at Pri-Med East! - The American Diabetes Association (ADA) has updated their standards of care for patients with diabetes. In this episode, we discuss some of the changes in the initial selection of glucose-lowering medications for type 2 diabetes mellitus (T2DM), including when alternatives to metformin may be appropriate. Hear strategies for making personalized, guideline-recommended choices that enhance care for patients with T2DM. Episode resource links: Pharmacologic Approaches to Glycemic Treatment. In: American Diabetes Association. Standardsof Care in Diabetes2024 - DiabetesCare 2024 Jan 1;47(Suppl 1):S1-S321 Guest: Alan M. Ehrlich, MD, FAAFP  Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com   

It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: Dexcom CGM is worn in space, two over-the-counter CGMs are now available, a large new study looks at potential dietary causes of type 1, and researchers are looking at a gel version of GLP-1 medications. Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX Astronauts on the Polaris-Dawn mission are wearing the Dexcom G6 CGM. Polaris Dawn launched this week with astronauts wearing the G6 to better understand the effects of spaceflight on human health. The crew intends to conduct research to advance human health on Earth and the understanding of health during long-duration spaceflights. “This health research-driven mission marks another first for Dexcom, with our industry-leading CGMs being worn by astronauts in outer space,” said Jake Leach, EVP and COO at Dexcom. “We are thrilled to play a role in building a future where people with diabetes are empowered to accomplish anything they set their minds to–including the possibility of exploring outer space–without being held back by their condition.” Over five days in space, the Polaris Dawn crew plans to conduct around 40 scientific experiments. That includes several aimed at better understanding the effects of spaceflight on glucose health. Labront, a platform assisting health researchers in collecting and analyzing physiological data, is collaborating with Dexcom. It plans to provide advanced analytics for the data collected by the crew.   According to a news release, the mission expects to explore how microgravity, fluid shifts, and blood flow restriction exercises impact glucose regulation. https://www.drugdeliverybusiness.com/dexcom-cgm-outer-space-polaris-dawn/ XX There are now two OTC CGMs.. Dexcom launched Stelo a few weeks ago and now Abbott says Lingo is for sale. They're both available on the companies' websites, cost about the same, but you can opt to buy only one Lingo where Stelo comes in pairs. Lingo is meant for people without diabetes – it's a health bio sensor. Abbott has another CGM called Libre Rio meant for people with type 2 who don't take insulin. Not a lot of details about what the real difference are here – likely just in the software – No word on when Rio will be available. https://www.cnbc.com/2024/09/05/-abbott-launches-its-first-over-the-counter-continuous-glucose-monitor-in-the-us.html XX Warning about flying with an insulin pump – And I want to be clear here because I'm sure you'll see some scary headlines. This is really about pressure emergencies in planes. For the study, researchers tested 26 insulin pumps in a hypobaric chamber programmed to mimic the atmospheric changes during a normal commercial airline flight. “The drop in cabin pressure during ascent may lead to a slight increase in insulin delivery as a result of the formation of air bubbles which displace excess insulin out of the cartridge,” Fan said in a meeting news release. “A slight reduction in insulin delivery is also possible during descent as the increasing air pressure dissolves the air bubbles, sucking insulin back into the pump.” People on insulin pumps could be in real trouble in the event of rapid decompression of the cabin at altitude, researchers said. In that case, the pumps could deliver an insulin overdose -- dropping blood sugar levels so much that there's a significant risk of hypoglycemia, results show. These researchers recommend disconnecting and reconnect at take off and landing, but that's not going to help if there is emergency rapid decompression. As always, be prepared with emergency glucagon and low snacks and supplies. https://www.healthday.com/health-news/diabetes/flying-could-upset-insulin-pump-function-for-type-1-diabetics XX Lilly moves forward with it's version of once weekly basal insulin. Clinical trials show it can help control both Type 1 and Type 2 diabetes as well as daily basal injections do. However, in those with type 1 diabetes, there was an increased risk for hypoglycemia.  This is the same issue with Novo Nordisk's Awiqli insulin – approved in Canada but not in the United States. https://www.upi.com/Health_News/2024/09/11/weekly-insulin-injections-effective-diabetes-weekly/8711726068680/ https://www.medscape.com/viewarticle/once-weekly-insulin-looks-good-t2d-risk-seen-t1d-2024a1000gh8 XX Eating what seems like really healthy foods could be associated with a higher risk of developing type 1 diabetes. New study shows that eating fruit, oats and rye in childhood is associated with a higher risk of developing type 1 diabetes (T1D). Eating berries, however, is linked to lower odds of developing the condition. What triggers the immune system's attack is unknown but is thought to involve a combination of a genetic predisposition and an environmental trigger such as a virus or foodstuff. T1D, the most common form of diabetes in children, is increasing worldwide. The number of cases worldwide is projected to double in just 20 years, from 8.4 million in 2021 to 17.4 million by 2040. Finland has the highest incidence of T1D globally, with 52.2 cases per 100,000 children under the age of 15 – more than five times higher than in the 1950s. 5,674 children (3,010 boys and 2,664 girls) with genetic susceptibility to T1D were followed from birth to the age of six. Food records completed by their parents repeatedly from the age of three months to 6 years provided information on the entire diet.   The 34 food groups covered the entire diet and, when they were all factored in, several foods were associated with a higher risk of developing T1D.   To the best of our knowledge, this is the first time a child's entire diet has been considered at the same time." The results show that the more fruit, oats or rye children ate, the more their risk of T1D increased. In contrast, eating strawberries, blueberries, lingonberries, raspberries, blackcurrants and other berries appeared to provide protection against T1D. The more berries a child ate, the less likely they were to develop T1D. Oats, bananas, fermented dairy products (such as yogurts) and wheat were associated with an increased risk of islet autoimmunity, whereas cruciferous vegetables, such as broccoli, cauliflower and cabbage, were associated with decreased risk. It is, however, too early to make any dietary recommendations. The researchers are quick to point out that they don't really know the “why” here. Could be the food itself, could be pesticides, and until the results are replicated they urge parents not to change their child's diet. https://www.news-medical.net/news/20240909/Eating-fruit-oats-and-rye-in-childhood-may-increase-type-1-diabetes-risk.aspx XX Researchers in France have developed a once-a-month hydrogel-based delivery system for semaglutide, significantly simplifying diabetes and weight management Semaglutide, marketed as Ozempic, Rybelsus, and Wegovy, is a GLP-1 receptor agonist that helps to regulate blood sugar levels and promote weight loss. This medication is especially effective in managing type 2 diabetes and is available in both injectable and oral forms. Semaglutide enhances the body's natural ability to control blood glucose and reduce appetite, providing a dual approach to treatment.     The new hydrogel delivery platform uses two innovative degradable polymers that are chemically bound to one another to form a gel, but allow slow, sustained release of soluble peptides over 1 to 3 months. How do you slow release a gel? With an injection. It goes under the skin. This is still in animal studies, so we're a ways off from human clinical trials. https://scitechdaily.com/new-semaglutide-hydrogel-say-goodbye-to-weekly-shots-for-diabetes-and-weight-loss/ XX   Edgepark Commercial XX   Embecta has received clearance from the Food and Drug Administration for its first insulin patch pump. The device can be used by people with Type 1 or Type 2 diabetes and worn for up to three days. It includes a 300-unit insulin reservoir. Embecta said Tuesday it plans to develop a closed-loop version of the pump for automated insulin dosing that it will submit to the FDA in the future using the Tidepool Loop algorithm. Earlier this summer, Insulet received FDA clearance to offer its Omnipod 5 pump to people with Type 2 diabetes. Diabetes tech firms have focused on Type 2 in recent years as insurance coverage improves. https://www.medtechdive.com/news/embecta-gets-fda-nod-for-insulin-patch-pump/725904/ XX An artificial intelligence (AI)–driven voice algorithm showed "excellent agreement" with the American Diabetes Association (ADA) risk test in detecting adults with type 2 diabetes (T2D), research presented at the European Association for the Study of Diabetes (EASD) 2024 Annual Meeting revealed.   The AI model detected T2D with 66% accuracy among women and 71% in men, and there was 93% agreement with the questionnaire-based ADA risk score, demonstrating comparable performance between voice analysis and an accepted screening tool.   The Colive Voice project includes volunteers from all over the world; however, the current study was restricted to adults from the United States, both with and without T2D, "This first proof of concept was limited to English speakers, and further research will need to enroll more diverse populations, in terms of languages and sociodemographic background," he said. "This study represents a first step toward using voice analysis as a first-line, highly scalable T2D screening strategy," the authors concluded. "The next studies will have to demonstrate the robustness of our approach in diverse populations and also include people living with prediabetes," Fagherazzi said. "If proven reliable, we expect such technology to be available in the next 5-10 years. Then, it could be deployed easily at scale in millions of smartphones worldwide and reduce undiagnosed diabetes cases." https://www.medscape.com/viewarticle/ai-voice-analysis-diabetes-screening-shows-promise-2024a1000ggw XX Join us again soon!

In this episode of StartUp Health NOW, Chuck Henderson, the CEO of the American Diabetes Association (ADA) and a member of StartUp Health's Health Moonshot Impact Board, took time out of his busy schedule at the recent ADA Scientific Sessions – the ADA's annual global gathering of more than 11,000 people working on foundational products and bleeding-edge ideas related to both Type 1 and Type 2 diabetes – to chat with us about innovation, collaboration, and the ADA's latest initiatives. Launch of the Obesity Association: The ADA has announced the formation of the Obesity Association, which will now be a division within the ADA, focusing heavily on integrating obesity care into diabetes standards. Cutting-Edge Research: The ADA is doubling down on its efforts to combat obesity by incorporating it more thoroughly into their standards of care, considered a critical resource in diabetes management. Health Equity: A significant focus is on health equity, ensuring that all programs are accessible and beneficial to underserved communities, including rural areas. Community Outreach: The ADA has initiated programs like mobile clinics in rural Alabama to address diabetic retinopathy, demonstrating their commitment to reaching underserved populations. Innovation and Competition: The ADA values innovation and competition, fostering early-stage research and encouraging disruptive ideas to push forward diabetes care and treatment. Collaboration with StartUp Health: Chuck Henderson expressed his appreciation for his involvement with StartUp Health. He highlights StartUp Health's role in connecting communities and emphasized the importance of our ecosystem in addressing chronic illnesses through innovative solutions like the Type 1 Diabetes Moonshot.     Innovating in Alzheimer's disease? Learn how you can join our Alzheimer's Moonshot. Want more content like this? Sign up for StartUp Health Insider™ to get funding insights, news, and special updates delivered to your inbox. Innovators: Health Transformer University fuels your health moonshot Funders: Become a Health Moonshot Champion

It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: A new study looks at insulin needs in men vs women, updates on stem cell transplants and a new look at COVID 19 and T1D plus a fully implantable CGM is announced. We'll also tell you about a T1D athlete drafted to the MLB. Lots more in this week's episode, full transcipt below.  Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links:   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX Do men and women have different insulin requirements? A new study conducted across Europe says yes – women overall need less. Published in the Journal of Diabetes Science and Technology this looked at over 9,000 adults with type 1 diabetes using data from patients using the Diabeloop Generation 1 (DBLG1) hybrid closed-loop pump system. In this study, women needed 14-percent less insulin overall than men. These researchers say these findings have important implications for the practical management of insulin therapy and highlight the necessity of considering gender as a crucial factor in diabetes treatment. The treatment guidelines provided by American and European Diabetes Societies do not currently have gender-specific recommendations for insulin-weight ratios. The co-founder and Chief Scientific and Technical Officer for Diabeloop. “This study also highlights the capacity to discover new insights from big-data analysis of real-world data.” *Insulin Requirements According to Gender and Weight in a Population of 9036 Adult Persons With Type 1 Diabetes Using Closed-Loop Insulin Delivery, https://doi.org/10.1177/19322968241252366). https://www.theglobeandmail.com/investing/markets/markets-news/GetNews/27419187/diabeloop-study-reveals-significative-gender-differences-in-insulin-requirements-for-type-1-diabetes-patients/   XX New drug therapy in those lucky diabetic mice boosted insulin-producing cells by 700% over three months, effectively reversing the disease. Scientists at Mount Sinai and City of Hope have been able to grow new beta cells in the body, in a matter of months. The therapy involved a combination of two drugs: one is harmine, a natural molecule found in certain plants, which works to inhibit an enzyme called DYRK1A found in beta cells. The second is a GLP1 receptor agonist. The latter is a class of diabetes drug that includes Ozempic, The researchers tested the therapy in mouse models of type 1 and 2 diabetes.. The signs of the disease quickly reversed, and stayed that way even a month after stopping the treatment.   The results are intriguing, but of course being an animal study means there's still much more work to be done before it could find clinical use. So far, harmine alone has recently undergone a phase 1 clinical trial in humans to test its safety and tolerability, while other DYRK1A inhibitors are planned for trials in humans next year. https://newatlas.com/medical/diabetes-reversing-drug-boosts-insulin-producing-cells/ XX Stem cell–derived beta-cell replacement therapy continues to show benefit in people with type 1 diabetes at a high risk for severe hypoglycemia. New info from Vertex shows that of a total 17 patients who received a full dose of their  investigational allogeneic stem cell–derived, fully differentiated pancreatic islet cell replacement therapy (VX-880), three, thus far, have achieved the primary study efficacy endpoint of elimination of severe hypoglycemic episodes with A1c < 7% at 1 year and the secondary endpoint of insulin independence. Others are on the same trajectory, Piotr Witkowski, MD, PhD, professor of surgery at The University of Chicago, Chicago, said at the recent American Diabetes Association (ADA) 84th Scientific Sessions. In his presentation, Witkowski also provided details about the deaths of two study participants that the company had announced in January 2024, neither of which were related to the VX-880 product. In fact, there have been no severe adverse events related to the product itself, with most due to either the infusion procedure or the immunosuppression. "These data highlight the curative potential of VX-880 in people living with type 1 diabetes and support further evaluation of VX-880 toward pivotal development," Witkowski said. For now, patients selected for the study are those who experience frequent severe hypoglycemia deemed to be a greater risk to the patient than that of immunosuppression. However, Ahn pointed out, "With VX-880, the obvious fly in the ointment is the need for immunosuppression which carries significant risk…There are multiple solutions being proposed, but we are still waiting for data as promising as the initial Vertex data is on that front." https://www.medscape.com/viewarticle/stem-cell-derived-islets-continue-show-benefit-t1d-2024a1000cx1 XX Still lots of COVID studies coming in about type 1. A German study suggests COVID 19 may speed up progression of existing but presymptomatic T1D in kids. These researchers had been screening and following children in an early presymptomatic stage of type 1 diabetes for several years. They noticed an increase in the numbers of Incidence of clinical type 1 diabetes nearly doubled after the pandemic started. "We know that the virus can infect the pancreatic islets so it could be causing damage or change in the beta cells that make insulin," said Ziegler when discussing possible mechanisms behind this association. "Second, there is generalized inflammation during the infection and there may be a stimulation of the immune response. Third, there could be metabolic stress from the infection that affects the beta cells that make insulin. To dive into this topic, youth were identified in the German Fr1da-screening program from 2015 to 2023. All patients had presymptomatic diabetes defined as persistent, confirmed positive results for two or more islet autoantibodies. Their progression was monitored at 3- to 6-month intervals. Clinical type 1 diabetes was defined according to American Diabetes Association   COVID infection was either self-reported via the family or identified with SARS-CoV-2 antibodies were confirmed in blood samples collected at study visits.   Vaccination against COVID-19 may be one way to protect presymptomatic type 1 diabetes youth from progression, Ziegler added. She said her group is currently testing whether COVID-19 vaccination can reduce new-onset, presymptomatic type 1 diabetes in a clinical trial  of children with genetic risk factors for the condition. https://www.medpagetoday.com/endocrinology/type1diabetes/111084 XX The FDA says no – for now - to Novo Nordisk's weekly insulin.  This has been approved in Canada and should be available there shortly. But the FDA says it wants more information related to the manufacturing process and the type 1 diabetes indication to complete the review. Novo said it does not expect to be able to fulfil the requests this year, and that it will work closely with the FDA regarding the next steps. The regulator's decision follows its outside panel's vote against the use of the weekly insulin icodec, in patients with type 1 diabetes due to risks of low blood sugar. https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-declines-approve-novo-nordisks-weekly-insulin-2024-07-10/ XX A couple of weeks ago we spoke to the attorneys taking on CGM monitronig in schools. They've helped a family in Connecticut and set a precdent.  A child with autism and diabetes was not getting reasonable accommodations under the federal Americans with Disabilities Act in a public preschool program. I'll link up the press release from the DOJ but this family wasn't getting any support and it just wasn't safe. The lawyers here tell me the ruling and settlement is just going to help them going forward as they try to make schools complient with CGM as a reasonable  accomodatin. https://www.justice.gov/usao-ct/pr/aba-therapy-provider-make-changes-comply-americans-disabilities-act   XX Ozempic could lower the risk of dementia and a range of other mental problems compared with other existing treatments for patients with diabetes. What's more, researchers found that Ozempic cut nicotine dependence in those patients.   This study relied on medical records from more than 100,000 U.S. diabetes patients, including more than 20,000 who were prescribed semaglutide between December 2017 and May 2021. After a year, patients who took Ozempic had a 48% lower risk of developing dementia than those on Januvia. The risk in Ozempic patients was also 37% lower than those who took Glucotrol and 9% lower than those on Jardiance. Notably, previous research has determined that diabetes patients are at a greater risk of developing dementia. But the authors emphasized that the analysis is observational. The results need to be replicated in a controlled trial that assigns patients to randomly take Ozempic and the other drugs, according to Dr. Max Taquet, another Oxford clinical lecturer and senior study author. https://www.cnbc.com/2024/07/16/healthy-returns-ozempic-may-lower-dementia-risk-nicotine-use.html XX   Edgepark Commercial XX The Omnipod 5 with Dexcom G7 integration is now available through select pharmacies with full availability expected in the fall.   The System uses new Pods that are compatible with both Dexcom G6 and G7, but the prescription code will stay the same as the current Omnipod 5 Pods. This means the community will have similar insurance coverage and access to what they have with Omnipod 5 today.   If you're looking to start on Omnipod 5 and you're currently using Dexcom G7, your doctor will need to send a prescription for both the Omnipod 5 Intro Kit and Omnipod 5 Pods, compatible with Dexcom G6-G7, to ASPN Pharmacies.   You can learn more at https://www.omnipod.com/innovation/dexcom-g7.   If you are already using Omnipod 5, you will get the new Pods compatible with Dexcom G6 and G7 through your Pod refills. You do not need a new prescription. The week of July 29th, you will receive a free software update for the Omnipod 5 App to your Controller or compatible Android smartphone which is needed to use the System with Dexcom G7. Accept the update. We recommend you continue to use your current Omnipod 5 Pods and Dexcom G6 supplies until the new Pods compatible with Omnipod 5 with Dexcom G6-G7 are available at your preferred pharmacy.   We'll email our users when the new Pods are available in most pharmacies.   You can learn more at https://www.omnipod.com/innovation/new-compatible-devices   XX Big promises about long-term implantable blood glucose monitor from a company called Focus. They say they're partnering with Glucotrack to quote - transform how people with diabetes interact with their condition. They're not calling this a CGM – rather it's a CBGM, continuous blood glucose monitor because it will measure glucose levels in blood, not in interstital fluid like CGMs do. They company says this is a fully subdermal location, with no external wearable. In preclinical studies, the CBGM has a MARD of 4.7% at day 90. That is MUCH lower than CGMs on the market – Dexcom and Libre are in the low 8s right now. BUT.. it hasn't been fully tested in people yet. Human clinical trials are set to start later this year. https://www.drugdeliverybusiness.com/focus-collaborates-glucotrack-implantable-cbgm/ XX Big congrats to Jamie Ferrer (Chy-may Fer-rare) On Monday, Ferrer's dream was realized when the Twins selected the Florida State outfielder in the fourth round (No. 126 overall) during Day 2 of the MLB Draft. Minnesota vice president of amateur scouting Sean Johnson said the club had its eyes on Ferrer since high school. “Recently, I was in Orlando at a conference called, “Friends for Life with CWD [Children with Diabetes],” and we had an event that was a sports day. … Kids would come up to me and either them or their families would ask me how I dealt with this [or that],” Ferrer said. “And seeing their faces light up whenever I said I was diagnosed at three and I played college baseball. … You hear people tell you no and that you can't do this because you have Type 1 diabetes … So why not inspire as many people as I can?”   “I'm super proud of being a Type 1 athlete, and it's something that I'll never shy away from talking about or showing off my insulin pump because it's who I am and it's something that I've had to deal with my entire life.” https://www.mlb.com/news/jaime-ferrer-selected-no-126-overall-by-twins-in-2024-mlb-draft XX Join us again soon!

Send us a Text Message.Ken D. Berry is a holistic physician, author, and influencer who promotes a low-carb, high-fat, and low-stress lifestyle to improve overall health and wellbeing. In this interview with nutrition and health coach, Stephen, Ken discusses his latest project, the American Diabetes Society, which aims to provide evidence-based information and resources for people with diabetes and those at risk. He also shares his thoughts on topics such as the benefits of a low-carb diet, the importance of transparency and open debate.  It's time to HELP those with Diabetes. Dr. Ken Berry wants to make a big change.Donate https://www.gofundme.com/f/join-ads-in-revolutionizing-diabetes-careDr. Ken Berry shares his frustration with the American Diabetes Association (ADA) for not acknowledging the benefits of a low-carb, ketogenic diet in managing and reversing diabetes.Thank you so much for listening to my podcast. I hope you enjoyed it. Your support means the absolute world to me. And if you're enjoying the show, I've got a small favor to ask you. I'd be incredibly grateful if you would consider becoming a supporter and make a small monthly donation. Your contribution will really help to improve the show. It's a small monthly contribution. You can cancel at any time, and the link is in the show notes. Support the Show.All my links in 1 easy list, including booking and personal training workout plans at LINKTREE You can now download the carnivore experience appApple direct link for apple devices Google play store direct link to app for Android Coach Stephen's Instagram Book me for coaching My growing UK carnivore YouTube channel I have set up a community that is all about eating low-carb and specifically carnivore. CLICK HERE Support my podcast from just £3 per monthBECOME A SUPPORTER Success stories Optimal Health 5 Star reviews All my facebook and other reviews are here Thanks to www.audionautix.com for any music included. Ple...

In this special sponsored episode from Sanofi, we welcome Jennifer Goldman. She is a professor of pharmacy at the Massachusetts College of Pharmacy and Health Sciences, board-certified in advanced diabetes management, and a certified diabetes care and education specialist. Together, we delve into the latest insights from the American Diabetes Association (ADA) guidelines, exploring topics such as intensifying injectable therapies and the pivotal role of basal insulin in Type 2 diabetes management. Jennifer provides expert guidance on identifying candidates for basal insulin therapy, managing severe hyperglycemia, and initiating basal insulin treatment in patients new to therapy. Additionally, she discusses the differences between basal insulin analogs and offers practical strategies for overcoming common challenges associated with basal insulin therapy. Connect with us in the coming weeks on LinkedIn (http://www.linkedin.com/in/kevinmd) and X (https://twitter.com/kevinmd) for the next part of this series, where you can learn more about the different types of basal insulin analogs to manage Type 2 diabetes. Disclosures This program is non-promotional and sponsored by Sanofi. Speakers are being compensated and/or receiving an honorarium from Sanofi in connection with this presentation. The content contained in this presentation was jointly developed by speakers and Sanofi. The program is not eligible for continuing medical education (CME) credits. Important information These materials aim to outline common clinical considerations and procedural steps for using referenced products. However, they may not be suitable for every patient or case. Results may vary. Results from one case study are not necessarily predictive of results in other cases.  Decisions regarding patient care rely on the physician's professional judgment, taking into account all available information for the individual case. Sanofi does not endorse or advocate for the use of its products beyond their FDA-approved labeling. We do not offer medical advice, diagnosis, or treatment. The health information provided herein is for general educational purposes only. Your health care professional remains the primary source of information regarding your health. Please consult your health care professional if you have any questions about your health or treatment. Intended for residents of the United States only. VISIT SPONSOR → https://www.sanofi.com/ SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast

In marking National Kidney Month, this episode features an interview with Robert Perkins, MD, Vice President, US Medical Affairs (Renal) at Bayer who spoke about kidney health and diabetes-inflicted chronic kidney disease.National Kidney Month is observed every March in the US to raise awareness about kidney health and promote preventive action. It aims to educate the public about the importance of kidneys to overall health and the risk factors for kidney disease, a major one being diabetes. At Bayer, Dr. Perkins is the strategic lead for a team of 8 HQ-based medical directors and a 40-member field medical team. He is responsible for evidence portfolio across two therapeutic indications, chronic kidney disease and heart failure, encompassing seven active trials and studies and more than 3,000 US patients. Dr. Perkins has also led the development and implementation of innovative digital educational outreach campaigns for primary care physicians. In previous roles, Dr. Perkins helped build and develop medical teams at Novartis and AstraZeneca. Last year, the American Diabetes Association (ADA) updated their standards of care guidelines for 2024, which outline strategies for diagnosing and treating diabetes (both type 1 and type 2) and outline methods of preventing and delaying type 2 diabetes as well as associated comorbidities like cardiovascular disease and chronic kidney disease.Tune into the episode to hear Dr. Perkins' insights about current advancements and challenges in tackling chronic kidney disease, the updated ADA guidelines and how a comprehensive approach to treating diabetes is necessary for reducing the risk of kidney complications.For more life science and medical device content, visit the Xtalks Vitals homepage.Follow Us on Social MediaTwitter: @Xtalks Instagram: @Xtalks Facebook: https://www.facebook.com/Xtalks.Webinars/ LinkedIn: https://www.linkedin.com/company/xtalks-webconferences YouTube: https://www.youtube.com/c/XtalksWebinars/featured

Since 2020, Charles "Chuck" Henderson has led the American Diabetes Association (ADA) as CEO. In 2023, he joined StartUp Health's Health Moonshot Impact Board, a unique, multi-disciplinary group of stakeholders passionate about advancing health innovation. On the Health Moonshot Impact Board, Henderson joins top thought leaders like Dr. Toby Cosgrove (former CEO, Cleveland Clinic) and Sue Siegel (former CEO, GE Ventures). In this StartUp Health NOW episode, StartUp Health's Logan Plaster sat down with Henderson to learn about his priorities in leading the ADA and why it was important to him to join StartUp Health's moonshot community. Innovators: Health Transformer University fuels your health moonshot Funders: Become a Health Moonshot Champion Want more content like this? You can subscribe to the podcast as well as other health innovation updates at startuphealth.com/content. Sign up for StartUp Health Insider™ to get funding insights, news, and special updates delivered to your inbox. Looking to break down health barriers? If you're an entrepreneur or investor, contact us to learn how you can join our Health Equity Moonshot. Passionate about Type 1 diabetes? If you're an entrepreneur or investor, contact us to learn how you can join our T1D Moonshot.

It's In the News, a look at the top stories and headlines from the diabetes community happening now. Top stories this week: an existing drug for arthritis is being studied for treatment of T1D, poison control centers report a big increase in calls about misdosing of Ozmepic and semaglutides, Tandem releases it's Tandem Source software, we've got an update on a possible non invasive glucose monitoring system, ADA releases it's standards of care and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Take Control with Afrezza  Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX Our top story this week… XX A world-first clinical trial has found a common drug used to treat rheumatoid arthritis can suppress the progression of type 1 diabetes in recently diagnosed patients. Australian reserachers say they've discovered that baricitinib *bare-uh-sit-en-ub* can preserve the body's own insulin production. The scientists recruited 91 people, aged between 10 and 30 years old, to take part in the double-blind randomised trial. All patients had been diagnosed with type 1 diabetes within the last 100 days and continued with their prescribed insulin therapy throughout the study. The results showed those in the baricitinib group were able safely and effectively to preserve their body's own insulin production and suppress the progression of type 1 diabetes. "Our trial showed that, if started early enough after diagnosis, and while the participants remained on the medication, their production of insulin was maintained. "People with type 1 diabetes in the trial who were given the drug required significantly less insulin for treatment." Dr Faye Riley, research communications manager at Diabetes UK, said of the latest trial: "These findings show by tackling the root of type 1 diabetes - an immune system attack - an existing drug can help to shield the pancreas, in people recently diagnosed with type 1, so they can continue making more insulin for longer. "This can give people with type 1 diabetes much steadier blood sugar levels and help to protect against serious diabetes complications down the line. "Immunotherapies are edging us towards a new era in type 1 diabetes treatment, and could help us overcome a major hurdle en route to finding a cure for the condition. "This trial takes us another step closer." The study was funded by JDRF, a non-profit organization which focuses on type 1 diabetes research. The research has been published in the New England Journal of Medicine. https://news.sky.com/story/world-first-trial-finds-arthritis-drug-may-help-treat-type-1-diabetes-13024706 XX Earlier this month, Dexcom's G7 became compatible with two pump systems: Beta Bionic's ilet pump and Tandem Diabetes tslim X2. Current customers should have received instructions on how to download the updated software – new pumps will be shipped with G7 software already loaded. Tandem has also announced their new Tandem Source platform – full launch in the US with international rollout slated for next year. Anyone in the U.S. who uses a Tandem pump—as well as their respective healthcare providers—will now have access to the Source platform. On the patient side, insulin dosage data will automatically transfer from the pump to the platform, by way of the t:connect mobile app, where it'll be compiled into three reports for your doctor. Patients will also be able to use the platform to access new software updates for their pumps and to reorder supplies as needed. Long term, the company hopes to use the data from users – which would be blinded- to update automated insulin dosing algorithms. https://www.fiercebiotech.com/medtech/tandem-begins-full-us-rollout-source-diabetes-management-platform XX New look at benefits from a plant based diet – this research says it can reduce the risk of type 2 diabetes by 24%. It's not just about weight loss. They reviewed data on more than 113,000 participants in a large-scale British observational study, gathered over 12 years. They found that normal values for cholesterol, blood sugar, inflammation, and insulin are associated with a low risk of diabetes. They also found that good liver and kidney function is important in diabetes prevention. A plant based diet helped with all of those factors. The researchers do point out that there is such a thing as an unhealthy plant-based diet. Those that are still high in sweets, refined grains and sugary drinks are associated with an increased risk of type 2 diabetes, researchers found. https://www.usnews.com/news/health-news/articles/2023-12-13/plant-based-diets-cut-diabetes-risk-by-24 XX Reports of more patients with type 2 diabetes having trouble getting coverage for medication like Ozempic and Mounjaro – because health insurance companies are putting new restrictions in place. Most U.S. health plans cover GLP-1s for type 2 diabetes but many providers will prescribe it off label for weight loss. There is another medication – Wegovy – approved for weight loss, it's the same drug as Ozempic just packaged in a difference dose and name. The average number of weekly Ozempic prescriptions rose 33% between the first and third quarters of this year, but has since dropped more than 6% to about 431,000, according to Iqvia Institute for Data Science. Doctors and patients are bracing for changes in January, when individual health plans often set new coverage terms. "It may be that January 1, all of a sudden something that was covered is no longer," said Dr. Robert Gabbay, chief science officer at the American Diabetes Association. https://www.reuters.com/business/healthcare-pharmaceuticals/us-diabetes-patients-face-delays-insurers-tighten-ozempic-coverage-2023-12-12/ XX Poison control centers across the US say they are seeing a steep increase in calls related to semaglutide, with some people reporting symptoms related to accidental overdoses. From January through November, the America's Poison Centers reports nearly 3,000 calls involving semaglutide, an increase of more than 15-fold since 2019. In 94% of calls, this medication was the only substance reported. The compounded versions of semaglutide are often different from the patented drug. Many contain semaglutide salts called semaglutide sodium and semaglutide acetate. The FDA says the salt forms of the drug have not been tested and approved to be safe and effective the way the patented form of the medication has, and thus they don't qualify for the compounding exemption in the law for drugs in shortage. In other cases, the compounded versions are sold in unapproved dosages. But these compounded versions are popular because they may cost less out-of-pocket, especially if the treatment isn't covered by insurance. The name-brand drugs are sold in pre-filled pens, which come with some safeguards. Patients dial to the correct dose and click to inject, so it's harder to make mistakes. Compounded versions, however, typically come in multidose glass vials, and patients draw their own doses into syringes. It's easy to get confused. https://www.cnn.com/2023/12/13/health/semaglutide-overdoses-wellness/index.html XX XX Type 2 diabetes patients who received endocrinology care through telehealth alone had poor glycemic outcomes compared with those who received in-person or hybrid care, which contrasts with prior research findings, according to a new study. Previous research has shown that telehealth is effective in improving glycemic control, but there has not been enough data on utilization and outcomes linked to routine telehealth care for type 2 diabetes since 2020, especially in the endocrinology setting, the researchers wrote. One reason may be that the strategies to support glycemic improvement deployed during in-person appointments, like self-management education and sharing home blood glucose data, have not been consistently translated to telehealth. “Implementation of approaches to overcome these differences, such as team-based virtual care and technological tools to automate blood glucose data sharing, are needed to ensure all patients receive high-quality diabetes care regardless of care modality,” they wrote. These study findings contrast with previous research, including a study published in early 2022 that revealed that telehealth maintained quality of care and led to better health outcomes for patients with type 2 diabetes during the COVID-19 pandemic. The study included 16,588 with type 2 diabetes who received care before or during the pandemic, with 7,581 having a telehealth visit with either a primary care physician or an endocrinologist. https://mhealthintelligence.com/news/telehealth-only-care-fails-to-improve-type-2-diabetes-outcomes XX Medtronic's deal to buy a South Korea based insulin patch pump maker is off. Back in May Medtrnoic announced a 738-million dollar deal to buy EOFlow, which makes EOPatch, a tubeless, wearable and fully disposable insulin delivery device. EOFlow already launched its EOPatch insulin delivery system in Korea and Europe. The company submitted the insulin delivery device for U.S. FDA clearance in January. https://www.massdevice.com/medtronic-nixes-738m-deal-for-insulin-patch-pump-maker-eoflow/ XX Commercial XX Update on non invasive continuous glucose monitoring. The most recent validation of the technology's accuracy has been released as a preprint. In an experiment, researchers fed thousands of radio frequency glucose readings into a machine learning model to translate them into blood sugar values and compared the results against those from a Dexcom G6. CGM accuracy is judged by mean absolute relative difference, or MARD. The statistic is reported as a percentage: a MARD of 10 percent, for example, means that the CGM is on average within 10 percent of the reference value. The Bio-RFID system scored a MARD of 11.27 percent. In truth, this result is difficult to interpret. Though Bio-RFID's MARD is not yet in the same neighborhood as its competitors' (the Freestyle Libre 3 and the Dexcom G7 report MARDs of 7.9 percent and 8.7 percent, respectively), the experiment wasn't a true test of the device's capabilities, because it didn't use a lab-drawn glucose measurement as its reference value. The volunteers also did not have diabetes, which meant that their blood sugar levels were likely more stable than those of most future customers. The FDA has specific accuracy standards that it expects CGM manufacturers to meet for devices intended for “nonadjunctive” use and for use in a closed-loop insulin pump system. Know Labs's product will need to meet these objective standards to be validated as a truly reliable CGM. The Path to Approval “Our expectation is that we'll be in front of the FDA as we move into the second half of 2024,” says Erickson. Much larger trials will be needed to show that the device works and meets FDA standards. Erickson says, “We expect to have an FDA-cleared device in 2025.” Though the business is still finalizing the form of the next generation, it expects that it can navigate the FDA approval process quickly. The FDA has already confirmed that RFID is quite safe and there should be little worry about side effects (though there could be a hazard of interference for patients already using electronic medical devices such as pacemakers). https://www.diabetesdaily.com/blog/this-company-is-racing-to-create-the-worlds-first-non-invasive-cgm-718069/ XX Today, the American Diabetes Association® (ADA) released the Standards of Care in Diabetes—2024 (Standards of Care), a set of comprehensive and evidence-based guidelines for managing type 1, type 2, gestational diabetes, and prediabetes based on the latest scientific research and clinical trials. It includes strategies for diagnosing and treating diabetes in both youth and adults, methods to prevent or delay type 2 diabetes and its associated comorbidities like cardiovascular disease (CVD) and obesity, and therapeutic approaches aimed at minimizing complications and enhancing health outcomes. "The latest ADA guidelines present pivotal updates for health care professionals, ensuring comprehensive, evidence-based care for diabetes management. These changes reflect our ongoing commitment to optimizing patient outcomes through informed, adaptable, and patient-centered health care practices,” said Robert Gabbay, MD, PhD, the ADA's chief scientific and medical officer. “The ADA's Standards of Care ensures health care professionals, especially our primary care workforce, provide the best possible care to those living with diabetes.” Notable updates to the Standards of Care in Diabetes─2024 include: New updates in managing obesity in people with diabetes, including approaches to reduce therapeutic inertia, support more personalization, and incorporate additional obesity measurements beyond body mass index (i.e., waist circumference, waist-to-hip ratio, and/or waist-to-height ratio). New screening recommendations for heart failure in people with diabetes. Updated recommendations for peripheral arterial disease (PAD) screening in people with diabetes. Guidance on screening and the use of teplizumab, approved to delay the onset of type 1 diabetes. More guidance on the use of new obesity medications, glucagon-like peptide 1 (GLP-1) agonists or dual glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, to reach sustained weight management goals. Updates in guidance on the diagnosis and classification of diabetes. A focus on hypoglycemia prevention and management. Emphasis on screening people with diabetes for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis at primary care and diabetes clinics. New emphasis on the evaluation and treatment of bone health and added attention to diabetes-specific risk factors for fracture. A focus on screening and management of people with diabetes and disability. Emphasis on enabling health care providers to master diabetes technology, using artificial intelligence for retinal screenings with necessary referrals, and embracing telehealth and digital tools for diabetes self-management education. New information on the possible association between COVID-19 infections and new onset of type 1 diabetes. "As the ADA's chair of professional practice committee, I'm excited to share our latest updates to advance diabetes care through new scientific insights and technological innovation, all aimed at enhancing experience for people with diabetes and health care professionals in managing this complex condition," said Nuha A. El Sayed, MD, MM Sc, the ADA's senior vice president of health care improvement. Other noteworthy changes to the 2024 Standards of Care include: Updated immunization guidance to include newly approved RSV vaccines in adults over 60 years of age with diabetes. New emphasis on cultural sensitivity in diabetes self-management education, with considerations for changing reimbursement policies. More detail and emphasis on psychosocial screening protocols to better identify diabetes distress. The importance of diabetes technology, with an emphasis on continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems. Continued emphasis on inclusion and person-centered care. “At the ADA, we are focused on improving the quality of care for anyone who lives with diabetes, prediabetes, or who is at risk of developing diabetes. The Standards of Care is critical to ensuring the improved treatment of diabetes, a chronic disease that requires continuous care through a well-informed and coordinated health care team. These standards equip health care professionals with the gold standard in diabetes care, ensuring the highest level of service and knowledge in the field,” said Chuck Henderson, the ADA's chief executive officer. The ADA annually updates its Standards of Care through the efforts of its Professional Practice Committee (PPC). Comprising 21 global experts from diverse professional backgrounds, the PPC includes physicians, nurse practitioners, certified diabetes care and education specialists, registered dietitians, pharmacists, and methodologists. Its members hold expertise in areas like adult and pediatric endocrinology, epidemiology, public health, cardiovascular risk management, kidney disease, microvascular complications, preconception and pregnancy care, weight management, diabetes prevention, behavioral and mental health, inpatient care, and technology in diabetes management. Additionally, the committee collaborates with 19 specialized content experts. The 2024 Standards of Care has garnered endorsements from the American College of Cardiology (Section 10), the American Society of Bone and Mineral Research (Bone section in Section 4), and the Obesity Society (Section 8). Today, the Standards of Care in Diabetes—2024 is available online and is published as a supplement to the January 2024 issue of Diabetes Care®. A shortened version of the guidelines, known as the Abridged Standards of Care, will be made available for primary care providers in the journal Clinical Diabetes®, along with a convenient Standards of Care app as well as a Standards of Care pocket chart. The online version will be annotated in real-time with necessary updates if new evidence or regulatory changes merit immediate incorporation through the “living” Standards of Care process. Other Standards of Care resources, including a webcast with continuing education (CE) credit and a full slide deck, can be found on the ADA's professional website, DiabetesPro®. https://diabetes.org/newsroom/press-releases/american-diabetes-association-releases-standards-care-diabetes-2024 XX Join us again soon!  

Neste sexto episódio em podcast da Série de Diabetes – Baseado em Evidências, Luiz Fernando Vieira, endocrinologista e conteudista do Portal, fala sobre a melhor forma de iniciar o tratamento no diabetes tipo 2. O especialista comenta ainda as opções medicamentosas disponíveis e qual é mais indicada em cada situação, seguindo os guidelines da American Diabetes Association (ADA) e da Sociedade Brasileira de Diabetes (SBD). Confira agora! A nova série Diabetes – Baseado em evidências tem por objetivo realizar uma ampla revisão baseada nas mais recentes evidências para atualizar os médicos sobre diferentes aspectos da diabetes. Essa doença, que é um dos maiores problemas de saúde mundial, apresenta impactos em todos os sistemas do organismo, por isso conhecê-la a fundo permitirá que o médico aperfeiçoe seu atendimento e tenha um melhor resultado terapêutico. Não deixe de conferir os próximos episódios!

Neste quinto episódio em podcast da Série Diabetes – Baseado em evidências, Luiz Fernando Vieira, médico endocrinologista e conteudista do Portal, fala sobre como devemos iniciar o tratamento para um indivíduo com diabetes mellitus tipo 1 (DM1) recém diagnosticado e como evoluir em seu tratamento. O especialista aborda também sobre como podemos iniciar a insulinoterapia em pessoas com diabetes tipo 2, seguindo os guidelines da American Diabetes Association (ADA) e a Sociedade Brasileira de Diabetes (SBD). A nova série Diabetes – Baseado em evidências tem por objetivo realizar uma ampla revisão baseada nas mais recentes evidências para atualizar os médicos sobre diferentes aspectos da diabetes. Essa doença, que é um dos maiores problemas de saúde mundial, apresenta impactos em todos os sistemas do organismo, por isso conhecê-la a fundo permitirá que o médico aperfeiçoe seu atendimento e tenha um melhor resultado terapêutico. Não deixe de conferir os próximos episódios! Confira esse e outros posts no Portal PEBMED e siga nossas redes sociais! Facebook Instagram Linkedin Twitter

This episode features an interview with Dr. Tania Kamphaus and Tony Villiotti about new research on the utility and promise of blood-based biomarker tests for the diagnosis of liver diseases like non-alcoholic steatohepatitis (NASH).The research is particularly timely because the American Diabetes Association (ADA) recently called for liver disease screening for all adults with type 2 diabetes.The research, published in Nature Medicine, presents results from a study that evaluated blood-based biomarker tests for the diagnosis of NASH.The study's co-author, Dr. Tania Kamphaus, Director of Translational Science, Metabolic Disorders, as well as Director of Patient Engagement, at the Foundation for the National Institutes of Health (FNIH), shared results from the study in this podcast episode. She discussed the potential of non-invasive tests to become the standard of care for liver disease diagnosis and the ongoing work her group is doing in this area.Tony Villiotti is the founder of the nonprofit, NASH Knowledge, and a patient whose NASH led to liver cancer and subsequent liver transplant. He spoke about the impact this research will have on the patient community. Tony believes that his liver cancer could have been prevented had a non-invasive test for NASH been available to him.Hear more about Dr. Kamphaus' group's research in liver disease and Tony's patient advocacy work to help improve awareness around NASH and help bring new diagnostics and treatments to light.For more life science and medical device content, visit the Xtalks Vitals homepage.Follow Us on Social MediaTwitter: @Xtalks Instagram: @Xtalks Facebook: https://www.facebook.com/Xtalks.Webinars/ LinkedIn: https://www.linkedin.com/company/xtalks-webconferences YouTube: https://www.youtube.com/c/XtalksWebinars/featured

Join Drs. Skolnik and Wettergreen, along with special guests: Crystal Woodward, MPS - Managing Director of Legal Advocacy at the American Diabetes Association® (ADA), and Carrie Lee, RN, ND, NCSN - Health Services Coordinator / Diabetes Resource Nurse at Boulder Valley School District in Colorado as they discuss diabetes and the back to school season. Given the advancements in medications and technologies, there are now greater considerations to take into account when it comes to diabetes management. In this episode, our hosts and guests will delve into important information that parents must be aware of in order to ensure the safety of their children with diabetes at school. Learn more about ADA's Safe at School® campaign and available resources at: diabetes.org/safeatschool. Share your diabetes story with us by leaving a message at (703) 755-7288. You might be featured on a future Diabetes Day by Day episode.

Join Prof. Francisco Giorgino & Dr. Richard E. Pratley as they discuss their highlights from the 83rd American Diabetes Association (ADA 2023) congress. The congress featured over 200 scientific sessions and symposia, and 1,400 posters. Among the topics discussed are trials investigating therapies to treat obesity in patients with type 2 diabetes (T2D), as well as discussion about remission and what it really means for T2D. For more free education, go to ⁠diabetes.knowledgeintopractice.com⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (⁠@dkipractice⁠) or connect on ⁠LinkedIn⁠. Disclosures Prof. Francisco Giorgino: Grants or contracts: Eli Lilly, Roche Diabetes Care Consulting: Eli Lilly, Novo Nordisk Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi Dr. Richard E. Pratley Research grant: Dompe, Novo Nordisk Honoraria for lectures, presentations and education events: Merck, Novo Nordisk Consulting: Bayer AG, Endogenex Inc., Gasherbrum Bio Inc., Henguri (USA) Ltd. Intas Pharmaceuticals Inc. Eli Lilly, Merck, Novo Nordisk, Pfizer, Rivus Pharmaceuticals Inc., Sun Pharmaceutical Industries Target Audience: Specialty: Primary care physicians (PCPs), endocrinologists, cardiologists, diabetologists Geographic: Global (ex US and UK audiences) Funding Information: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.

Join Drs. Skolnik and Wettergreen, along with special guest Becky Barnett - Director of Summer Camps at the American Diabetes Association® (ADA), as they discuss the ADA's diabetes summer camps and the life-changing impact they create for thousands of children living with diabetes every summer. Learn more about camp at diabetes.org/camp! Share your diabetes story with us by leaving a message at (703) 755-7288. You might be featured on a future Diabetes Day by Day episode.

Neste episódio, você ficará por dentro das principais temas abordadas no American Diabetes Association ( ADA 2023), que ocorreu em San Diego (EUA) entre os dias 23 e 27 de junho. Os temas abordados tiveram foco na diabetes, na obesidade e na discussão de novas terapias emergentes para essas condições. Dê um play!

Chegou mais um Check-up Semanal, com as novidades da medicina e da saúde que você precisa saber para começar a semana atualizado. Confira os temas do check-up de hoje: cobertura do American Diabetes Association (ADA 2023); celulite orbitária; reposição hormonal na menopausa; algoritmo predição IAM; buprenorfina versus metadona para tratamento de dependência de opioide e qual droga causa mais delirium no pós-operatório de cirurgia ortopédica. Ouça agora! Confira esse e outros posts no Portal PEBMED e siga nossas redes sociais! Facebook Instagram Linkedin Twitter

We kick off a month of showcasing remarkable female leaders from some of retail's leading brands, with special guest, Tracey Brown, Walgreens Boots Alliance's Executive Vice President and President, Walgreens Retail & U.S Chief Customer Officer. Tracey's diverse background in advertising, non-profit leadership, and previous stint at the other "Wal" (Walmart) prepared her well for her current assignment at one of the world's largest and most successful drugstore chains.We review the tremendous evolution of the company from its founding in 1901 to becoming a leader in health and wellness. We unpack what it means to be a Chief Customer, the challenge of breaking down silos to put the customer at the center of all you do, and the critical role of agility to maintain your competitive edge. We close with some of Tracey's top leadership tips on how to mobilize people to do go above and beyond for the customer. But we kick things off with a quick review of the week in retail news, including the NRF's annual sales forecast, Lululemon's strong earnings report, and Macys CEO Jeff Gennette's plan to hand the keys of the kingdom to Bloomingdale's CEO Tony Springs early next year, Then we discuss Alibaba's decision to split into six groups, more news out of Amazon, Bed, Bath & Beyond's hail mary financing strategy, and more new formats from Nike. About TraceyTracey Brown is executive vice president, president of Walgreens retail and U.S. chief customer officer, overseeing the transformation of Walgreens to a healthcare company, to create more joyful lives through better health.She is responsible for the Walgreens consumer experience across all consumer touchpoints and leads development of strategies to advance Walgreens across a complex and dynamic competitive landscape. Brown oversees store operations, merchandising, marketing, product, digital, omnichannel, store format, data and analytics, and supply chain organizations, as Walgreens further accelerates its digital transformation, in order to create a seamless integration across all channels – in-store, mobile and online – to provide a unified, consistent brand experience.Brown has more than 30 years of experience driving business growth, operations, creating omnichannel customer experiences and leveraging digital capabilities to connect consumers and brands. Most recently, she served as chief executive officer for the American Diabetes Association (ADA), where she led the organizational transformation including fundraising, advocacy, science and research while fighting for people living with diabetes.Prior to the ADA, Brown was senior vice president, operations and chief experience officer for Sam's Club, a division of Walmart Inc.  She also served as CEO and managing director of RAPP Dallas, a data-drive integrated marketing agency, chief operating officer for direct marketing agency Direct Impact and director of worldwide consumer marketing for Advanced Micro Devices.  Earlier in her career, she held leadership positions at American Express, Proctor & Gamble and Exxon Mobil.Brown graduated from University of Delaware with her B.S. in chemical engineering and received her MBA from Columbia Business School in New York.She currently serves on the Board of Directors for Weight Watchers and Yeti. In 2021, she was named one of Savoy Magazine's Most Influential Black Corporate Directors, and in 2022, she was listed on Forbes CEO Next List.About UsSteve Dennis is an advisor, keynote speaker and author on strategic growth and business innovation. You can learn more about Steve on his       website.    The expanded and revised edition of his bestselling book  Remarkable Retail: How To Win & Keep Customers in the Age of Disruption is now available at  Amazon or just about anywhere else books are sold. Steve regularly shares his insights in his role as a      Forbes senior contributor and on       Twitter and       LinkedIn. You can also check out his speaker "sizzle" reel      here.Michael LeBlanc  is the Founder & President of M.E. LeBlanc & Company Inc and a Senior Advisor to Retail Council of Canada as part of his advisory and consulting practice.   He brings 25+ years of brand/retail/marketing & eCommerce leadership experience, and has been on the front lines of retail industry change for his entire career.  Michael is the producer and host of a network of leading podcasts including Canada's top retail industry podcast,       The Voice of Retail, plus  Global eCommerce Leaders podcast, and The Food Professor  with Dr. Sylvain Charlebois.    You can learn more about Michael   here  or on     LinkedIn. Be sure and check out Michael's latest venture for fun and influencer riches - Last Request Barbecue,  his YouTube BBQ cooking channel!

Autor: Maristela Strufaldi • Ramos S, et al. Terapia Nutricional no Pré-Diabetes e no Diabetes Mellitus Tipo 2. Diretriz Oficial da Sociedade Brasileira de Diabetes (2022). Acesso em 28 de março de 2023. • Evert AB, et al. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care. 2019 May;42(5):731-754. • Schwingshackl L, et al. A network metaanalysis on the comparative efficacy of different dietary approaches on glycaemic control in patients with type 2 diabetes mellitus. Eur J Epidemiol. 2018 Feb;33(2):157–70 • Toledo E, et al. Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial. BMC Med. 2013 Sep 19;11:207. • Salas-Salvadó J, et al. Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial. Diabetes Care. 2019 May;42(5):777-788. • Delgado-Lista J, et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022 May 14;399(10338):1876-1885. • Weber B, et al. Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial. Am Heart J. 2019 Sep;215:187-197. • Chiavaroli L, et al. DASH Dietary Pattern and Cardiometabolic Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Nutrients. 2019 Feb 5;11(2):338. • Freire R. Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets. Nutrition. 2020 Jan;69:110549. • Davies MJ, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022 Dec;65(12):1925-1966.

The primary goal of inpatient diabetes management is to achieve and maintain optimal blood sugar control, minimize the risk of complications, and ensure a safe and speedy recovery. The American Diabetes Association (ADA) recommends a blood sugar target of 140-180 mg/dL for most hospitalized patients. However, individualized targets may be set based on the patient's medical history, comorbidities, and the reason for hospitalization. Insulin is the most effective medication for controlling blood sugar levels in hospitalized patients. Patients who are already using insulin at home may require adjustments in their insulin doses while hospitalized. Patients who are not using insulin may require initiation of insulin therapy. Overall, inpatient diabetes management requires a multidisciplinary team approach that includes physicians, nurses, dietitians, and diabetes educators. The goal is to achieve optimal glycemic control and minimize the risk of complications, ensuring a safe and successful hospital stay for patients with diabetes. Let's listen in to learn more

Join Dr Carol Wysham and Dr Katherine Tuttle as they discuss advances in kidney disease management in patients living with type 2 diabetes. Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982416). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification https://pubmed.ncbi.nlm.nih.gov/12859163/ KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/32998798/ Prevalence of Non-diabetic Kidney Disease and Inability of Clinical Predictors to Differentiate It From Diabetic Kidney Disease: Results From a Prospectively Performed Renal Biopsy Study https://pubmed.ncbi.nlm.nih.gov/36517108/ Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) https://repository.niddk.nih.gov/studies/edic/ UK Prospective Diabetes Study https://www.dtu.ox.ac.uk/ukpds/ Kidney Disease and Obesity: Epidemiology, Mechanisms and Treatment https://pubmed.ncbi.nlm.nih.gov/28090083/ Diet and Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/31728497/ SGLT2 Inhibitors and the Diabetic Kidney https://pubmed.ncbi.nlm.nih.gov/27440829/ GLP-1 Receptor Agonists in Diabetic Kidney Disease: From Clinical Outcomes to Mechanisms https://pubmed.ncbi.nlm.nih.gov/32694999/ Cardiovascular Outcomes Trials: A Paradigm Shift in the Current Management of Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/35927730/ Effects of Long-term Antihypertensive Treatment on Kidney Function in Diabetic Nephropathy https://pubmed.ncbi.nlm.nih.gov/4077229/ A Randomized Trial of Intensive Versus Standard Blood-Pressure Control https://pubmed.ncbi.nlm.nih.gov/26551272/ Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus https://pubmed.ncbi.nlm.nih.gov/20228401/ Effects of a Fixed Combination of Perindopril and Indapamide on Macrovascular and Microvascular Outcomes in Patients With Type 2 Diabetes Mellitus (the ADVANCE Trial): A Randomised Controlled Trial https://pubmed.ncbi.nlm.nih.gov/17765963/ Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) https://pubmed.ncbi.nlm.nih.gov/36202661/ Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/27299675/ Empagliflozin in Heart Failure With a Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/34449189/ Cardiovascular and Renal Outcomes With Empagliflozin in Heart Failure https://pubmed.ncbi.nlm.nih.gov/32865377/

In this episode we sit down with two-time Super Bowl champion and local radio personality, Christian Fauria, to talk about what his transition from the NFL to on-air radio personality was like, how other well-known athletes have handled similar transitions into broadcasting careers, and what his advice is for rookies preparing to enter the media spotlight. Christian's impressive NFL career as a tight end speaks for itself, but arguably his most important job began in 2019, when his son was diagnosed with type 1 diabetes. The experience inspired Christian to become a staunch advocate and fundraiser for diabetes-related research and treatment, and launch the Christian Fauria 25-Hour Crusade for a Cure that same year. To date, the multimedia event has raised more than $550,000 in support of the American Diabetes Association (ADA). During our conversation, Christian shares what his experience navigating his son's diabetes diagnosis has been like, and how his advocacy and the public's support can help make a real difference in the fight against the disease. We hope you enjoy the conversation!

CVS Shows “Pledges” Do Not Equal Direct “Donations” In November 2021, US pharmaceutical giant CVS's social responsibility team announced a $10 million commitment to the American Diabetes Association (ADA) to be delivered over three years, as reported by Quartz. However, what CVS omitted is that the donations collected from customers through in-store fundraising weren't going to be in addition to the initial pledge. Rather, they would be used in lieu of donations coming from CVS's coffers. Customers subsidized CVS's generosity without knowing it, as their donations were part of a larger pledge that CVS had made to the ADA. A new lawsuit, which is seeking class-action status, claims that by failing to disclose the exact way in which the funds raised would be used, CVS committed fraud. Nonprofits (and donors) interested in better understanding corporate partnerships should heed the word “pledge” as merely marketing lingo until actual monetary donations are received by the NPO organizations such corporations purport to support. Read more ➝   Summary   How a Hotel Was Converted into Housing for Formerly Homeless People | nytimes.com Stacey Abrams's Georgia Nonprofit Could Face Criminal Investigations for Unlicensed Fundraising | Washington Free Beacon Crain's 2022 Notable Women in Nonprofits | Crain's Detroit Business Santa Clarita Nonprofit Organization Unveils 'Horseless' Carriages – NBC Los Angeles | NBC Southern California   

CVS Shows “Pledges” Do Not Equal Direct “Donations” In November 2021, US pharmaceutical giant CVS's social responsibility team announced a $10 million commitment to the American Diabetes Association (ADA) to be delivered over three years, as reported by Quartz. However, what CVS omitted is that the donations collected from customers through in-store fundraising weren't going to be in addition to the initial pledge. Rather, they would be used in lieu of donations coming from CVS's coffers. Customers subsidized CVS's generosity without knowing it, as their donations were part of a larger pledge that CVS had made to the ADA. A new lawsuit, which is seeking class-action status, claims that by failing to disclose the exact way in which the funds raised would be used, CVS committed fraud. Nonprofits (and donors) interested in better understanding corporate partnerships should heed the word “pledge” as merely marketing lingo until actual monetary donations are received by the NPO organizations such corporations purport to support. Read more ➝   Summary   How a Hotel Was Converted into Housing for Formerly Homeless People | nytimes.com Stacey Abrams's Georgia Nonprofit Could Face Criminal Investigations for Unlicensed Fundraising | Washington Free Beacon Crain's 2022 Notable Women in Nonprofits | Crain's Detroit Business Santa Clarita Nonprofit Organization Unveils 'Horseless' Carriages – NBC Los Angeles | NBC Southern California   

Background. Diabetes programs are difficult to implement in low-income settings. Mentoring clinics is promising to implement initiatives. We mentored local Community Health Workers (CHWs) to implement a diabetes program for low-income Latino(a)s (N=59) with type 2 diabetes in a twophased approach, each 6-months. Methods. -Phase 1 (training, feasibility assessment): participants randomized to the diabetes program or usual care. CHW-instructors (CHW-Is) led the program, CHWs observed. -Phase 2 (mentoring): CHWs led the program, CHW-Is mentored. -The program included monthly group visits and weekly CHWs/CHWIs-participant telehealth contact. -Outcomes included baseline to 6-month clinical changes i.e., HbA1c, adherence to medications and six American Diabetes Association (ADA) guidelines, CHW pre/posttest scores, and hypoglycemia. Results. Significant outcomes included improved HbA1c levels, medication and ADA adherence, hypoglycemic events, and CHWs test scores.

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 20 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. This issue will review: Empagliflozin in Patients with Chronic Kidney Disease NEJM Prescription Patterns of Cardiovascular- and Kidney-Protective Therapies Among Patients With Type 2 Diabetes and Chronic Kidney Disease Relationship Between Carbohydrate Intake (Quantity, Quality, and Time Eaten) and Mortality (Total, Cardiovascular, and Diabetes) Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Sodium–Glucose Cotransporter 2 Inhibitor Treatment: The FIDELITY Analysis Effects of a Low-Carbohydrate Dietary Intervention on Hemoglobin A1c A Randomized Clinical Trial   For more information about each of ADA's science and medical journals, please visitwww.diabetesjournals.org. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

Christie Schumacher PharmD, BCPS, BCACP, BCCP, BC-ADM, CDCES, FCCP, joins The Huddle to talk through the use of GLP-1 and GIP/GLP-1 receptor agonists for your people with type 2 diabetes.  You'll learn what medications fall into the class of GLP-1 and GIP/GLP-1 receptor agonists, how they work and the benefits they can offer people with type 2 diabetes. These medications can be a useful tool in the therapeutic toolkit as highlighted in the recently updated ADA/EASD consensus statement, so this episode will offer practical considerations when initiating GLP-1 and GIP/GLP-1 receptor agonists in patients and managing possible side effects.We want to thank our sponsor, Lilly Diabetes, for their support of this episode.VV-MED-128766 ©2022 Lilly USA, LLC.  All rights reservedResources:ADA and EASD Consensus Report for the Management of Hyperglycemia in Type 2 Diabetes, 2022:  Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) | Diabetes Care | American Diabetes Association (diabetesjournals.org)ADCES Incretin-Based therapies tip sheet: DiabetesEducator.org/docs/default-source/living-with-diabetes/tip-sheets/medication-taking/incretin-based_therapies_tip_sheet_1006202291a90b03-fff9-4b81-98c9-42ef98f0c501.pdfEpisode Transcript: DiabetesEducator.org/docs/default-source/podcast-docs/incretin-full-show.docxMedication Taking Resources from ADCES: 1) For healthcare professionals: DiabetesEducator.org/MedicationTaking 2) For people with diabetes:  DiabetesEducator.org/TakingMedication

It's in the News.. the top diabetes stories of the past seven days. This week, one state caps not just insulin prices, but diabetes supplies for some, Lilly is out with a new integrated pen system, new study look at DKA at diagnosis of type 1 and what that means for health issues later on, and more! Learn more about the T1D Exchange: www.t1dexchange.org/stacey  Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM*   Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX And by my new book “Still The World's Worst Diabetes Mom: More Real Life Stories of Parenting a Child With Type 1 Diabetes” available on Amazon now. XX Delaware Governor John Carney last month signed Senate Bill 316, which will cap the monthly cost of diabetes supplies and equipment at $35 for those on state insurance plans. This law will make blood glucose meters and strips, urine testing strips, syringes, continuous glucose monitors (CGM) and supplies, and insulin pump, and pump supplies more affordable and accessible. Senate Bill 316 will apply to state-regulated health plans and state employee plans, which will take effect in 2023 and 2024, respectively. The $35 per month cap includes deductible payments and cost-sharing amounts charged once a deductible is met. The cap does not, however, apply to high deductible health plans or catastrophic health plans. Although much of the conversation about diabetes costs focuses on insulin, diabetes supplies are also a significant cost for people with diabetes. According to the American Diabetes Association (ADA), people with diabetes have medical expenses of about 2.3 times higher than those without diabetes. Diabetes supplies account for about 15 percent of diabetes medical expenses. On average, people with diabetes, even those with private insurance, spend $490 out-of-pocket on diabetes-related supplies each year. https://diatribe.org/delaware-caps-monthly-cost-diabetes-supplies-35 XX New report estimates 1 point 3 million adults with diabetes have rationed their use of insulin within the last year. That's 16.5 percent of everyone who's been prescribed insulin. We told you about this report published last month in the journal Annals of Internal Medicine. It's getting more attention – and it should – as the Washington Post picked it up for a series of reports their doing on health stats. The report attributes the rationing to the cost of the drug and what it describes as “inadequate” insurance coverage. The price of the four most popular types of insulin has tripled in the past decade, according to the American Diabetes Association. https://www.washingtonpost.com/wellness/2022/11/08/diabetes-insulin-rationing/ XX One of the insulin makers will begin rolling out a new diabetes management platform in the next few weeks. Lilly is launching the Tempo platform, which includes prefilled, disposable Tempo Pens for insulin delivery with the compatible TempoSmart mobile app and the Tempo Smart Button, which is designed to track the pens' insulin dosages.The Tempo Smart Button was cleared by the FDA in mid-September, Lilly said in this week's announcement. When attached to the top of a Tempo insulin pen, it takes in and stores insulin dosing data, then automatically transfers that information to the TempoSmart app. TempoSmart can connect to a variety of other devices and apps, like Dexcom's continuous glucose monitors and Lilly's own blood glucose monitor, among others, but also from more general health-tracking wearables like those from Fitbit, Garmin, Google and Apple. https://www.fiercebiotech.com/medtech/eli-lilly-lines-launch-diabetes-management-platform-tracks-insulin-pen-use-blood-sugar XX XX New research at Georgia Tech shows promise in beta cell transplantation without having to take additional immunosuppressive drugs. This is cell therapy with a new biomaterial called iTol-100. That's the basis of a new startup called iTolerance. Long way to go here but a lot of promise for many other conditions as well at type 1. This is less cell encapsulation, as other companies are working toward, but it's more of a soft material that can mix right with the cells at the time of transplant. This research started with a three year grant from JDRF. https://www.research.gatech.edu/new-startup-develops-potential-cure-type-1-diabetes XX Not a big surprise, but children diagnosed while in DKA can increase the risk of health issues later on. These issues can include extended stays in hospital, poorer long-term control of blood sugar levels, and even a higher mortality rate. The authors of the study point out that providing a comprehensive explanation of the classic symptoms of T1D in childhood to the general public, those active in the childcare or daycare settings, and primary care physicians could help raise awareness of the symptoms of T1D. Furthermore, public health measures could be used, e.g., implementing a general islet-cell autoantibodies screening program for children to reduce the number of dangerous metabolic imbalances. https://www.news-medical.net/news/20221108/Study-highlights-the-need-for-early-and-timely-diagnosis-of-type-1-diabetes-in-children-and-adolescents.aspx XX New weekly injection for type 2 had some promising results, helping people meet blood glucose goals 4-12 weeks earlier than those taking traditional medications. The new medication is called Tirzepatide brand name Mounjaro, and it helped people meet weight loss and blood glucose targets four weeks sooner than semaglutide, which is branded as Ozempic or Wegovy and between four and 12 weeks thatn those treated with once daily long acting insulin like Tresiba. https://scitechdaily.com/a-new-and-improved-diabetes-drug/ XX Quick clarification from last week! I mentioned a study showing that people with type 1 see good results from taking GLP-1 receptor agonists and SGLT 2 inhibitors, two types of drugs approved for type 2. I had said that both also increased the risk of DKA. That's not true.. I got it wrong. Only SGLT 2 inhibitors seem to increase that risk. The GLP-1 medicines have brand names like Ozempic or Trulicity and the SGLT-2 are Invokana or Jardiance. https://www.medwirenews.com/diabetes/real-world-adjunctive-medication-outcomes-type-1-diabetes/23662504 XX XX XX Back to the news in a moment but first.. The T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. The registry is now available on the T1D Exchange website and is simple to navigate, mobile and user-friendly. For more information or to register, go to www.t1dregistry.org/stacey XX XX XX On the podcast next week.. Tom from Type One Talks The past episode was all about thinking through your use of CGM, questions to ask of yourself, your family and anyone with whom you plan to share. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

It's in the News.. the top diabetes stories of the past seven days. This week: new research looks at off-label use of GLP and SGLT drugs for people with type 1, Medtronic gets 780G approval in Canada, finger prick early detection of type 1, and lots going on for Diabetes Awareness Month. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here Episode Transcription Below (or coming soon!) Please visit our Sponsors & Partners - they help make the show possible! *Click here to learn more about OMNIPOD* *Click here to learn more about AFREZZA* *Click here to learn more about DEXCOM* Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and these are the top diabetes stories and headlines of the past seven days. XX In the news is brought to you by T1D Exchange! T1D Exchange is a nonprofit organization dedicated to improving outcomes for the entire T1D population. https://t1dexchange.org/stacey/ XX And by my new book “Still The World's Worst Diabetes Mom: More Real Life Stories of Parenting a Child With Type 1 Diabetes” available on Amazon now. XX Our top story this week, Researchers say a blood test for early diagnosis of type 1 diabetes can stave off serious illness and hospitalization in children. This Australian study looked at the finger prick sample that is collected in the home and mailed to the lab. It included more than 17-thousand children and young adults, mostly in families with a history of type 1. The team of researchers are the first to use this method to screen diabetes in Australia. They said, We want to make type 1 diabetes screening accessible to every Australian child no matter where they live. Our recent work has proven that we can do this cheaply, accurately, and conveniently," The study is published in Pediatric Diabetes. https://medicalxpress.com/news/2022-11-home-screening-diabetes.html XX Medtronic gets the okay from Canada for it's MiniMed 780G system. It's now available in more than 60 countries around the world, with the U.S. notably missing from the list. Current 770G users will be able to upgrade their devices with the new system's software. The MiniMed 780G is equipped with Medtronic's SmartGuard technology, a hybrid closed-loop system what works with Medronic's CGM. It's approved for ages 7-80. Medtnoic submitted to the FDA in the spring of 2021, nearly a year after securing CE mark approval in Europe. The U.S. sign-off has been slow to arrive, however, thanks in large part to the FDA's discovery of quality control issues at the California headquarters of Medtronic's diabetes business. A December 2021 letter from the agency outlined shortfalls it discovered at the Los Angeles-area facility in a routine inspection, prompting Medtronic to implement corrective actions and other process improvements to address the issues. https://www.fiercebiotech.com/medtech/still-awaiting-us-approval-medtronics-auto-adjusting-insulin-pump-lands-canadian-nod XX XX People with type 1 diabetes who take GLP-1 receptor agonists or SGLT-2 inhibitors in real life seem to line up with controlled trials. The GLP-1 medicines have brand names like Ozempic or Trulicity and the SGLT-2 are Invokana or Jardiance. These are newer medications and people with type 1 are cautioned to take them carefully because of the higher risk of DKA. However, these researchers say after 12 months of use people taking a GLP-1 receptor agonist had a significant reduction in glycated hemoglobin (HbA1c), from an average of 7.7% to 7.3% (61 to 56 mmol/mol), as well as in bodyweight, from an average of 90.4 to 85.4 kg. and they used less insulin overall. SGLT2 inhibitors were used by 39 study participants for an average duration of 24.2 months, mostly with the intent to achieve better glycemic control (73.3%), but also for weight loss (37.8%), reduced insulin requirements (26.7%), and reduced glucose variability (24.4%). Also, about 12% of users initiated SGLT2 inhibitors for their beneficial cardiovascular or renal properties. In line with clinical trial findings, these real-world users had significant reductions in average HbA1c after 12 months of use, from 7.9% to 7.3% (63 to 56 mmol/mol), and in basal insulin dose, from a daily average of 31.3 to 25.6 units, but not in bolus insulin. And contrary to the results of controlled trials, although SGLT2 inhibitor users had a weight reduction, this was small and not statistically significant, at an average of 89.2 and 87.5 kg before and after 12 months, respectively. https://www.medwirenews.com/diabetes/real-world-adjunctive-medication-outcomes-type-1-diabetes/23662504 XX Taking a personalized approach to kidney disease screening for people with type 1 diabetes (T1D) may reduce the time that chronic kidney disease (CKD) goes undetected. The finding, published in Diabetes Care(link is external), provides the basis for the first evidence-based kidney screening model for people with T1D. Current CKD screening recommendations include annual urinary albumin excretion rate (AER) testing for anyone who has had T1D for at least five years. The new findings suggest that AER screening could be personalized to optimize testing frequency and early detection of CKD. Specifically, people with T1D who are at low risk of developing CKD could be tested for AER less frequently to reduce burden and cost, and those at high risk for CKD could be tested more frequently to facilitate earlier CKD detection. People with T1D have an estimated 50% risk of developing CKD over their lifetime. Important to note, these numbers and this study is based on 30 years of data, dating back to the landmark DCCT trial. https://www.nih.gov/news-events/news-releases/nih-funded-study-finds-personalized-kidney-screening-people-type-1-diabetes-could-reduce-costs-detect-disease-earlier XX Lots of stuff happening for diabetes awareness month. Embecta Corp. (“embecta”) (Nasdaq: EMBC), one of the largest pure-play diabetes care companies in the world, today announced it will ring the opening bell at Nasdaq on November 1, 2022, in recognition of National Diabetes Awareness Month. “We are proud to celebrate this year's Diabetes Awareness Month by ringing the Nasdaq Opening Bell with representatives of several organizations that make diabetes, and supporting the people who are living with diabetes, their sole focus,” said Devdatt “Dev” Kurdikar, president and chief executive officer of embecta. “Our company is honored to recognize the patients, caregivers, healthcare providers, and advocacy organizations working together to improve access to education and progress toward the vision of a life unlimited by diabetes.” embecta also recognizes the 100-year milestone of the first successful injection of insulin that was administered to a person with diabetes. Today, 1 in 10 adults around the world live with diabetes1, an estimated 537 million people, and almost half don't know they have it. “Our community often faces stigma and isolation associated with diabetes as we frequently practice self-management of the disease,” said Anna Norton, chief executive officer of DiabetesSisters. “Increased access to education and resources that will improve the standard of care and quality of life across the community is essential, and we're proud to stand with embecta to share in this mission.” The bell ringing ceremony will be streamed live via Nasdaq's Facebook page. Additionally, highlights from the ceremony will be shared across embecta's social media channels. Please visit embecta.com for additional information regarding Diabetes Awareness Month. About embecta embecta, formerly part of BD (Becton, Dickinson and Company), is one of the largest pure-play diabetes care companies in the world, leveraging its nearly 100-year legacy in insulin delivery to empower people with diabetes to live their best life through innovative solutions, partnerships and the passion of more than 2,000 employees around the globe. For more information, visit embecta.com. XX Dexcom has teamed up with ESPN's Adam Schefter – his wife has type 1 – to launch Dexcom U, the first-ever NIL (name, image, likeness) program designed to celebrate college athletes with diabetes and inspire people with diabetes who have athletic dreams of their own. NIL is name image likeness, it's the new program that allows college athetes to be paid. Dexcom says According to a recent study, nearly half (43%) of adults with Type 1 diabetes felt like quitting sports and physical activities because of their diagnosis, and one in five (20%) went through with quitting. These athletes tell their stories and how Dexcom helps them. I'll link up the video and we are set to speak with some of them in the next couple of weeks. XX A new study released by the American Diabetes Association® (ADA), illustrates the significant barriers that low-income Americans, people of color, older Americans, and people with diabetes living in states with the highest prevalence of the disease face in accessing continuous glucose monitors (CGM). These barriers are especially high for Americans on Medicaid, who are the least likely to have access to a CGM. CGMs continually monitor blood glucose (blood sugar), giving real-time updates. The devices provide significant, potentially life-changing benefits for diabetes management, and in turn for the avoidance or delay of serious co-morbidities, hospitalizations, and even death. “It is disappointing to see that access to vital diabetes management tools like CGMs often depends on your income, the color of your skin, your age, and where you live,” said Dr. Robert Gabbay, chief scientific and medical officer at the ADA. "The ADA is committed to addressing access barriers—such as inadequate health insurance coverage, steep Medicare and Medicaid coverage requirements, and physician shortages—to ensure that everyone who can benefit from a CGM can get one.” The ADA is working with the Centers for Medicare and Medicaid Services, state Medicaid programs, and Congress to eliminate barriers people face in accessing diabetes technology like CGMs. The CGM study is available on the ADA's website. XX Diabetes on Nasdaq XX Great start to a blog post by Tim Street, he writes over at DiabeticTech. He's trying out 6 CGMs currently on the market. Dexcom ONE Medtrum Nano Dexcom G6 Glucomen Day GlucoRX Aidex Freestyle Libre2 You can check out his blog to see the photos of him wearing all of the CGMs and hear his methods for testing. https://www.diabettech.com/cgm/unboxing-and-applying-the-six-cgms/?utm_source=dlvr.it&utm_medium=facebook XX Dexcom also has a See Diabetes campaign for this month which gives you a chance to create your own overlay patch. I've created one for the show, you can it on social along with others with the #SeeDiabetes hashtag. Patti LaBelle, Mark Andrews and Nick Jonas are taking part.. If you design an overlay – I'll put the link in the show notes – you may be order a few for free – they're saying limited supply. A cynic would say this is a creative way to use up the G6 overlay patches before the G7 comes out but.. personally I think it's a really creative and fun idea. I like how mu patch came out, but I doubt my son will wear it! XX Back to the news in a moment but first.. The T1D Exchange Registry is a research study conducted online over time, designed to foster innovation and improve the lives of people with T1D. The platform is open to both adults and children with T1D living in the U.S. Personal information remains confidential and participation is fully voluntary. Once enrolled, participants will complete annual surveys and have the opportunity to sign up for other studies on specific topics related to T1D. The registry aims to improve knowledge of T1D, accelerate the discovery and development of new treatments and technologies, and generate evidence to support policy or insurance changes that help the T1D community. By sharing opinions, experiences and data, patients can help advance meaningful T1D treatment, care and policy. The registry is now available on the T1D Exchange website and is simple to navigate, mobile and user-friendly. For more information or to register, go to www.t1dregistry.org/stacey XX XX XX On the podcast next week.. Tom from Type One Talks The past episode was all about thinking through your use of CGM, questions to ask of yourself, your family and anyone with whom you plan to share. Listen wherever you get your podcasts That's In the News for this week.. if you like it, please share it! Thanks for joining me! See you back here soon.

Episode 114: Diabetes care updateYvette presents updates from ADA on diabetes care regarding SGLT-2 inhibitors, GLP-1 receptor agonists, and finerenone. Written by Yvette Singh, MSIV, American University of the Caribbean. Comments and text edition by Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.The American Diabetes Association (ADA) released revisions in May 2022; specifically regarding sodium-glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RA), and finerenone for cardiovascular and renal comorbidities. What are SGLT2 inhibitors and GLP-1 receptor agonists?SGLT2 inhibitor class of oral antidiabetic drugs, including empagliflozin, canagliflozin, dapagliflozin, and more. They increase the excretion of glucose and sodium in the urine by inhibiting SGLT2 in the kidney, thus lowering blood glucose levels. In other words, it has a glucoretic effect. GLP-1 receptor agonists are a class of non-insulin drugs, including exenatide, liraglutide, semaglutide, and more. They mimic the intestinal hormone incretin and bind to its receptor, which slows the rate at which foods leave the stomach, controls appetite, and regulates insulin and glucagon secretion.What is the NEW use of SGLT-2 Inhibitors and GLP-1 RA in treatment?Traditional glucocentric approaches recommend initial medications such as metformin for most adults with type 2 diabetes, leaving SGLT-2 inhibitors and GLP-1 receptor agonists as alternative options mainly for patients with high risk for atherosclerotic cardiovascular disease in whom additional glucose lowering was needed after metformin treatment. Current guidelines now recommend these agents (SGLT-2 inhibitors and GLP-1 RA) for any T2DM patient with current or high-risk for ASCVD, chronic kidney disease (CKD), or heart failure (HF). This guideline stands regardless of the need for additional glucose lowering and/or metformin use. This has now changed through trials, demonstrating that cardiovascular disease and chronic kidney disease benefits independent of a medication's glucose-lowering potential.HbA1c has long been used to guide clinical decision-making about type 2 diabetes. However, systematic reviews have revealed minimal benefits in the normalization of HbA1c.Moreover, the cardiovascular and kidney protection of SGLT-2 inhibitors and GLP-1 receptor agonists are unrelated to their impact on HbA1c. Double-blinded randomized clinical trials showed that SGLT-2 inhibitors reduced the risk of cardiovascular death and hospitalization for heart failure in patients with or without diabetes. Therefore, cardiovascular and kidney risk, rather than HbA1c, constitutes a possible indication for the two medication classes. If patients with ASCVD remain above goal A1C despite the addition of an SGLT-2 inhibitor or GLP-1 RA, then adding the agent the patient is not currently on out of the two is recommended before dipeptidyl peptidase-4 aka (DPP-4) inhibitors, basal insulin, or sulfonylureas because the combined use of an SGLT-2 inhibitor and GLP-1 RA can produce an additive risk reduction for cardiovascular and renal adverse events.What is Finerenone, and how does it help with diabetes? Finerenone (Kerendia®) selectively blocks sodium reabsorption and overactivation of mineralocorticoid receptors within epithelial and non-epithelial tissues. This, in turn, reduces fibrosis and inflammation of both the kidneys and blood vasculature.Finerenone use for patients with advanced CKD, i.e., moderately elevated albuminuria, eGFR of 25- 60 mL/min, and diabetic retinopathy, is encouraged for nephroprotection. However, Patients with less-advanced CKD, i.e., stages 1-2, do not receive any benefit. Regardless of the severity of CKD, SGLT-2 inhibitors remain first-line therapy.Although Finerenone improves cardiovascular outcomes and reduces CKD progression for patients, it is still unknown if there are any additive cardioprotective effects if used with SGLT2 inhibitors and/or GLP-1 receptor agonists.Some Closing Pearls: The use of SGLT2 inhibitors in patients with eGFR > 25 decreased from 30 previously.If the A1c goal is not being met, combination therapy of insulin with a GLP receptor agonist can be considered, as this combination treatment has been shown to increase the efficacy and duration of insulin.Overall, this new change could be very beneficial if accepted internationally. Though understandably, there could be some limitations to this guideline given the availability and cost of these medications, as well as their contraindication of use in specific populations such as pregnancy, ages >65 with concurrent risk factors for hypoglycemia or dehydration, and those with history of acute pancreatitis. ____________________________Conclusion: Now we conclude our episode number 114 “Diabetes care update.” Yvette explained that the ADA now recommends the use of SGLT2 inhibitors and GLP-1 agonists in any patient with type 2 diabetes with current or at high risk for cardiovascular disease, chronic kidney disease, or heart failure. Primary care physicians should become familiar with the dosing, cautions, side effects, and contraindications of these meds. Also, a newer medication for CKD in diabetes was mentioned: Finerenone. Diabetes treatment continues to evolve, and we hope this information is useful for you. This week we thank Hector Arreaza, Yvette Singh, and Fiona Axelsson. Audio edition by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________________Lacanlale, Jana K et al. “Notable Revisions in Diabetes Treatment According to ADA Guidelines.” Pharmacy Times, 26 Mar. 2021, https://www.pharmacytimes.com/view/notable-revisions-in-diabetes-treatment-according-to-ada-guidelines.Li, Sheyu, et al. “SGLT-2 inhibitors or GLP-1 receptor agonists for adults with type 2 diabetes: a clinical practice guideline.” British Medical Journal 2021; 373:n1091. doi:10.1136/BMJ.n1091Royalty-free music used for this episode: BUrn Flow by Gushito, downloaded on September 22, 2022, from https://www.videvo.net/royalty-free-music-track/burn-flow/1008877/ 

Episode 112: Statins in Primary CareDr. Tiwana explains the use of statins for the primary prevention of cardiovascular disease.Written by Ripandeep Tiwana, MD (Post-Doctoral Research Fellow at Cedar Sinai Medical Center – Heart Institute). Edition of text and comments by Hector Arreaza, MD.____________________________________________You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Definition.Statins commonly referred to as lipid-lowering medications, are important in primary care as they serve multiple long-term benefits than just lipid lowering alone. They are HMG-CoA reductase inhibitors. As a refresher, this is the rate-controlling enzyme of the metabolic pathway that produces cholesterol. This enzyme is more active at night, so statins are recommended to be taken at bedtime instead of during the day. Statins are most effective at lowering LDL cholesterol. However, they also help lower triglycerides and raise HDL cholesterol.Statins are not limited to just patients with hyperlipidemia. They reduce illness and mortality in those who have diabetes, have a history of cardiovascular disease (including heart attack, stroke, peripheral arterial disease), or are simply at high risk for cardiovascular disease. Statins are used for primary and secondary prevention.Types of statins.How do we determine which statin our patients need?First, we need to know that not all statins are created equal. They vary by intensity and potency thus, and they are categorized as either low, moderate, or high intensity.Several statins are available for use in the United States. They include Atorvastatin (Lipitor), Fluvastatin (Lescol XL), Lovastatin (Altoprev), Pitavastatin (Livalo, Zypitamag), Pravastatin (Pravachol), Rosuvastatin (Crestor, Ezallor), Simvastatin (Zocor)Commonly used in clinics: Simvastatin, Atorvastatin, and Rosuvastatin.Statin Dosing and ACC/AHA Classification of Intensity                                  Low-intensity                                   Moderate-intensity                                     High-intensityAtorvastatin              NA 1                                                          10 to 20 mg                                                   40 to 80 mgFluvastatin                20 to 40 mg                                          40 mg 2×/day; XL 80 mg                                NALovastatin                 20 mg                                                       40 mg                                                                         NAPitavastatin               1 mg                                                          2 to 4 mg                                                                   NARosuvastatin             NA                                                            5 to 10 mg                                                          20 to 40 mgSimvastatin                10 mg                                                      20 to 40 mg                                                             NAOf note, atorvastatin and rosuvastatin are only for moderate or high-intensity use, and do not use simvastatin 80 mg.Identifying patients at risk.How do we determine who needs statin therapy?Once we become familiar with the different statins, we must figure out which intensity is advised for our patient. Recommendations for statin therapy are based on guidelines from The U.S. Preventive Services Task Force (USPSTF), American Diabetes Association (ADA), and the American College of Cardiology/American Heart Association (ACC/AHA) which recommend utilizing the ASCVD risk calculator in those patients who do not already have established cardiovascular disease.ASCVD stands for atherosclerotic cardiovascular disease, defined as coronary heart disease, cerebrovascular disease, or peripheral arterial disease presumed to be of atherosclerotic origin. ASCVD remains a leading cause of morbidity and mortality in the United States, especially in individuals with diabetes.The ASCVD risk score determines a patient's 10-year risk of cardiovascular complications, such as a myocardial infarction or stroke. This risk estimate considers age, sex, race, cholesterol levels, use of blood pressure medication, diabetic status, and smoking status. Regarding age, this calculator only applies to the age range of 40-79 as there is insufficient data to predict risk outside this age group.There are several online and mobile applications available to calculate this score. Once calculated it gives a recommendation for which intensity statin to use. However, as this is a recommendation, it is essential to use your own clinical judgment to decide what is best for your individual patient. Please refer to the above table as a reference for which statin and dose you may consider using.Keeping the above calculator in mind, additional statin guidelines are recommended by the ACC:Patients ages 20-75 years and LDL-C ≥190 mg/dl use high-intensity statin without risk assessment. (You do not need the calculator.)People with type 2 diabetes and aged 40-75 years use moderate-intensity statins, and risk estimate to consider high-intensity statins. (It means moderate for all diabetics older than 40, high for some.)Age >75 years, clinical assessment, and risk discussion. Age 40-75 years and LDL-C ≥70 mg/dl and 10%. Grade B recommendation: prescribe a statin for the primary prevention of CVD.Grade C – 40-75 years with >= 1 cardiovascular risk factor AND estimated 10-year ASCVD risk 7.5-10%. Grade C recommendation: selectively offer a statin for the primary prevention of CVD. The likelihood of benefit is smaller in this group than in persons with a 10-year risk of 10% or greater.Grade I - The USPSTF found insufficient evidence to recommend for or against initiating a statin for the primary prevention of CVD events and mortality in adults 76 years or older.The USPSTF is also very clear regarding the intensity of statin therapy. They explained that there is limited data directly comparing the effects of different statin intensities on health outcomes. Most of the trials they reviewed used moderate-intensity statin therapy. They conclude that moderate-intensity statin therapy seems reasonable for most persons' primary prevention of CVD.The USPSTF has a broader recommendation, whereas the ACC guidelines are more detailed and individualized and provide guidance on the recommended intensity of statin therapy.Labs needed.Establish baseline labs for serum creatinine, LFTs, and CK only if there is a myopathy risk. Routine monitoring of LFTs, serum creatinine, and CK is unnecessary; only check if clinically indicated.A lipid panel should be checked in 6-8 weeks, and the patient should monitor themselves for any side effects, including myalgias. If LDL-C reduction is adequate (≥30% reduction with intermediate statins and 50% with high-intensity statins), regular interval monitoring of risk factors and compliance with statin therapy is necessary to sustain long-term benefit.Side effects and contraindications.Some common side effects include URI-like symptoms, headache, UTI, and diarrhea. Some patients are very hesitant to take any medications. Warning about side effects may decrease compliance. Major  contraindications for statin therapy include active liver disease, muscle disorders, pregnancy, and breastfeeding.Special considerations.Chronic kidney disease: The preferred statins for CKD with severe renal impairment are atorvastatin and fluvastatin because they do not require dose adjustment. Pravastatin would be a second choice.Chronic liver disease: Statins are contraindicated in patients with decompensated cirrhosis or acute liver failure. Abstinence from alcohol is critical in patients with chronic liver disease who are taking statins. Pravastatin and rosuvastatin are the preferred agents. Check lipid levels to determine if LDL-C reduction is accomplished with no changes in aminotransferases. You may consider stopping, increasing dose, or changing statin as you discuss the risks vs. benefits with your patient.Conclusion: Simply put, if a patient has an LDL of greater than 190, is a diabetic, has an established history of cardiovascular disease, or is at risk for it, then the patient should ideally be taking a statin unless there is a contraindication, allergy, or other special circumstance that limits him/her from doing so. If you have patients that apply to any of the above scenarios and are not already on a statin, determine their risk, and consider starting them on a statin “stat” to reduce morbidity and mortality. On the other hand, be mindful of overprescribing. Do not prescribe statins to patients who do not meet the above criteria.________________________________________Now we conclude our episode number 113, “Statins in Primary Care.” Statins are powerful medications for the prevention of cardiovascular disease. Do not forget to recommend non-pharmacologic measures such as healthy eating and physical activity, but let's also consider adding a statin to patients who are at moderate to high risk for cardiovascular disease.This week we thank Hector Arreaza and Ripandeep Tiwana. Audio by Adrianne Silva.Even without trying, every night, you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you; send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!______________________________________References:1. Statins, U.S. Food & Drug Administration, 2014, December 16, fda.gov, https://www.fda.gov/drugs/information-drug-class/statins, accessed September 14, 2022.2. Chou R, Cantor A, Dana T, et al. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: A Systematic Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2022 Aug. (Evidence Synthesis, No. 219.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK583661/3. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2019; March 17. https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2019/03/07/16/00/2019-acc-aha-guideline-on-primary-prevention-gl-prevention. 4. ASCVD Risk Estimator Plus, published by the American College of Cardiology, https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/, accessed September 14, 2022.5. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication, U.S. Preventive Services Task Force, Final Recommendation Statement, 2022, August 23. https://uspreventiveservicestaskforce.org/uspstf/recommendation/statin-use-in-adults-preventive-medication6.  Videvo. “Distinction.” Https://Www.videvo.net/Royalty-Free-Music-Track/Distinction/227882/, Https://Www.videvo.net/, https://www.videvo.net/royalty-free-music-track/distinction/227882/. Accessed 26 Sept. 2022.

In this special podcast we will be focusing on the Consensus Report: Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD).  This report was simultaneously published in Diabetologia and Diabetes Care. The report is available at:   https://diabetesjournals.org/care/article/doi/10.2337/dci22-0034/147671/Management-of-Hyperglycemia-in-Type-2-Diabetes . Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Vanita Aroda, M.D., who is a the Director of Diabetes Clinical Research at the Brigham and Women's Hospital in Boston, MA, and is an Associate Professor of Medicine at Harvard Medical School

In this episode of Curbside Consults, we examine the latest standards of medical care published by the American Diabetes Association (ADA). We are joined by Bob Gabbay, who is Chief Science and Medical Officer at the American Diabetes Association, an Associate Professor of Medicine at Harvard Medical School, and one of the authors of the ADA's new 2022 Standards of Medical Care in Diabetes document.

NEJM Group In this episode of Curbside Consults, we examine the latest standards of medical care published by the American Diabetes Association (ADA). We are joined by Bob Gabbay, who is Chief Science and Medical Officer at the American Diabetes Association, an Associate Professor of Medicine at Harvard Medical School, and one of the authors of the ADA’s new 2022 Standards of Medical Care in Diabetes document. https://www.listennotes.com/e/fdce9586151f456da485dff078e7410c/

TAKING CONTROL OF YOUR DIABETES – THE PODCAST! ...With Expert Endocrinologists Living with T1D, Drs. Steven V. Edelman & Jeremy PettusDiabetes & Eye Health – Dr. Robert Miller (Ophthalmologist & Dr. E's Med School Buddy)Questions We'll Cover in This Episode:•  What are the causes of diabetic eye disease?•  What are the risk factors for diabetic eye disease?•  How does blood pressure relate to eye disease?•  What is time in range and how does it relate to eye disease?•  Why is a routine eye exam so important?•  What happens at a routine eye exam?•  What are your recommendations for someone who is pregnant with diabetes?•  What is a low vision physician?This video is in collaboration with the American Diabetes Association "Focus on Diabetes" Initiative.  Focus on Diabetes™ is a multiyear initiative from the American Diabetes Association® (ADA) that brings together leading organizations in vision care to increase awareness of and help reduce, treat, and manage diabetes-related eye diseases. This podcast is made possible by an unrestricted educational grant from VSP® Vision Care and Regeneron Pharmaceuticals, Inc. For more resources related to diabetes and eye health please visit: diabetes.org/fodRoutine Eye Exam Video: https://youtu.be/nzFEbp5pPAIDr. E's Eye Injection for Macular Edema Video: https://youtu.be/YdqOWFRhbL8Special Guest Speaker - Robert B. Miller, MD. (“Dr. Miller”) •  Completed Medical School in 1982, along with the most esteemed classmate, Dr. Edelman!•  Former Medical Director:  Advanced Valley Eye Associates in Davis, CA•  Large, very busy, comprehensive ophthalmology practice in Davis.•  Practiced for > 35 years in Davis!•  Professor Emeritus of Ophthalmology:  at Univ. of Calif, Davis, Eye Center•  Teaching medical and surgical ophthalmology to surgeons in training.•  Attending physician:  Kaiser Permanente, Retinal Department, Sacramento, CA•  Currently working in Retinal Clinic, providing ongoing care for diabetics.•  Medical Director:  San Blas Eye Clinic, Liga International•  Ongoing semi-annual volunteer charity trips to Mexico ★ Support this podcast ★

The importance of weight loss in type 2 diabetes was a major topic at the recent American Diabetes Association (ADA) 2022 Scientific Sessions. As weight management is a complex issue affected by both genetic and environmental factors, we shed light on the latest advances in obesity care for individuals with type 2 diabetes. Join us as we examine the effect of lifestyle interventions, metabolic surgery and the latest pharmaceutical agents, and discuss the state of the field with Dr Robert Kushner. By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources. References available here Dr Robert Kushner declares the following financial relationships from the past 24 months: Consultant: Lilly, Pfizer Board member: Novo Nordisk, WW Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose. The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity. Funding: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

Entre os dias 03 e 07 de junho, aconteceu o congresso da American Diabetes Association (ADA 2022), realizado em New Orleans, nos Estados Unidos. As discussões ocorreram in loco trouxeram novidades a respeito do diabetes. Este foi o primeiro congresso presencial da ADA desde o início da pandemia de COVID-19. Aperte o play e confira o episódio!

Published in Diabetes Care every January, the Standards of Medical Care in Diabetes by the American Diabetes Association (ADA) provides recommendations for the care of patients with diabetes.  And every year clinicians eagerly read, discuss, and apply them in their practices.  In this episode, we discuss some of the highlights. Guest Author: Jennifer N. Clements, PharmD, BCPS, BCACP, CDCES, BC-ADM Special Guest: Joshua Neumiller, PharmD, CDCES Music by Good Talk

In celebration of Healthy Vision Month in May, the Focus on Diabetes™ initiative is launching The Next Step Eye Health Challenge to raise awareness of diabetes-related eye disease and the steps people can take to maintain better eye health. My guest is Dr. Robert Gabbay, the Chief Scientific and Medical Officer for the American Diabetes Association (ADA).

In celebration of Healthy Vision Month in May, the Focus on Diabetes™ initiative is launching The Next Step Eye Health Challenge to raise awareness of diabetes-related eye disease and the steps people can take to maintain better eye health. My guest is Dr. Robert Gabbay, the Chief Scientific and Medical Officer for the American Diabetes Association (ADA).

No episódio de hoje do check-up semanal, o editor-chefe médico do portal PEBMED, Ronaldo Gismondi, comenta os destaques do congresso da American Diabetes Association (ADA 2021). Entre os estudos apresentados, estão: a utilização do teste point-of-care (POC) para diagnósticos de diabetes, o estudo GRADE trial em pacientes com DM2, novos estudos com agonistas do GLP-1 para o controle do diabetes, tirzepatida para controle glicêmico no diabetes e os estudos AMPLITUDE-M e SUSTAIN FORTE. Confira!

A1C is an easy way to diagnose and monitor diabetes, use and limitations of A1C are discussed with Dr Rodriguez. Vaginal metformin is mentioned as an anecdote which has not been proven to work we remembered Memorial Day. Introduction: Vaginal Metformin.  By Hasaney Sin, MD, and Hector Arreaza, MD.Today is May 31, 2021.  There’s a saying that I came across on social media that has always spoken to me which I find relevant to our vocation. “The more I learn, the more I find out I don’t know”. So comes the joys (and challenges) of our chosen career. Case in point, have you ever heard of vaginal metformin? Neither have I, until today. There was a randomized clinical trial plan in 2013 at Assuit University in Egypt studying the effectiveness of vaginal metformin for the treatment of polycystic ovarian syndrome (PCOS). As primary care providers, we are very aware of the gastrointestinal side effects of metformin when taken PO. This sometimes prevents compliance with metformin. The study at Assuit University was to study the effectiveness of metformin when given vaginally in the effectiveness of treating PCOS, while also decreasing the undesirable side effects of metformin when given PO in hopes of also ultimately improving adherence. Unfortunately, the study was planned to be finished in 2014, but no results have been published thus far[1]. Stay tuned in case there is any update.Arreaza: I had to do a search because I was very curious too. There is at least one occurrence when vaginal metformin was mentioned, at least in English. It was in an online forum where a doctor recommended vaginal metformin for PCOS to a patient. This has not been evaluated or approved by any organization, so I would not recommend it. You know what would be great? Metformin patches! There you have a business idea guys: The Metfo-patch®. This is Rio Bravo qWeek, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it’s sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. Introduction: Memorial Day. Written by Valerie Civelli, MD, read by Steven Saito, MD, and Hector Arreaza, MDWhat is Memorial Day? Memorial Day is an American holiday at the end of May to honor the men and women who died while serving in the US military. It has great historical meaning to Americans. It originated from the Civil War which claimed more lives than any other conflict in US history. Civil war ended in 1865.   A fun fact to know, is that Memorial Day, was originally called “Decoration Day”.  It was 3-years after the Civil war ended, May 5, 1868, that “Decoration Day” was declared as a time for the nation to decorate the graves of those lost in war.  Graves were adorned with flowers and their lives celebrated.  Maj. Gen. John A. Logan then declared that “Decoration Day” should be observed on May 30th. It is believed that this date was chosen because flowers would be in full bloom across the country. The “birthplace” of “Memorial Day” was recognized as coming from Waterloo, New York, because Waterloo was the first to use this term to expand honor and recognition of all US fallen soldiers of war from the Civil War and from World War I. In 1971, “Memorial Day” was officially declared a national federal holiday: The National Moment of Remembrance encourages all Americans to pause wherever they are at 3:00 p.m. local time on Memorial Day for a minute of silence, to remember and honor those who have died in service to the nation. If you value your freedom wherever you are, this Memorial Day at 3:00 p.m., pause for a minute to recognize all of our military men and women, both past and present who served and continue to serve our country. We honor every soldier who lost his or her life in any war against America. You are the reason for our freedoms.  You gave the ultimate sacrifice, and we do not take this for granted. To all military members who have died at war, we appreciate the privileges we have today because of you. We honor the costly price at which it came.  We remember you. We honor you. We sincerely thank you. Happy Memorial Day everyone! ___________________________A1C.By Hector Arreaza, MD, and Yodaisy Rodriguez, MD.   Definition. Glycated hemoglobin (glycohemoglobin, hemoglobin A1c, or just A1c) is a form of hemoglobin that is chemically linked to a sugar. Glucose spontaneously bind with hemoglobin, when present in the bloodstream of humans.A1C refers to the percentage of glycosylation of the hemoglobin A1C chain and correlates with the average blood glucose levels over the previous 2-3 months from the slow turnover of red blood cells in the body. A RBC lives 120 days.History of A1C. Huisman and Meyering separated glycohemglobin for the first time in 1958. A1c for monitoring the degree of control of glucose metabolism in diabetic patients was proposed in 1976 by Anthony Cerami, Ronald Koenig and coworkers.A1C was first included in the ADA guidelines as a diagnostic test for diabetes in 2010. Prior to that random glucose or fasting plasma glucose were used for diagnosis.For diagnosis of diabetes, A1C testing should be done by a technique certified by the National Glycohemoglobin Standardization Program and consistent with the Diabetes Control and Complications Trial reference assay.A1C levels. A1C 6.5% is diabetes.Of note, other criteria for diagnosing diabetes: Fasting plasma glucose >126 mg/dL, 2-hour plasma glucose > 200, random glucose >200 plus classic symptoms.In patients with prediabetes, A1C should be tested yearly.The American Diabetes Association (ADA) has recommended glycated hemoglobin testing (HbA1c) twice a year for patients with stable glycemia, and quarterly for patients with poor glucose control. Use ADA guidelines to assess targets.Point-of-care A1C (POC A1C): POC is not recommended for screening or diagnosis but it is good for monitoring.A1C limitations.There are some limitations to A1C testing, and an incomplete correlation between A1C level and average glucose level in certain individuals.Nonglycemic Factors That May Interfere with A1C MeasurementFalsely lower A1C: Acute blood loss, Chronic liver disease, Hemolytic anemias, Patients receiving antiretroviral treatment for human immunodeficiency virus, Pregnancy, Vitamins E and C. Patients being treated for iron, B12 or folate deficiency, EPO, chronic hemolysis (thalassemia). Lower or elevate A1C: Hemoglobinopathies or hemoglobin variants, Malnutrition Falsely elevate A1C: Aplastic anemias, Hyperbilirubinemia, Hypertriglyceridemia, Iron deficiency anemias, Renal failure, Splenectomy.For example, when RBCs have a short life, like in acute bleeding, the A1C is falsely low. On the other hand, when RBCs live longer (history of splenectomy and aplastic anemias) the A1C is falsely elevated. It’s a good idea to do CBC with A1C.Ethnic groups: Hemoglobinopathies or hemoglobin variants can change A1C levels and may be more prevalent among certain racial and ethnic groups. A1C tends to be higher in some races/ethnic groups: AA, Hispanic-Americans, Asian-Americans.Other A1C limitations: It gives you an average, patient may be experiencing hypoglycemia alternated with hyperglycemia and result in normal A1C. Screening for diabetes.ADA: Screen for diabetes or prediabetes all asymptomatic adults, according to the ADA, who have overweight or obesity with one or more risk factor (first degree relative with diabetes, high risk race or ethnic group, history of CVD, hypertension, dyslipidemia, PCOS, physical inactivity, severe obesity, acanthosis nigricans), patients with prediabetes (every year), women with GDM (every 3 years), all other patients after 45 years of age. If results are normal, test every 3 years, patients with HIV.USPSTF: Adults aged 40 to 70 years who are overweight or obese. The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese. (Draft: Asymptomatic adults ages 35 to 70 years who are overweight or obese) This is a Grade B recommendation. Clinicians should offer or refer patients with abnormal blood glucose to intensive behavioral counseling interventions to promote a healthful diet and physical activity. The USPSTF recommends screening for gestational diabetes mellitus (GDM) in asymptomatic pregnant women after 24 weeks of gestation. This is a Grade B recommendation.Grade I recommendation (insufficient evidence): Asymptomatic pregnant women, Before 24 Weeks of Gestation. The USPSTF concludes that the current evidence is insufficient to screen for GDM in asymptomatic pregnant women before 24 weeks of gestation.A1C Targets.A1C goals can range from 6.5% to 8%. Target is individualized based on life expectancy, disease duration, presence of complications, CVD risk factors, comorbid conditions and risks for severe hypoglycemia. Sometimes your goal can be independent of A1C, for example, your goal can be to avoid complications. As a fun fact, A1C is not used in veterinary medicine.Conclusion.By Hector Arreaza, MD. Now we conclude our episode number 54 “A1C”, three characters that may not mean much for most people but for patients with diabetes, it is a very important number to remember. Remember to check the A1C in all your patients with poor control of diabetes every 3 months, or every 6 months in patients with good control. A1C has its limitations but it certainly is the best way to assess your patients’ glycemic control. We started this episode by giving you a random report about vaginal metformin, the study was unfinished, and we also reminded you of the importance of remembering our heroes during Memorial Day. Even without trying, every night you go to bed being a little wiser.Thanks for listening to Rio Bravo qWeek. If you have any feedback about this podcast, contact us by email RBresidency@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. This podcast was created with educational purposes only. Visit your primary care physician for additional medical advice. This week we thank Hector Arreaza, Hasaney Sin, Valerie Civelli, Yodaisy Rodriguez, and Steven Saito. Audio edition: Suraj Amrutia. See you next week!References:Vaginal Administration of Metformin in PCOS Patients, U.S. National Library of Medicine, Clinical Trials.Gov, https://clinicaltrials.gov/ct2/show/study/NCT02026869. Office of Public and Intergovernmental Affairs, U.S. Department of Veteran Affairs,  https://www.va.gov/opa/speceven/memday/history.asp, accessed on May 26, 2021.  Pippitt K, Li M, Gurgle HE. Diabetes Mellitus: Screening and Diagnosis. Am Fam Physician. 2016 Jan 15;93(2):103-9. Erratum in: Am Fam Physician. 2016 Oct 1;94(7):533. PMID: 26926406. https://www.aafp.org/afp/2016/0115/p103.html. Standards of Medical Care in Diabetes – 2021, Diabetes Care, January 1, 2021, vol 44 issue supplement 1, https://care.diabetesjournals.org/content/diacare/suppl/2020/12/09/44.Supplement_1.DC1/DC_44_S1_final_copyright_stamped.pdf.

While the numbers are constantly rising, more than 1 in 10 Americans – or more than 34 million people – live with diabetes already today. For many of them, nerve damage caused by diabetes – a condition called diabetic neuropathy – is a common complication that can cause painful shooting and stabbing sensations along with burning, tingling and numbness that affect the lower extremities. To understand more about the challenges patients face due to this condition, a new national survey reveals its findings on what it truly means to live with diabetic nerve pain. Here to discuss neuropathic pain associated with diabetic peripheral neuropathy – or diabetic nerve pain – and the survey findings is Dr. Rodica Pop-Busui, MD, PhD, Professor of Internal Medicine, Metabolism, Endocrinology and Diabetes and Vice Chair Clinical Research, Department of Internal Medicine at the University of Michigan, Ann Arbor and Lindsay Colbert, Executive Director of the Foundation for Peripheral Neuropathy. Rodica Pop-Busui, MD, PhD, is the Larry D. Soderquist Professor of Diabetes, a prominent diabetologist at Michigan Medicine and a recognized leader in the field of diabetes and diabetes complications. She is the Vice Chair for Clinical Research in the Department of Internal Medicine and the Associate Director of Clinical Research, Mentoring and Development of the Elizabeth Weiser Caswell Diabetes Institute at the University of Michigan. Her research interests involve chronic complications of diabetes, particularly diabetic peripheral and cardiovascular autonomic neuropathy, as well as diabetic foot complications, diabetic kidney disease and cardiovascular disease, and the design and conduct of traditional and pragmatic clinical trials for patients with diabetes. Dr. Pop-Busui has published more than 200 peer-reviewed manuscripts and book chapters, and received awards from the American Diabetes Association (ADA) and the University of Michigan. She has chaired the most recent American Diabetes Association Position Statement on Diabetic Neuropathy, and has served as Chair of the American Diabetes Association Scientific Research Review Clinical and Chair of the ADA Diabetes & Cardiovascular Disease Interest Group. She is also one of the principal investigators in the recently established NIDDK Diabetes Foot Consortium. She has led neuropathy studies in several of the most important national and international diabetes clinical trials to date including: the NHLBI-funded Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, the NIDDK funded Bypass Angioplasty Revascularization Diabetes 2 (BARI- 2D) and Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications. In addition, she designed and leads several investigator-initiated studies funded by NIDDK and Pharma to unveil disease modifying agents for diabetic neuropathy and other diabetes complications. Lindsay Colbert, MA, is Executive Director of the Foundation for Peripheral Neuropathy (FPN), a public charity organization based outside of Chicago, Illinois, that is dedicated to improving the lives of patients living with peripheral neuropathy. In her tenure with the organization, Colbert has lead FPN to increase awareness of peripheral neuropathy, prioritize research and funding in the field, and provide educational programs to patients throughout the world who are desperate for answers and hope. Colbert holds a Master of Arts degree in International Development and French from the University of Wisconsin-Madison. Prior to joining FPN in 2017, Colbert developed her marketing, fundraising and nonprofit management skills for over a decade at two Chicago-based institutions, namely Rotary International and Northwestern University. She resides in a Chicago suburb with her husband and two daughters. In her free time, Colbert enjoys traveling, cycling, gardening, and playing with her children.

The American Diabetes Association (ADA) currently recommends insulin as the preferred agent for the management of type 2 diabetes mellitus during pregnancy. However, metformin is routinely used as it has several advantages over insulin including the lower cost, less maternal weight gain, and less maternal hypoglycemia. The MiTy study explores the benefits and risks of a combination of metformin plus insulin.  Guest Authors:  Hugh Quinn, PharmD and Mallory Telese, PharmD Guest Panelists: Erin Raney, PharmD, BCPS, BC-ADM and Rebecca Stone, PharmD, BCPS, BCACP Music by Good Talk

There is a wide range of opinions re: the best goals for A1c. Jenny Ruhl's book and website Blood Sugar 101 is an example of diabetics searching for prevention through tighter control. They have the "5% Club". This is a group of diabetics that maintain A1c levels less than 6%, " a level most doctors consider normal". They go on to talk about how this can be done safely- and how it increases safety long-term due to decreased arterial damage. The American Diabetes Association (ADA) standards are very different. 6.5% is considered an "aggressive goal", which should be done only for young people, not on meds other than metformin, focused on lifestyle. 7.5% is considered the standard and usual goal for "nonpregnant adults". And finally, 8% is considered a better goal for older diabetics, requiring more meds, and having lower life expectancy. There is actually scientific evidence for both sides of this debate. We'll cover that in other videos.For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources:·PrevMed's website·PrevMed's YouTube channel·PrevMed's Facebook page

Host: Jennifer Caudle, DO Guest: Carlos Campos, MD, MPH Guest: Pablo F. Mora, MD Guest: Joshua Stolker, MD Each year, the American Diabetes Association (ADA) releases updates to their Standards of Medical Care in Diabetes. Joining Dr. Jennifer Caudle to share their insights on what’s updated in the 2020 treatment algorithm is endocrinologist Dr. Pablo Mora, cardiologist Dr. Joshua Stolker, and family medicine specialist Dr. Carlos Campos. Novo Nordisk is a registered trademark of Novo Nordisk A/S. © 2020 Novo Nordisk All rights reserved. US20DI00339 October 2020

On September 20, 2020, our host Dr. Marianne Ritchie was joined by Dr. Robert Gabbay and Dr. Jeffrey Joseph​ for a discussion on diabetes. Dr. Gabbay, is the Chief Scientific and Medical Officer for the American Diabetes Association (ADA), the global authority on diabetes. He is also an Associate Professor of Medicine at Harvard Medical School. Dr. Joseph is a Professor of Anesthesiology, the Vice-Chairman & Director of Research for the Department of Anesthesiology, and Director of the Jefferson Artificial Pancreas Center at Thomas Jefferson University Hospital.Each week we highlight the #RealChampions in your life! Your family, friends, or colleagues who go the extra mile to help others in their community. For this week, Your Real Champion was Mae Krier! Hear the inspirational story of one of the millions of “Rosies” who helped America in the war against Hitler. Mae helped to establish the annual “Rosie the Riveter” Day and earned the Congressional Medal of Honor for “Rosie”.

As discussed in our previous episode, it is vital to monitor blood glucose when receiving insulin-based therapy due to the risk of hypoglycaemia. However, given the relative crudeness of insulin-based treatment, SMBG testing is not an infallible way of preventing hypogycaemia. What are the other risks, and how can we address these? Join Professor Simon Heller of the University of Sheffield for a detailed discussion of risk factors, management strategies, and how to empower patients to minimise their risk of hypoglycaemia References Davies MJ, D'Alessio DA, Fradkin J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701. Iqbal A, Heller SR. The role of structured education in the management of hypoglycaemia. Diabetologia. 2018;61(4):751-760. Philis-Tsimikas, A., Klonoff, D.C., Khunti, K. et al. Risk of hypoglycaemia with insulin degludec versus insulin glargine U300 in insulin-treated patients with type 2 diabetes: the randomised, head-to-head CONCLUDE trial. Diabetologia 63, 698–710 (2020). Silbert R, Salcido-Montenegro A, Rodriguez-Gutierrez R, Katabi A, McCoy RG. Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies. Curr Diab Rep. 2018;18(8):53. Published 2018 Jun 21. Yorke E, Atiase Y. Impact of structured education on glucose control and hypoglycaemia in Type-2 diabetes: a systematic review of randomized controlled trials. Ghana Med J. 2018;52(1):41-60. This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education

A vital aspect of insulin-based treatment is glucose monitoring, typically using on-the-spot finger prick blood tests. While this is essential to monitor treatment effectiveness and prevent hypoglycaemia, it can be difficult for patients to adapt to a new routine. What can we do to support people in adapting to regular glucose monitoring? Join Professor Richard Holt from the University of Southampton for a detailed discussion of monitoring approaches and introducing these to your patients. References: American Diabetes Association. 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S193-S202. Danne T, Nimri R, Battelino T, et al. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care. 2017;40(12):1631-1640. Davies MJ, D'Alessio DA, Fradkin J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701. This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

The US department of Health and Human Services says the most common way to determine, if a person is overweight or obese is to calculate body mass index (BMI), which is an estimate of body fat, based on comparing a person’s weight to his or her height. However, BMI can be flawed with more lean muscle weight, such as the case with a fit person or athlete.The Centers for Disease Control and Prevention (CDC) comments that, “BMI does not measure body fat directly, but research has shown that BMI is moderately correlated with more direct measures of body fat obtained from skinfold thickness measurements, bioelectrical impedance, underwater weighing, dual energy x-ray absorptiometry (DXA) and other methods.” When BMI is added to a person’s potential health comorbidities (high blood pressure, cardiovascular, liver, or kidney disease), there can be a higher risk to complications associated with viral-associated diseases, such as Covid-19. “BMI appears to be strongly correlated with various adverse health outcomes consistent with these more direct measures of body fatness,” notes the CDC.For adults, a BMI of 18.5 to 24.9 is considered normal weight; 25.0 to 29.9 is considered overweight; 30.0 to 39.9 is considered obese, and 40.0 and higher is considered extremely obese.The World Health Organization (WHO) states that the number of obese people has tripled worldwide in the last twenty years – reaching the status of a global epidemic – mainly associated with improper dietary habits and a sedentary lifestyle.According to April 2020 research – Obesity, Bioactive Lipids, and Adipose Tissue in Insulin Resistance – published in the online, peer reviewed journal Nutrients, “obesity is a state of pathological increase in the amount of adipose tissue, which boosts the risk of numerous diseases, such as cardiovascular disease, some types of cancer, and type 2 diabetes.” The study authors from the Department of Hygiene, Epidemiology and Metabolic Disorders, Medical University of Bialystok, Poland, stress that “there are a number of causes leading to the development of obesity, including genetic and environmental factors. The contribution of genetic factors to obesity is very important and is thought to be responsible for 40–70% of obesity cases.”However, note the Polish researchers, “it appears that non-genetic factors, especially environmental factors such as unhealthy eating habits and lack of physical activity, also play a substantial role in generating obesity.” Let’s add sleep duration and daytime sleepiness to the list of complications that may affect being overweight and obese.When insulin resistant – a precursor to type 2 diabetes and obesity – insulin stimulates fat storage and inhibits fat breakdown for energy. Under normal conditions, insulin is an anabolic (building) hormone that increases the uptake of amino acids by muscle tissue and enhances protein synthesis (making muscle).The American Diabetes Association (ADA) defines insulin resistance as, “a condition in which the response of cells to insulin is impaired with respect to carbohydrates, lipids, and proteins, resulting in elevated blood glucose levels.”The ADA further states that, “insulin has a wide spectrum of effects on metabolic processes in adipocytes (fat cells); therefore, it is considered the most important hormone regulating anti-lipolytic processes, and deterioration of cell sensitivity to this hormone or impairment of the insulin pathway may affect the metabolism of adipose (fat) tissue.” The central accumulation of fat tissue – known as an android visceral fat - is consistent with a male fat pattern. Female fat accumulation – known as a gynoid fat pattern – is the increase of subcutaneous (under the skin) fat in the hip and thigh regions. Read the rest at MackieShilstone.com

Dr. Christofides is dual board-certified in Endocrinology, Diabetes and Metabolism as well as Internal Medicine. She received both her undergraduate and medical degrees from The Ohio State University. She completed her internal medicine residency at Mount Carmel Medical Center and her fellowship training in Endocrinology, Diabetes and Metabolism at Louisiana State University Medical Center in New Orleans. She is a Fellow of the American Association of Clinical Endocrinologists (AACE), the highest honor in her specialty. She has served as President of the Ohio River Regional Chapter of AACE, President of the Ohio Chapter of the American Diabetes Association (ADA), Chair of the Medical Advisory Board of the Central Ohio Diabetes Association (CODA) and a member of its Board of Directors. She is affiliated with Mt. Carmel Hospitals and with Specialty Select Hospitals. Connect with Elena Christofides: https://endocrinology-associates.com/ https://www.realself.com/find/Ohio/Dublin/MediZen-Health https://shopwiththedoc.com/ Twitter: @DoctorEndocrine and @DrElena Connect with Nick Holderbaum: Personal Health Coaching: https://www.primalosophy.com/ Nick Holderbaum's Weekly Newsletter: Sunday Goods (T): @primalosophy (IG): @primalosophy iTunes: https://podcasts.apple.com/us/podcast/the-primalosophy-podcast/id1462578947 YouTube: https://www.youtube.com/channel/UCBn7jiHxx2jzXydzDqrJT2A The Unfucked Firefighter Challenge

Talk to a Dr. Berg Keto Consultant today and get the help you need on your journey (free consultation). Call 1-540-299-1557 with your questions about Keto, Intermittent Fasting or the use of Dr. Berg products. Consultants are available Monday through Friday from 8:30 am to 9 pm EST. Saturday & Sunday 9 am to 5 pm EST. USA Only. Join my FREE 30-Day Low-Carb, No-Cheat Challenge Here! http://bit.ly/30-DayKetoChallenge Take the Free Keto Mini-Course: https://bit.ly/2Cpb03l Download Keto Essentials https://m.me/drericberg?ref=w2128577 Take Dr. Berg's Advanced Evaluation Quiz: http://bit.ly/EvalQuiz Your report will then be sent via email analyzing 104 potential symptoms giving you a much deeper insight into your body issues. It's free and very enlightening. Many of you have asked, “is a low carb diet safe for diabetes?” The answer is yes. In fact, the American Diabetes Association (ADA) now acknowledges that the low-carb diet is beneficial for type 2 diabetes. “Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.” The only problem is that they didn't define what a good low-carb diet is. The ADA recommends somewhere around 40% carbohydrates, which is still far too high (it should be around 5%). As you probably know by now, I recommend a ketogenic diet and intermittent fasting to keep blood sugars under control. If you've been waiting for the ADA to approve keto before you started, now is the time to begin. Take a look at some of the links at the top of the description to get started. Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional & natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government & the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning. FACEBOOK: fb.me/DrEricBerg?utm_source=Podcast TWITTER: http://twitter.com/DrBergDC?utm_source=Podcast YOUTUBE: http://www.youtube.com/user/drericberg123?utm_source=Podcast DR. BERG'S SHOP: https://shop.drberg.com/?utm_source=Podcast MESSENGER: https://www.messenger.com/t/drericberg?utm_source=Podcast DR. BERG'S VIDEO BLOG: https://www.drberg.com/blog?utm_source=Podcast

Tracey Brown is the CEO of the American Diabetes Association (ADA) and a dynamic and transformative leader. As the sixth CEO in five years for the ADA, Tracey had to deal with an organization in decline and one that had endured a lot of disruption caused by the frequent changes in leadership. She has risen to the challenge in an incredible way and is changing lives and impacting others with her work at the ADA.   In the second of this two-part episode of The Culture Gap, Tracey gives us an inside look into the transformation of this organization. She shares how focusing on the customer experience is taking a center stage at the ADA, and how she is reshaping her organization's culture to reflect this. Tracey also shares more about her experience with collaboratively designing strategy, communicating with stakeholders, and building out a team that will tackle the challenges of the future. Welcome to Culture Gap.   Key Takeaways: [:43] Daniel introduces his guest for this episode — Tracey Brown. [1:22] How did Tracey frame the case for change at the ADA in the first few months of her leadership? [9:05] The customer experience is taking center stage in a lot of organizations, including at the ADA. What are Tracey's thoughts on how this will play out in the future of the organization? [13:21] Tracey talks about how she started creating the values for the organization, why those values were chosen, and how they have shaped the activities of the ADA. [19:48] Quantifying the impact of different activities is important to determine which activities take priority. [23:58] Getting the right team together to lead a transformation can be tricky. Tracey shares her experience with getting the right people in the right roles. [27:57] Tracey explains why it is so important to maintain clear communication of the facts and data during a period of transformation. [32:00] Tracey breaks down her four-year blueprint for change for the ADA. [38:24] What would Tracey tell her younger self?   Brought to You By: The Culture Gap Podcast THRUUE Podfly Productions   Learn more about: Tracey Brown American Diabetes Association The Culture Gap Podcast Episode: “Tracey Brown, CEO of the American Diabetes Association (Part 1 of 2)” Start with Why: How Great Leaders Inspire Everyone to Take Action, by Simon Sinek

Tracey Brown is the CEO of the American Diabetes Association (ADA) and a dynamic and transformative leader. Prior to her current role at the ADA, Tracey was working with Sam's Club and Walmart and made some significant strides during her tenure there. Today, she is changing lives and impacting others with her work at the ADA. In the first of this two-part episode of The Culture Gap, Tracey shares a little about her childhood and how her parents shaped her value system from a young age, including her thoughts around what it means to be a leader. She also shares insights about what it takes to grow a membership model business like Sam's Club and highlights some of the key principles of Walmart that are often overlooked but that influenced her decision-making process to join the ADA. Purpose, passion, and position have aligned for Tracey who continues to shine her light in the world and change the lives of others. Welcome to Culture Gap.   Key Takeaways: [:41] Daniel introduces his guest for this episode — Tracey Brown. [1:33] Who is Tracey Brown? [2:53] What are some core values that shaped Tracey as a child? [6:34] Who is the first person Tracey thinks of when she thinks of a leader, and why? [9:23] What was Tracey's time working at Walmart like? Tracey explains more about the concept of membership and how it played out at Sam's Club. [17:39] Tracey shares how she moved from working with Walmart to joining the American Diabetes Association. [24:28] Tracey and Daniel discuss some of the social good that is done by Walmart and its subsidiaries, and how that influenced Tracey's decision-making process. [26:42] Purpose, passion, and position have aligned for Tracey to do great work in the American Diabetes Association. [27:19] Tracey relates a life-changing moment with her daughter and how she turned her life around from that point.   Brought to You By: The Culture Gap Podcast THRUUE Podfly Productions   Learn more about: Tracey Brown American Diabetes Association Walmart Sam's Club Doug McMillon John Ferner

Show Notes Please take our listener survey at https://forms.gle/spMwHJS795Qnfgww7 Diabetic Hyperglycemic Emergencies: A Systematic Approach, by H. Evan Dingle, MD and Corey Slovis, MD, FACP, FACEP, FAAEM, FAEMS American Diabetes Association (ADA) and International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines are reviewed in addition to the references used by each consensus statement. Also, a primary literature review was conducted with particular attention given to prospective studies. Topics reviewed include: Etiology and pathophysiology of DKA and HHS Precipitating causes Differential diagnosis Diagnostic studies ECG Lab Imaging Treatment IV fluids Insulin therapy Potassium Sodium bicarbonate Phosphate Pediatrics IVF changes Insulin changes Cerebral edema Airway management Euglycemia DKA Thrombosis and anticoagulation. Time stamps: 00 Introduction 1:34 Cases 21:47 Summary of key points 26:37 Closing  

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association’s four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 20 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. This month we review articles on: Efficacy and safety of dapagliflozin in the elderly Lactic Acidosis from Metformin – FDA analysis Economic and Clinical Burden of Nonalcoholic Steatohepatitis in Patients With Type 2 Diabetes in the United States 2019 update to: Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Transitioning to Fixed-Ratio Combination Therapy: Practical Advice General practitioner advice associated with greater physical activity in adults with type 2 diabetes Empagliflozin Effectively Lowers Liver Fat Content For more information about each of ADA’s science and medical journals, please visit www.diabetesjournals.org. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Abington Jefferson Health

Rounding off our first season of the podcast, we join Dr Vanita Aroda of Brigham and Women's Hospital for a discussion of future trends in diabetes management. Take a quick walk down memory lane of how practice has changed, and the direction the next decade could head. References Davies MJ, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018; 41(12):2669-2701. Rowley WR, et al. Diabetes 2030: Insights from Yesterday, Today, and Future Trends. Popul Health Manag. 2017;20(1):6–12. Kerr D, et al. Diabetes and technology in 2030: a utopian or dystopian future? Diabet Med. 2018; 35(4):498-503. ESC. New apps for atrial fibrillation. Available online. Kebede MM, Pischke CR. Popular Diabetes Apps and the Impact of Diabetes App Use on Self-Care Behaviour: A Survey Among the Digital Community of Persons With Diabetes on Social Media [published correction appears in Front Endocrinol (Lausanne). 2019 Apr 05;10:220]. Front Endocrinol (Lausanne). 2019;10:135. Coskun T, et al. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept. Mol Metab. 2018; 18:3-14. Vuylsteke V, et al. Imeglimin: A Potential New Multi-Target Drug for Type 2 Diabetes. Drugs R D. 2015;15(3):227–232. This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

O que existe entre a metformina e a insulina? Discutimos isso no episódio de hoje! Criamos 4 situações: paciente com alto risco cardiovascular, paciente que deseja emagrecer, paciente sem recurso financeiro e paciente que precisa evitar hipoglicemia. Essa abordagem é a indicada pela American Diabetes Association (ADA). Gostou do esquema? Compartilhe com a gente no Instagram @tadeclinicagem ou no e-mail tadeclinicagem@gmail.com! REFERÊNCIAS: American Diabetes Association. "9. Pharmacologic approaches to glycemic treatment: standards of medical care in diabetes—2019." Diabetes care 42.Supplement 1 (2019): S90-S102.

James McCarter, MD, PhD. is a researcher and author of over 60 scientific publications and patents. He recently led research and clinical operations for San Francisco-based Virta Health, a nationwide medical provider that delivers the first clinically-proven treatment to safely and sustainably reverse type 2 diabetes without medications or surgery. Dr. McCarter recently directed the Virta - Indiana University Health clinical trial demonstrating reversal of diabetes using nutritional ketosis and guided behavior change. This trial has resulted in changes to the American Diabetes Association Standards of Care and consensus statement on nutrition in 2019, reflecting the benefit of low-carbohydrate diets.  In this podcast, James discusses the results that have emerged from this research and the incredible outcomes Virta is demonstrating in helping people reverse their type-2 diabetes and improve cardiac risk markers. He also talks about the five facets of treatment behind Virta’s success, and the business model they employ to make treatment more widely available.  Dr McCarter recently spoke at the AACE (American Association of Clinical Endocrinology) meeting in Kansas City on ketosis for T2D. These slides provide nice visuals for all of the Virta-IUH trial outcomes as well as background information. Here’s the outline of this interview with Jim McCarter: [00:00:19] Two-year clinical trial: Athinarayanan, Shaminie J., et al. "Long-Term Effects of a Novel Continuous Remote Care Intervention Including Nutritional Ketosis for the Management of Type 2 Diabetes: A 2-year Non-randomized Clinical Trial." Frontiers in endocrinology 10 (2019): 348. [00:00:23] Virta Health. [00:01:09] Type 2 Diabetes (T2D) affects 30 million people in the US, 400 million worldwide. [00:02:24] Long term complications of T2D. [00:04:16] Ketogenic diet: Getting people off the glucose rollercoaster. [00:08:47] Setting up the clinical trial; Sarah Hallberg, DO, MS, Virta Medical Director. [00:10:13] Nine papers published by Virta so far: 7 on the trial and 2 reviews: 1, 2, 3, 4, 5, 6, 7, 8, 9, plus whitepaper on cardiovascular benefits of Virta treatment. [00:10:46] 5 facets to treatment: In-house medication management, health coaching, nutrition behavior change education, biometric feedback, online community. [00:16:05] Podcasts with Doug Hilbert: How Busy Realtors Can Avoid Anxiety and Depression Without Prescriptions or the Help of a Doctor, and Ancestral Health Symposium ‘18 Recap. [00:16:54] Doug Hilbert’s AHS talk 2018: AHS18 Douglas Hilbert - Virta 1 Year Clinical Trial Results/Patient Outcomes. [00:18:13] Adherence to the program: 74% of patients completed 2 years of the trial. [00:18:26] Blog post: Top 10 Keto Myths Debunked After 150,000 Days of Patient Care. [00:20:30] Jeff Volek, PhD, RD & Stephen Phinney, MD, PhD. [00:21:20] Ketone metabolism: beta-hydroxybutyrate, acetoacetate and acetone. [00:23:05] Beta-hydroxybutyrate as an histone deacetylase (HDAC) inhibitor; Study: Shimazu, Tadahiro, et al. "Suppression of oxidative stress by β-hydroxybutyrate, an endogenous histone deacetylase inhibitor." Science 339.6116 (2013): 211-214. [00:24:10] Higher levels of ketones correlate with greater reductions of hemoglobin A1c and greater weight loss. [00:24:29] Ken Ford, Podcast: Optimal Diet and Movement for Healthspan, Amplified Intelligence and More with Ken Ford (ketone signaling is discussed at minute 54:20). [00:25:58] Kaiser study on diabetes remission rates: Karter, Andrew J., et al. "Incidence of remission in adults with type 2 diabetes: the diabetes & aging study." Diabetes Care 37.12 (2014): 3188-3195. [00:29:09] Readout: creating less invasive ways for measuring metabolic markers. [00:29:28] Dan Ariely; Shapa scale and app. [00:31:55] Non-scale victories (NSV). [00:32:56] Ashley Mason podcasts: Paleo Psychology with Ashley Mason PhD and Mindfulness and Cognitive Behavioral Strategies for Diabetes and Sleep Problems. [00:33:22] Elimination of drugs that cause hypoglycemia (e.g., sulphonylureas). [00:34:13] Common pitfalls: Electrolytes. [00:37:46] Myth: Keto causes diabetic ketoacidosis. [00:38:50] Improvements in cardio risk markers; Study: Bhanpuri, Nasir H., et al. "Cardiovascular disease risk factor responses to a type 2 diabetes care model including nutritional ketosis induced by sustained carbohydrate restriction at 1 year: an open label, non-randomized, controlled study." Cardiovascular diabetology 17.1 (2018): 56. [00:44:25] Dave Feldman on The Fat Emperor Podcast with Ivor Cummins: LDL and All-Cause Mortality  - Does Cholestesterol Kill You?; Related NBT podcasts: How to Drop Your Cholesterol, with Dave Feldman, and How Not to Die of Cardiovascular Disease, with Ivor Cummins. [00:49:15] American Diabetes Association (ADA) changed their Standards of Care and consensus statement on nutrition in 2019. [00:51:04] Virta's value-based business model. [00:54:13] Navigating difficult food environments. [00:55:52] Robb Wolf; Chickasaw Nation. [01:01:43] Cardiovascular effects of GLP-1 agonist and SGLT2 inhibitor drugs; Studies: Busch, Robert S., and Michael P. Kane. "Combination SGLT2 inhibitor and GLP-1 receptor agonist therapy: a complementary approach to the treatment of type 2 diabetes." Postgraduate medicine 129.7 (2017): 686-697, and DeFronzo, Ralph A. "Combination therapy with GLP‐1 receptor agonist and SGLT2 inhibitor." Diabetes, Obesity and Metabolism 19.10 (2017): 1353-1362. [01:02:13] Podcast: Nudge Tactics for Performance and Health, with Simon Marshall, PhD. [01:04:50] Find James on Twitter, Medium and LinkedIn.

Amy Riolo, an expert in olive oil, shares benefits of the Mediterranean diet for those living with diabetes.If you're living with diabetes, it's important to keep close tabs on the foods you eat so as to keep your symptoms in check. Now, one diet has been deemed the "gold standard" in diabetes care. The Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), Management of Hyperglycemia in Type 2 Diabetes, 2019, cites evidence that the Mediterranean diet is an effective component of diabetes lifestyle management.Additionally, U.S. News and World Report has ranked the Mediterranean Diet as the "Best Diet Overall" in its yearly assessment.In her book, The Mediterranean Diabetes Cookbook, 2nd Edition: A Flavorful, Heart-Healthy Approach to Cooking, Amy Riolo, an expert in olive oil, shares benefits of the Mediterranean diet for those living with diabetes. She also explains how to find and identify an olive oil that is of good quality, so you can reap all its health benefits.BonusBug Bite Symptoms You Should Never Ignore

Jane Fadesere has over 16 years of experience as a community pharmacist. She has practiced pharmacy in Maryland, Washington DC, West Virginia, Louisiana and currently in Texas. She has experience in various pharmacy settings including pain management, medical supplies, independent pharmacy, and chain pharmacy.  Jane practices medication safety on a daily basis, ensuring that patients receive the right medications and dosages. Jane obtained her Doctor of Pharmacy degree from Howard University, Washington DC. She also has a dual MBA/MPH earned from Benedictine University, Lisle IL. She is currently a staff pharmacist with CVS Pharmacy. Her interest in public health started while she was in pharmacy school. In this episode, she discusses some of the opportunities that exist for the role of the pharmacist in public health.  She talks about her strong desire to help educate and empower underserved and underinsured populations, especially those who suffer from diabetes and cardiovascular disease. Jane refers to herself as a “volunteer junkie” and has served as a volunteer for the American Diabetes Association (ADA) since 2010, as well as several other organizations. She serves on the Board of Directors of Minority Women Pharmacists Association, Inc. (MWPA). MWPA became incorporated in 2018 and part of their mission is to enhance the presence of minority women in the healthcare industry, provide service to their communities, and to support each other.

Lisa is a results-orientated experienced professional with over 10 years plus experience in driving transformation innovation/re-invention, business growth and empowering people to achieve. Prior to ADA, she has worked at Fortune 500 consumer packaged goods companies like Georgia-Pacific, Anheuser-Busch and big box retailers like Sam’s Club-Walmart Inc. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization on a mission to prevent and cure diabetes, as well as improve the lives of all people affected by the disease. For nearly 80 years, the ADA has driven discovery by funding research to treat, manage and prevent all types of diabetes, while working relentlessly for a cure.

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association’s four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 15 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. This month we review articles on: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) Trends in Cardiovascular Mortality in People with and without Diabetes in the U.S. Immunosuppressive Therapy for Severe Type B Insulin Resistance For more information about each of ADA’s science and medical journals, please visit www.diabetesjournals.org. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Director, Family Medicine Residency Program, Abington Jefferson Health

Kelly Close founded Close Concerns in 2002; its mission is to make everyone smarter about diabetes. At Close Concerns, Kelly and her team write approximately three million words each year on diabetes, prediabetes, obesity, and digital health for Closer Look, a highly praised service covering the goings-on in the field. Kelly's passion for the field comes from her extensive professional work as well as from her personal experience, having had diabetes for over 30 years. Kelly is the author of more than 30 peer-reviewed manuscripts as well as Targeting a Cure for Type 1 Diabetes: How Long Do We Have to Wait?, a widely praised book published by the American Diabetes Association (ADA) in 2013. She also wrote the foreword for the widely praised Bright Spots & Landmines by Adam Brown, published in 2017. Kelly is an associate editor of Clinical Diabetes, a journal focused on diabetes for primary care physicians published quarterly by the ADA. Close Concerns is a winner of the ADA’s “Excellence in Health Communications” Award, and Kelly and her team write a quarterly column in Journal of Diabetes, a peer-reviewed journal based in Shanghai. Kelly chairs the diaTribe Foundation, a nonprofit established in 2013 to improve the lives of people with diabetes and prediabetes and to advocate for action. She is also the founder of diaTribe.org, begun in 2006 as an educational resource for people with diabetes; diaTribe.org’s free educational mailers go to over 100,000 people every 2 weeks. Before starting Close Concerns and the diaTribe Foundation, Kelly’s work focused on life sciences more broadly. Over nearly a dozen years, she worked on Wall Street (investment banking at Goldman Sachs, equity research at Merrill Lynch) and at McKinsey & Company, where her work centered on life science, managed care, and nonprofit organizations. Kelly has a BA in economics and English from Amherst College, magna cum laude, and an MBA from Harvard Business School. She was a founding board member of the Institute for Responsible Nutrition, led by University of California, San Francisco’s Robert Lustig, MD, and a previous executive board member of the Diabetes Hands Foundation and the Behavioral Diabetes Institute. She and her husband and three children are cohosts of the popular San Francisco–based discussion series CPS Lectures. 01:22 Why Kelly started diaTribe. 02:22 Empowering patient decisions and disease management. 03:51 The power of numbers in making change. 04:12 Other advocacy groups inside and outside the diabetes realm. 05:09 Paying attention to direct costs as well as indirect costs. 05:44 The four areas of constraints to obtaining the outcomes desired in treating diabetes. 06:34 Behavior design and behavior change. 07:52 Overcoming diabetes constraints. 08:18 “You can’t know where you want to go with your diabetes management until you know where you are.” 10:10 Supporting patients and continuous glucose monitoring. 13:01 “What’s not going well here, and what’s changeable?” 15:18 “Until we’re doing much more to create healthy communities and supporting communities, we will not be successful.” 15:52 Go to diatribe.org/brightspots for educational materials for your diabetes patients. 17:00 Avoiding stigmatizing language. 17:40 Ensuring you have a diabetes educator or social worker who understands what resources are available. 17:51 Finding community organizations like Wellville—EP118 with Rick Brush. 18:40 The dichotomy of engaged patients vs those who aren’t. 19:39 The importance in understanding where patients are coming from and their emotional well-being. 21:24 The impressiveness of Kaiser moving half of their appointments to telehealth. 23:02 Health technologies helping to improve diabetes outcomes and how they are finding reimbursement. 24:46 Innovated payers funding diabetes research to improve outcomes. 25:48 The excessive expenses associated with diabetes today. 28:12 “The only good thing about this spending ... [is] that a lot could happen to reduce that.” 28:59 Houston’s efforts to make an impact on diabetes in the community level. 30:44 “I think today the really forward-thinking companies are really thinking about stakeholder value.” 32:10 You can learn more by going to diatribe.org, follow diaTribe on Facebook and Twitter, and check out diatribe.org/foundation and diatribe.org/brightspots.

An experienced senior executive with several years of experience in the pharmaceutical and biotechnology industry, Will has held key positions where he was instrumental in launching a variety of innovative platforms in medical affairs. He speaks frequently regarding the ever-changing role of medical affairs at most major medical affairs conferences and is currently president and CEO of the ACMA, whose primary mission is to create industry standards and goals for medical affairs professionals. Will has held key management roles across the industry within medical affairs, such as at Eisai, Retrophin, Gilead Sciences, Abbott Laboratories, Boehringer Ingelheim, and Merck. Will previously also served as vice president of medical and scientific affairs at CME LLC, a leading provider of continuing medical education to health care providers nationwide. He also has worked on the strategic management consulting side with companies such as Veeva Systems and often provides medical affairs consultancy services for Bain, McKinsey, BCG, Atheneum Partners, and Alpha Insights. He has published extensively and led a number of initiatives focusing in the areas of ischemic heart disease, dyslipidemia, diastolic heart failure, type 2 diabetes, and obesity, where he has collaborated with some of the nation's top research institutions, such as the Pennington Biomedical Research Center, the Washington Center for Weight Management & Research, the Yale School of Medicine Digestive Diseases Program, and the University of Pennsylvania's Center for Weight & Eating Disorders. Will was most recently invited to speak at the Center for Medical Technology Policy's (CMTP) conference on Comparative Effectiveness Research to help inform payers, health care policy makers, physicians, and patients on the most effective ways to design clinical trials to better address gaps in medicine. He also presented at the 2014 annual American Diabetes Association (ADA) Conference on preventing the progression of type 2 diabetes among prediabetic overweight and obese individuals. In 2008, Will published a book entitled The Rise of Chemistry: Implications for Industry and Education. He has also held several academic appointments at Seton Hall University's School of Health and Medical Sciences; New Jersey City University; Kean University's College of Natural, Applied, and Health Sciences; and Touro Colleges of Osteopathic Medicine, Pharmacy, and Physical Therapy teaching a variety of courses, including clinical therapeutics, pharmacology, pathophysiology, and epidemiology. Will has served as a board member for the MSL Institute. He is a member of several organizations, including the American College of Cardiology (ACC), the American Diabetes Association (ADA), The Obesity Society (TOS), the American Association of Clinical Endocrinology (AACE), the American Society of Bariatric Physicians (ASBP), the American Heart Association (AHA), the Drug Information Association (DIA), and the American Chemical Society (ACS). 00:00 Will's background and how he became president and CEO of the ACMA. 02:30 The difference between a sales rep and a medical science liaison (MSL). 04:35 The need for better education among medical affairs and pharma workers. 09:10 Working with key thought leaders and the Consensus Statement they are currently working on. 12:00 How accreditation courses work to help MSLs provide more of a balanced view of a pharma product. 15:50 The pressure for Pharma and manufacturers to become Outcomes Companies. 16:25 How are MSLs evolving? 17:20 “Really, what is the value of the product?” 22:00 How ACMA remains unbiased in their course curriculum. 23:15 How health care providers can verify that they are getting the clearest unbiased pharma information possible from their MSLs. 25:25 EP187 with Sandra Leal and Todd Eury, EP181 with Dr. Lipi Roy. 25:40 The state of opioid addiction in America and how pharma information contributed to the problem. 30:05 EP148 and AEE2 with Jennifer Miller. 30:25 “It's time there's a third party that's vetting what we're doing.” 32:40 You can learn more at medicalaffairsspecialist.org.

In Season 3 ep. 4, Emily and Christie chat about all things advocacy with American Diabetes Association (ADA) advocate, Basma Adams (@bastheboss on Instagram), about her time spent fighting for T1D's rights on Capitol Hill as well as her go-to low snacks.

Should I give bicarbonate to DKA patients with severe acidemia? I've certainly been admonished for NOT doing it. The reason for withholding bicarb has been that I've heard that it doesn't help and may actually be a bad idea. I can't say the action (or inaction) was based on a deep understanding. How could bicarb in DKA be a bad idea if even the American Diabetes Association (ADA) recommends we give a bicarb to DKA patients with pH under 6.9? The argument in favor of giving bicarb is that the more acidemic the patient, the higher the risk of circulatory collapse and cardiac arrest. Even though there is no evidence of benefit, the ADA gives a very specific set of steps to take in the low pH patient.. Because severe acidosis may lead to numerous adverse vascular effects, it is recommended that adult patients with a pH less than 6.9 should receive bicarbonate. Specially 100 mmol sodium bicarbonate, two ampules, in 400 mL sterile water with 20 mEq KCL admitted at a rate of 200ml/hr for 2 hours until the venous pH is over 7. If the ph isn’t over 7 at that point, they say repeat the bicarb infusion every 2 hours until the ph is over 7.0 With that sort of exact guidance, you'd think there would be evidence to back it up, but here is the sentence that precedes the above recommendation. No prospective randomized studies concerning the use of bicarbonate in DKA with pH values

Friend of the show John Graham is our guest today as we report from the offices of the American Society of Association Executives. He last joined us to talk about his role as President and CEO and the work of ASAE on Episode 74 (http://throughthenoise.us/mediacast/74-asae-john-graham/) and today's episode is just as illuminating as the first. Other associations work to advance the goals of their mission while ASAE's work serves the executives of those organizations helping make them more effective. We learn about their "NPD" or New Product Development structure of creating business plans for nonprofit offerings as well as their exciting new conference, the Experience Design Project which connects leadership across the spectrum of meeting and conference planning. You won't want to miss this or our thrilling new segment WAG -- the Word Association Game. John H. Graham has been the President and CEO of the American Society of Association Executives (ASAE) since 2003, and he has been involved in associations for more than 40 years. Previously, he served as CEO of the American Diabetes Association (ADA) for 13 years and worked for a total of 24 years at ADA. ASAE is a membership organization of more than 21,000 association executives and industry partners representing 9,300 organizations. Its members manage leading trade associations, individual membership societies and voluntary organizations across the United States and in nearly 50 countries around the world.

In this case-based lecture, Dr. Krishansamy walks through several real-life examples of patients and their indications for novel treatments for diabetes with a focus on mechanisms of action. Included in this lecture is an overview and update on the American Diabetes Association (ADA) guidelines and European Association for the Study of Diabetes (EASD). Finally, she takes a look at new technology to treat type one diabetes.

Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes, but risk is reduced with identification and early treatment. Glucose measurements are affected by preanalytical sample handling, such as temperature of storage, phlebotomy–analysis interval, and use of a glycolysis inhibitor. We evaluated glucose concentrations and the incidence of GDM after strict implementation of the American Diabetes Association (ADA) preanalytical guidelines, compared with usual hospital conditions.

Face to face fundraising is still the most effective form of fundraising. Telling a story about how the funds are needed and how they will be used are important elements in the art of fundraising for associations, not to be left out in the age of social media. John H. Graham has been the President and CEO of ASAE since 2003, and he has been involved in associations for more than 40 years. He previously served as CEO of the American Diabetes Association (ADA) for 13 years and worked for a total of 24 years at ADA. ASAE is a membership organization of more than 21,000 association executives and industry partners representing 9,300 organizations. Its members manage leading trade associations, individual membership societies and voluntary organizations across the United States and in nearly 50 countries around the world.  

Family Program Position providing support and outreach for Alaska Air National Guard Gretchen Nealy Haney Gretchen moved to Anchorage, Alaska in 2000, shortly after she began her career working in the support services. Gretchen volunteered her time with the American Diabetes Association (ADA) which led to a full time career with the ADA. Years later Gretchen was asked to manage the Family Program Position providing support and outreach for Alaska Air National Guard and continued working in the Military Member and Family Support Services for over 8 years at the Headquarters Level. Gretchen brought change and created a working relationship between the military services and the community allowing a partnership and transition for military and family members. She has also assisted in the creation of Memorandum of Understandings, policy letters and guidance and excelled in unit and leadership training for the air and army guard locally and nationally, in addition to providing services to the Air/Army/Marine and Navy Reserve. Gretchen's community outreach created recognition of issues surrounding victims of sexual assault and the National Guard. As the Program Manager for the Transition Assistance for the military, Gretchen helped in providing a link and resources for the Alaska Brain Injury Network from 2007-2008.

Host: Farhad Zangeneh, MD Guest: James R. Gavin, III, MD, PhD Host Dr Farhad Zangeneh welcomes James R. Gavin III, MD, PhD, clinical professor of medicine at Emory University School of Medicine and at the Indiana University School of Medicine. Together they will explore the trends in the growth of diabetes in African Americans, the policies needed to address these problems, and some of the barriers that prevent better outcomes in diabetes care for African Americans and other high-risk minorities. James R. Gavin III, MD AND PHD, clinical professor of medicine at Emory University School of Medicine and at the Indiana University School of Medicine. Dr. Gavin serves as CEO and Chief Medical Officer of Healing Our Village, Inc. He also belongs to a number of organizations, including the Institute of Medicine, the American Diabetes Association (ADA), the American Society of Clinical Investigation, the American Association of Physicians, and the Atlanta Rotary Club.

Jaime A. Davidson, MD, discusses guidelines and statements issued by a number of organizations, including the American Diabetes Association (ADA), addressing the diagnosis of type 2 diabetes mellitus (T2DM) and how they differ in some key aspects.

In der Juli-Ausgabe von Diabetes Care und im Rahmen der letzten Jahrestagung der American Diabetes Association (ADA) wurde von einer internationalen Expertengruppe die Empfehlung ausgegeben, HbA1c ab einem Wert von 6,5% als diagnostisches Kriterium für Diabetes mellitus Typ II heranzuziehen. Billrothhaus-News bat den Diabetologen Univ.-Prof. Dr. Martin Clodi um ein Statement zu dieser Empfehlung. Möglich wird der Einsatz des HbA1c zur Diagnose des Diabetes durch eine deutliche Verbesserung der Laborbestimmung. Die bisherige Schwankungsbreite wird von 20% bzw. 15% auf 3% bzw. 5% reduziert. Die HbA1c-Bestimmung hat gegenüber dem oralen Glukosetoleranztest den grossen Vorteil, dass Faktoren wie Nüchternheit des Patienten, Stress oder akute Erkrankungen keinen Einfluss auf die Bestimmung haben. Der Wert 6,5% wurde deshalb gewählt, weil man in grossen epidemiologischen Untersuchungen erkannt hat, dass Komplikationen bei Patienten mit Diabetes (z.B. Retinopathien) erst ab diesem Wert auftreten. Die Empfehlung wird derzeit in den nationalen Diabetesgesellschaften diskutiert, und es ist zu erwarten, dass das HbA1c als neues Kriterium zur Diagnostik des Diabetes Mellitus Typ 2 anerkannt wird.