Podcasts about diabetes prevention program

In this episode of Core Conversations with Natalie Baggio, we continue our conversation about diabetes prevention and the everyday choices that can make a difference. Corewell Health experts share how the Diabetes Prevention Program combines education, lifestyle coaching and ongoing support to help participants build healthier habits. They also offer practical tips for making better food choices, including adding more whole grains, vegetables, beans and fiber to your diet. Plus, learn how small changes can add up over time, from keeping healthier snacks on hand to taking a 10-minute walk after a meal. Discover how nutrition, movement, sleep and support can all play a role in reducing your risk for type 2 diabetes.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we continue our conversation about diabetes prevention and the everyday choices that can make a difference. Corewell Health experts share how the Diabetes Prevention Program combines education, lifestyle coaching and ongoing support to help participants build healthier habits. They also offer practical tips for making better food choices, including adding more whole grains, vegetables, beans and fiber to your diet. Plus, learn how small changes can add up over time, from keeping healthier snacks on hand to taking a 10-minute walk after a meal. Discover how nutrition, movement, sleep and support can all play a role in reducing your risk for type 2 diabetes.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we continue our conversation about diabetes prevention and the everyday choices that can make a difference. Corewell Health experts share how the Diabetes Prevention Program combines education, lifestyle coaching and ongoing support to help participants build healthier habits. They also offer practical tips for making better food choices, including adding more whole grains, vegetables, beans and fiber to your diet. Plus, learn how small changes can add up over time, from keeping healthier snacks on hand to taking a 10-minute walk after a meal. Discover how nutrition, movement, sleep and support can all play a role in reducing your risk for type 2 diabetes.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we continue our conversation about diabetes prevention and the everyday choices that can make a difference. Corewell Health experts share how the Diabetes Prevention Program combines education, lifestyle coaching and ongoing support to help participants build healthier habits. They also offer practical tips for making better food choices, including adding more whole grains, vegetables, beans and fiber to your diet. Plus, learn how small changes can add up over time, from keeping healthier snacks on hand to taking a 10-minute walk after a meal. Discover how nutrition, movement, sleep and support can all play a role in reducing your risk for type 2 diabetes.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we’re talking about diabetes, prediabetes and the steps you can take to better understand and manage your risk. Natalie is joined by Corewell Health experts Nicole and Elena to discuss diabetes risk factors, prevention, advances in blood sugar monitoring and the resources available to patients throughout the community. They also share how individualized support and access to technology can make a meaningful difference for people living with diabetes. Plus, learn about Corewell Health’s Diabetes Prevention Program and Deliciously Balanced: Cooking for Blood Sugar Health, a series of hands-on classes at Lake Michigan College combining blood sugar education, cooking and a shared meal. Learn how prevention, education and nutrition can help you take a more active role in managing your blood sugar and overall health.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we’re talking about diabetes, prediabetes and the steps you can take to better understand and manage your risk. Natalie is joined by Corewell Health experts Nicole and Elena to discuss diabetes risk factors, prevention, advances in blood sugar monitoring and the resources available to patients throughout the community. They also share how individualized support and access to technology can make a meaningful difference for people living with diabetes. Plus, learn about Corewell Health’s Diabetes Prevention Program and Deliciously Balanced: Cooking for Blood Sugar Health, a series of hands-on classes at Lake Michigan College combining blood sugar education, cooking and a shared meal. Learn how prevention, education and nutrition can help you take a more active role in managing your blood sugar and overall health.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we’re talking about diabetes, prediabetes and the steps you can take to better understand and manage your risk. Natalie is joined by Corewell Health experts Nicole and Elena to discuss diabetes risk factors, prevention, advances in blood sugar monitoring and the resources available to patients throughout the community. They also share how individualized support and access to technology can make a meaningful difference for people living with diabetes. Plus, learn about Corewell Health’s Diabetes Prevention Program and Deliciously Balanced: Cooking for Blood Sugar Health, a series of hands-on classes at Lake Michigan College combining blood sugar education, cooking and a shared meal. Learn how prevention, education and nutrition can help you take a more active role in managing your blood sugar and overall health.See omnystudio.com/listener for privacy information.

In this episode of Core Conversations with Natalie Baggio, we’re talking about diabetes, prediabetes and the steps you can take to better understand and manage your risk. Natalie is joined by Corewell Health experts Nicole and Elena to discuss diabetes risk factors, prevention, advances in blood sugar monitoring and the resources available to patients throughout the community. They also share how individualized support and access to technology can make a meaningful difference for people living with diabetes. Plus, learn about Corewell Health’s Diabetes Prevention Program and Deliciously Balanced: Cooking for Blood Sugar Health, a series of hands-on classes at Lake Michigan College combining blood sugar education, cooking and a shared meal. Learn how prevention, education and nutrition can help you take a more active role in managing your blood sugar and overall health.See omnystudio.com/listener for privacy information.

Sign-up for Newsletter (and get 1-page action summary)Episode Summary: In this episode, I explore whether it's ever “too late” to change your health future—and why the science suggests that earlier is better, but later still matters. Can you still change your future? The answer is hopeful, but nuanced. Younger listeners may assume they have plenty of time, while older listeners may wonder whether the damage has already been done. In both cases, the evidence points to a more useful truth: some risks accumulate over time, some damage may be partly repaired, and many future outcomes can still be changed.I begin with a personal update about using EMDR to address exercise-related fear. At 69, I've found that it has helped me feel more confident and enjoy intense exercise more. Would it have been better to try it decades ago? Probably. But that does not mean it was too late to benefit now.The episode then walks through a five-part framework for thinking about health changes. First, some changes are best made early because damage accumulates. Blood pressure is a clear example: long-term cumulative blood pressure exposure in young adulthood has been linked with later cardiovascular disease risk, which is why “my arteries are keeping score now” is such an important message.  Glaucoma follows a similar logic: elevated eye pressure can silently damage the optic nerve, so early detection and treatment matter.Second, some damage may be partly repaired. Smoking cessation is the clearest example. Lung cancer risk declines the longer someone has stopped smoking, although prior smoking risk does not disappear completely.  I also discuss the Lifestyle Heart Trial, where intensive lifestyle changes were associated with regression of coronary atherosclerosis and fewer cardiac events over time, while also noting that the study was small and required major changes that may not be realistic for everyone. Third, even when we cannot erase the past, we can still protect the future. The Diabetes Prevention Program showed that lifestyle changes reduced the risk of developing type 2 diabetes by 58% overall and 71% among adults over age 60.  The UKPDS also reminds us that early glucose control after diabetes diagnosis can have lasting benefits, especially for complications involving the eyes, nerves, and kidneys. Fourth, it is never too late to build certain capacities. Strength training is a powerful example. In one study of frail adults up to age 96, high-resistance training led to major strength gains and improved walking speed.  That does not mean we are trying to become bodybuilders at 90. It means we are training for independence, balance, confidence, and the ability to keep doing the things that make life meaningful.Finally, timing may matter, but sometimes we do not yet know how much. Social connection is strongly tied to health and happiness, as shown in the Harvard Study of Adult Development, but we do not know exactly how much risk can be reversed by building new relationships later in life.  Sauna use has also been associated with lower cardiovascular and cognitive risk, but it is less clear whether benefits require lifelong use or can still meaningfully begin later. The practical question becomes: does this activity also bring you joy now?Takeaways: Earlier is better, but later is not too late. Start by asking what part of your future you can still influence from here. Check your blood pressure, see your eye doctor, consider strength training, reconnect with a friend, or address a fear that has been holding you back. The goal is not perfection—it is progress, and there is still time for that.Send us Fan MailSupport the show

Send us a text and chime in!Yavapai County Community Health Services (YCCHS) will offer the PreventT2 lifestyle change program to Verde Valley residents. Prevent T2 is part of the National Diabetes Prevention Program, led by the Center for Disease Control and Prevention (CDC), and is proven to prevent or delay type 2 diabetes. The CDC estimates that more than 1 in 3 adults – 96 million Americans – have prediabetes. More than 8 in 10 adults with prediabetes don't know they have it. Prediabetes increases the risk of type 2 diabetes, heart disease, and stroke. In PreventT2, participants work with a trained YCCHS Health Educator to...   For the written story, read here >> https://www.signalsaz.com/articles/verde-valley-residents-offered-free-diabetes-prevention-program/ Check out the CAST11.com Website at: https://CAST11.com Follow the CAST11 Podcast Network on Facebook at: https://Facebook.com/CAST11AZFollow Cast11 Instagram at: https://www.instagram.com/cast11_podcast_network

Diabetes prevention programs or DPPs were developed by the CDC over a decade ago to help people with prediabetes avoid frank development of diabetes, but very few people access them. Nas Mathioudakis, a diabetes expert at Johns Hopkins and one … People with prediabetes can benefit from an AI based diabetes prevention program, Elizabeth Tracey reports Read More »

The information in this podcast does not provide medical advice, diagnosis or treatment. It should not be used as a substitution for health care from a licensed healthcare professional. Consult with your healthcare provider for individualized treatment or before beginning any new program.  Living with a chronic condition takes more than willpower—it requires resilience, support, and access to the right programs. In this episode, we explore how people in Wisconsin are building that resilience while managing health challenges like prediabetes. We will highlight the state's Diabetes Prevention Program (DPP), a proven lifestyle change program that helps people live healthier, longer lives. We will hear from Pam Geis with the Wisconsin Department of Health Service, Division of Public Health, who coordinates Wisconsin's Diabetes Prevention Program, and Debb, who has lived the experience, and is a Diabetes Prevention Program graduate. Together, they will share the tools, mindsets, and community connections that foster long-term health and resilience. Resources Discussed During Interview:https://www.dhs.wisconsin.gov/prediabetes/index.htm https://www.cdc.gov/diabetes-prevention/index.html  WebMD Coaching and DPP Program, call 1-800-821-6591 or visit www.webmdhealth.com/wellwisconsin

Investor Nancy Brown joins us at Aspen Ideas Health to share her blueprint for impactful investments. Identify public health breakthroughs that deliver measurable cost and quality improvements — then show how they can thrive in the marketplace. You don't have to look far to see this playbook in action. One of the year's biggest health exits, Omada Health, is a digital version of the CDC's Diabetes Prevention Program. At Oak HC/FT, Nancy has partnered with entrepreneurs who are redefining how America stays healthy — and she's eager to see more people with public health roots take the leap into building impactful companies.Please note: this conversation happened before HR1 was passed, so big Medicaid cuts were a threat but not yet a reality when we spoke.In this episode, we discuss:Lessons from Todd Park in the early days of athenahealthHow to turn good ideas into great businessesNancy's advice in an era of policy disruption: keep on building and proving valueThe lesson Kaiser Permanente is still teaching usNancy reminds us that in reality, even a brilliant idea needs to have ROI built in:“We look for entrepreneurs, for innovators, who have really defined a way in which to find a cohort of patients, it could be pregnant Medicaid moms... And they have identified if they apply a certain clinical process consistently to that population, they will get a consistently good outcome, quality outcome, and they can do it in a sustainable [way] at a sustainable price.”Relevant LinksRead Oak HC/FT's AI Investment PolicyExplore businesses Nancy mentioned from Oak HC/FT's investment portfolio:Maven ClinicOshi Health About Our GuestNancy Brown is a General Partner at Oak HC/FT, a leading venture and growth equity firm investing in transformative healthcare and fintech companies. Since joining Oak HC/FT at its inception in 2014, Ms. Brown has focused on identifying and supporting technology-enabled healthcare services that deliver measurable clinical and financial impact. She focuses on growth equity and early-stage venture investments in healthcare, serving on the boards of innovative companies such as Firefly Health, Groups Recover Together, InterWell Health, Maven Clinic, Oshi Health, Regard, Unite Us, and Wayspring. Her portfolio also includes Noom, TurningPoint Healthcare Solutions, Limeade (ASX: LME), OncoHealth, and OODA Health.Ms. Brown brings over three decades of operational and leadership experience to her investment role. Prior to Oak HC/FT, she was Vice President of Strategy and Business Development at McKesson Technology Solutions and Chief Growth Officer at MedVentive (acquired by McKesson in 2012). Previously, she served as Senior Vice President of Clinical Services and Corporate Development at athenahealth, and earlier held senior roles at McKesson and Harvard Community Health Plan. She also co-founded Abaton.com, one of the first web-based clinical solution companies, which was later acquired by McKesson.A graduate of the University of New Hampshire (B.S. in Zoology) and Northeastern University (MBA), Ms. Brown is an active mentor and advisor. She serves on Northeastern's D'Amore‑McKim School of Business Dean's Executive Council and is involved in the Roux Institute's Future of Healthcare Founder Residency program.

After an extended break, Shelley Swapp returns to The Wellness Restoration Project with a fresh focus and an exciting new direction.In this energizing kickoff episode, Shelley shares why she's relaunching the show to explore nutrigenomics — the rapidly growing science that reveals how the foods we eat and the nutrients we absorb influence the way our genes express.She reflects on decades of shifting diet trends — from low-fat and Atkins to today's high-protein craze — and explains why one-size-fits-all nutrition has failed so many of us. You'll hear a powerful story from Shelley's time launching the national Diabetes Prevention Program and how it led her to question conventional approaches to women's health.This episode will leave you hopeful, curious, and ready to rethink what it means to eat for your body instead of against it.In this episode, you'll learn:What nutrigenomics is — and why it's changing the future of personalized nutrition.Why some diets seem to “work” for one person and not another.How stress, hormones, and individuality shape your results.The difference between following rules and building alignment with your biology.Tune in if you're ready to:Move past generic health advice.Understand your unique genetic blueprint.Begin your own wellness restoration — from restriction to alignment.

NEW! Support your strength and muscle goals with PUORI Creatine+ — a clean, effective creatine monohydrate supplement enhanced with taurine. Get 20% off at puori.com/VANESSA In today's episode, Vanessa sits down with one of the most influential figures in obesity and metabolism research — Dr. James Hill, Professor of Nutrition Sciences at the University of Alabama at Birmingham and co-founder of the National Weight Control Registry. Dr. Hill has spent over four decades studying how people successfully lose weight, maintain it long-term, and preserve their lean mass and metabolic health. Dr. Hill has led landmark clinical trials such as the Diabetes Prevention Program, Look AHEAD, and the Beef WISE Study on high-protein diets. His decades of work reveal why weight loss is only the beginning — and why the real secret to success lies in learning the completely different skill set of maintenance. OneSkin is powered by the breakthrough peptide OS-01, the first ingredient proven to reduce skin's biological age. I use the OS-01 Face and Eye formulas daily—they've transformed my skin's smoothness, firmness, and glow. Visit oneskin.co/VANESSA and use code VANESSA for 15% off your first purchase In this conversation, you'll hear: The protein “lever” Dr. Hill uses to curb appetite and protect muscle during a cut—plus why the source may matter less than you think Three habits most long-term maintainers share (and one that surprised even him) The moment your “diet” must flip into “maintenance”—and a simple sign you're ready The smallest daily tweak from his research that predicts whether you'll regain or not What exercise actually changes in your metabolism beyond calorie burn—and how much you really need The simple resistance-training + protein formula he gives midlife women to keep muscle while losing fat His three-bucket framework (diet, activity, mind state) and a 60-second self-check to find which bucket is breaking your results The mindset shift that moves people from “I always regain” to “this is who I am” — plus a quick exercise to uncover your real why The step-by-step exit plan he uses when patients come off GLP-1s—starting with what to do in week one to avoid rebound If you've ever lost weight and struggled to keep it off, this episode shows you which levers matter most—and how to pull them so your results stick while your metabolism and muscle thrive. Get delicious high protein meal recipes! Connect with Vanessa on Instagram @ketogenicgirl Free High-Protein Keto Guide  Get 20% off on the Tone LUX Crystal Red Light Therapy Mask or the Tone Device breath ketone analyzer at https://ketogenicgirl.com with the code VANESSA Follow @optimalproteinpodcast on Instagram to see visuals and posts mentioned on this podcast. Link to join the Facebook group for the podcast Mentioned in this episode: • Dr. James Hill's upcoming book: Losing the Weight Loss Meds: A 10-Week Playbook for Stopping GLP-1 Medications and Keeping the Weight Off — now available for pre-order • The National Weight Control Registry; The Diabetes Prevention Program (DPP); The Look AHEAD Study; The Beef WISE Study The content provided in this podcast is for informational purposes only and should not be construed as medical advice. Consult with a healthcare professional before making significant changes to your diet or exercise regimen.

On our Wednesday health focus, Lana Kunik discussed the National Diabetes Prevention program offered at the Sight Center of Northwest PA. The conversation touched on how uncontrolled diabetes can lead to vision loss and blindness.

Full shownotes, transcript and resources here: https://soundbitesrd.com/294                  Make America Healthy Again (MAHA) is a public health-oriented slogan and initiative aimed at addressing the health challenges facing Americans led by the Secretary of Health and Human Services, Robert F. Kennedy, Jr. Scientists, medical professionals and public health officials have criticized the movement, citing concerns about Robert F. Kennedy Jr.'s past remarks and views regarding vaccines and public health. Tune in to this episode to learn about: ●       a nutrition and public health expert's reflection on the first 6 months of MAHA ●       funding cuts to various nutrition programs, research and landmark trials such as the Diabetes Prevention Program ●       the administration's focus on food dyes, seed oils and the FoodPyramid ●       how health professional societies are responding so far ●       opportunities for meaningful changes in public health nutrition ●       what the new DGAs might look like ●       resources for more information

Reshare from September 1, 2024:Hawaii Matter's guest is Elia Titiimaea, the Program Coordinator for the Hawaii Department of Health - Diabetes Prevention Program. Diabetes can lead to serious health problems including kidney failure and amputation. We'll learn what diabetes is, its symptoms, how to battle it, and more. Lei Jardine-Kanahele, a recent participant in the Diabetes Prevention Program is our second guest. She tells us how the program works and how she succeeded. Host: Michael THawaii Matters, a Pacific Media Group program

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 25 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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.    Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes 2.    Lorundrostat Efficacy and Safety in Patients with Uncontrolled Hypertension Meta-Analysis 3.    The Diabetes Prevention Program and Its Outcomes Study: NIDDK's Journey Into the Prevention of Type 2 Diabetes and Its Public Health Impact 4.    Comparative effectiveness of alternative second‐line oral glucose‐lowering therapies for type 2 diabetes: a precision medicine approach applied to routine data 5.    Phase 3 Trial of Semaglutide in Metabolic Dysfunction– Associated Steatohepatitis   For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: 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; Chair-Department of Family Medicine, Abington Jefferson Health

Sponsored by Harford County Health DepartmentIn this inspiring episode of Conversations with Rich Bennett, we sit down with Kenneth Kunken, a man whose journey redefines resilience and determination. After a tragic football injury left him paralyzed in 1970, Ken refused to let his circumstances define him. He became the first quadriplegic to graduate from Cornell University, earned multiple Ivy League degrees, and went on to have an impressive 40-year career as an Assistant District Attorney. Ken shares how he transitioned from an aspiring engineer to a motivational speaker, disability advocate, and father of triplets—all while overcoming the odds. His memoir, I Dream of Things That Never Were: The Ken Kunken Story, details his incredible journey of breaking barriers and proving that a positive mindset and a strong support system can change everything. This episode is sponsored by the Harford County Health Department, promoting their free 12-month Diabetes Prevention Program, designed to help individuals manage weight, diet, stress, and physical activity. Learn more at HarfordCountyHealth.com/diabetes-prevention. https://kenkunken.com/ Sponsor Message:This episode of Conversations with Rich Bennett is proudly sponsored by the Harford County Health Department. Did you know that 1 in 3 adults in the U.S. is pre-diabetic, and most don't even know it? Taking charge of your health starts with awareness—and action. The Harford County Health Department's Diabetes Prevention Program is a FREE, 12-month program designed to help you:·         Lose weight and maintain a healthy lifestyle·  Send us a textHarford County Health DepartmentTo protect, promote, and improve the health, safety, and environment of Harford County residents.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showFollow the Conversations with Rich Bennett podcast on Social Media:Facebook – Conversations with Rich Bennett & Harford County LivingFacebook Group (Join the conversation) – Conversations with Rich Bennett podcast group | FacebookTwitter – Conversations with Rich Bennett & Harford County LivingInstagram – Harford County LivingTikTok – CWRB (@conversationsrichbennett) | TikTok Sponsors, Affiliates, and ways we pay the bills:Recorded at the Freedom Federal Credit Union StudiosHosted on BuzzsproutRocketbookSquadCast Contests & Giveaways Subscribe by Email ...

Erica Hill, a Diabetes Prevention Program Lifestyle Coach at the UK Barnstable Brown Diabetes Center, discusses warning signs of prediabetes and the center's Diabetes Prevention Program. To sign up for virtual classes, visit https://ukhealthcare.uky.edu/form/diabetes-prevention-program-info

Diabetes affects many families in Newfoundland and Labrador. We hear about a program at the Ches Penney Family YMCA looking to prevent that. It's called Small Steps for Big Changes, and we get details from the Eastern Canada Regional Research Lead with the program. (Guest-host Heather Barrett with Dr. Katie Wadden)

La berberina es uno de los suplementos alimenticios más usados hoy en día. Pero, ¿sirve de algo? ¿hay investigación de calidad que le respalde? ¿sirve para bajar de peso y controlar la glucosa? Esto y más, aprenderás en este episodio de Doctor Mau Informa. Suscríbete a mi podcast en tu plataforma favorita. Anda, hazlo ahora mismo.   #doctormauinforma Suscríbete a mi boletín informativo en: www.drmauriciogonzalez.com/ ⁣ Redes sociales: ⁣ ⁣ YouTube: /@doctormauinforma Instagram: www.instagram.com/dr.mauriciogonzalez TikTok: www.tiktok.com/@drmauriciogonzalez Twitter: www.twitter.com/DrMauricioGon CONTACTO ► booking@drmauriciogonzalez.com ¡Nos escuchamos pronto!⁣ Fuentes:    Li Z, Wang Y, Xu Q, et al. Berberine and health outcomes: An umbrella review. Phytother Res. 2023;37(5):2051-2066. doi:10.1002/ptr.7806 Dong H, Wang N, Zhao L, Lu F. Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. Evid Based Complement Alternat Med. 2012;2012:591654. doi:10.1155/2012/591654 Diabetes Prevention Program Research Group. Long-term Effects of Metformin on Diabetes Prevention: Identification of Subgroups That Benefited Most in the Diabetes Prevention Program and Diabetes Prevention Program Outcomes Study. Diabetes Care. 2019;42(4):601-608. doi:10.2337/dc18-1970 Diabetes Prevention Program Research Group. Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care. 2012;35(4):731-737. doi:10.2337/dc11-1299   Learn more about your ad choices. Visit megaphone.fm/adchoices

Sponsored by Harford County Health DepartmentIn this episode of Conversations with Rich Bennett, Rich is joined by award-winning journalist and author Roni Robbins to explore her powerful novel, Hands of Gold. Roni shares the incredible story of her grandfather, whose resilience through the Holocaust, a workplace shooting, and personal tragedies inspired her fictionalized account of his life. Together, they discuss themes of love, family, perseverance, and the importance of preserving history. This heartfelt conversation delves into the impact of past generations on shaping our present and highlights the relevance of these stories in today's world.This episode is proudly sponsored by the Harford County Health Department, promoting healthier lifestyles through their Diabetes Prevention Program. Visit harfordcountyhealth.com to learn more.Home - Roni RobbinsSponsor Message:This episode of Conversations with Rich Bennett is brought to you by the Harford County Health Department, dedicated to building a healthier community. Are you at risk for type 2 diabetes? The Harford County Health Department's Diabetes Prevention Program can help. This free, year-long program offers practical guidance on nutrition, physical activity, and lifestyle changes to reduce your risk and support long-term health. Don't wait to take charge of your well-being—visit harfordcountyhealth.com tSend us a textTar Heel Construction Group Harford County Living Stamp of Approval for Roofing, Siding and Exterior Services Harford County Health DepartmentTo protect, promote, and improve the health, safety, and environment of Harford County residents.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the showFollow the Conversations with Rich Bennett podcast on Social Media:Facebook – Conversations with Rich Bennett & Harford County LivingFacebook Group (Join the conversation) – Conversations with Rich Bennett podcast group | FacebookTwitter – Conversations with Rich Bennett & Harford County LivingInstagram – Harford County LivingTikTok – CWRB (@conversationsrichbennett) | TikTok Sponsors, Affiliates, and ways we pay the bills:Recorded at the Freedom Federal Credit Union StudiosHosted on BuzzsproutRocketbookSquadCast Contests & Giveaways Subscribe by Email ...

Today's guest is Elia Titiimaea. He's the Program Coordinator for the Hawaii Dept. of Health Diabetes Prevention Program. Diabetes can lead to serious health problems including kidney failure and amputation. We'll learn what diabetes is, its symptoms, how to battle it, and more. We'll also talk to Lei Jardine-Kanahele, a recent participant in the Diabetes Prevention Program. She tells us how the program works and how she succeeded. Michael T is your host.

In this episode of Conversations with Rich Bennett, we're joined by experts from the Harford County Health Department to discuss a critical health issue: diabetes prevention. Rich and his guests share personal insights and professional advice on the importance of diet, exercise, and lifestyle changes to prevent diabetes. Listeners will hear real success stories from participants in local diabetes prevention programs and learn about evidence-based strategies to improve their health. Sponsored by the Harford County Health Department, this episode offers invaluable tips for those looking to take control of their health and make lasting lifestyle changes.» Diabetes Prevention (harfordcountyhealth.com)Sponsor Message:This episode of Conversations with Rich Bennett is proudly sponsored by the Harford County Health Department. Did you know that 1 in 3 American adults has prediabetes, and most don't even know it? The Harford County Health Department is here to help with their CDC-recognized Diabetes Prevention Program. This free, year-long lifestyle change program is designed to help you take control of your health through expert guidance on healthy eating, physical activity, and weight loss, all while providing community support. Participants who complete the program reduce their risk of developing type 2 diabetes by over 58%.Don't wait! Visit harfordcountyhealth.com/diabetes-prevention today to learn more and register for this life-changing program.Send us a Text Message.EMILY ANNE PHOTOGRAPHY – "everyday is a day worth capturing all of life's precious moments, one photo at a time." (emilyadolph.com)Harford County Health DepartmentTo protect, promote, and improve the health, safety, and environment of Harford County residents.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the Show.Follow the Conversations with Rich Bennett podcast on Social Media:Facebook – Conversations with Rich Bennett & Harford County LivingFacebook Group (Join the conversation) – Conversations with Rich Bennett podcast group | FacebookTwitter – Conversations with Rich Bennett & Harford County LivingInstagram – Harford County LivingTikTok – CWRB (@conversationsrichbennett) | TikTok Sponsors, Affiliates, and ways we pay the bills:Recorded at the Freedom Federal Credit Union StudiosHosted on BuzzsproutRocketbookSquadCast Contests & Giveaways Subscribe by Email ...

In this episode of “Conversations with Rich Bennett,” Rich sits down with Stephen Marks, author of the Braxton's America trilogy. Stephen shares his personal journey inspired by his niece's battle with Type 1 diabetes, which led him to write a series blending humor, satire, and political commentary. They discuss the importance of raising awareness for diabetes, the challenges in finding a cure, and Stephen's efforts to adapt his story for a streaming series. This episode is sponsored by the Harford County Health Department's Diabetes Prevention Program, helping individuals take control of their health.Steve Marks | Author | Join the Fight (stephenrmarksauthor.com)Sponsor Message:This episode of “Conversations with Rich Bennett” is brought to you by the Harford County Health Department. Discover their free Diabetes Prevention Program, designed to help you lose weight, eat healthier, manage stress, and increase physical activity. This 12-month program offers the tools and support you need to develop lifelong healthy habits and reduce your risk of developing diabetes. To learn more or to sign up, go to » Diabetes Prevention (harfordcountyhealth.com). Take control of your health today with the Harford County Health Department.Send us a Text Message.EMILY ANNE PHOTOGRAPHY – "everyday is a day worth capturing all of life's precious moments, one photo at a time." (emilyadolph.com)Harford County Health DepartmentTo protect, promote, and improve the health, safety, and environment of Harford County residents.Disclaimer: This post contains affiliate links. If you make a purchase, I may receive a commission at no extra cost to you.Support the Show.Follow the Conversations with Rich Bennett podcast on Social Media:Facebook – Conversations with Rich Bennett & Harford County LivingFacebook Group (Join the conversation) – Conversations with Rich Bennett podcast group | FacebookTwitter – Conversations with Rich Bennett & Harford County LivingInstagram – Harford County LivingTikTok – CWRB (@conversationsrichbennett) | TikTok Sponsors, Affiliates, and ways we pay the bills:Recorded at the Freedom Federal Credit Union StudiosHosted on BuzzsproutRocketbookSquadCast Contests & Giveaways Subscribe by Email ...

In today's episode with Dr. Melody Hartzler, you'll hear us take a deep dive on: 1. What is type 2 diabetes, and what causes it? 2. What is insulin resistance? 3. Medications and lifestyle interventions for type 2 diabetes 4. The role of gut health in type 2 diabetes 5. Nutrients and natural remedies in the management of type 2 diabetes Dr. Hartzler has developed a passion for functional medicine and treating the underlying causes of disease. Her focus areas are functional gastrointestinal disorders, nutritional deficiencies, metabolic conditions, and autoimmune conditions. She is also a nationally recognized speaker on diabetes and functional medicine. Dr. Hartzler is currently Board Certified Ambulatory Care Pharmacy Specialist (BCACP) and is Board Certified in Advanced Diabetes Management (BC-ADM). She is also the owner of PharmToTable and the Director of Clinical Services for Profero Team. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

Kathy Williams has an MBA from Goizueta School of Business, Emry University and Mechanical Engineering from the University of Cincinnat. She has also been certified by the University of Pittsburgh's Diabetes Prevention Program. As CEO of Williams ConsultlingGroup, Kathy is an author, speaker, health strategist and diabetic prevention advocate. She also has a private coaching practice where she helps clients eliminate their cravings and sugar addiction in 90 days.   Like many of us in the field, Kathy has her own personal story. From being prediabetic, she halted her prediabetic progression back to a normal blood sugar level, which she has maintained for over 10 years.  Notably - She was even able to help her son, a type ONE diabetic to reduce his insulin and greatly improve his blood sugar levels. This is far and beyond what most doctors can achieve. She did this with changing his diet. Clearly she has found a way to reach out to children as well as adults. Of interest to us at Food Junkies:, what can Kathy tell us about how to encourage and support families to live a sugar free life - in a world that equates love with sugar?  Follow Kathy: Connect with Kathy "Sugar Free Girl" Williams, your SUGAR SHRINK Free Health Transformation Call: https://link.pipelinepro.co/widget/booking/IIjTGPR0qpvImRcg69N2 Link to free resources: https://ilivesugarfree.com/links Website: https://ilivesugarfree.com/ Purchase the Book "Oh So Sweet to Live Sugar Free": https://ilivesugarfree.com/my-book The content of our show is educational only. It does not supplement or supersede your healthcareprovider's professional relationship and direction. Always seek the advice of your physician or other qualified mental health providers with any questions you may have regarding a medical condition, substance use disorder, or mental health concern.        

One in three U.S. adults are pre-diabetic, yet 80% remain unaware of their condition. In this episode, Laurence Girard, the CEO and founder of Fruit Street Health, shares his journey as a healthcare entrepreneur, raising over $33 million in equity financing and delivering the CDC's Diabetes Prevention Program via telehealth. Initially offering telemedicine software for dietitians, Fruit Street pivoted to diabetes prevention based on advice from a Fitbit executive, resulting in a program that reduces the risk of type 2 diabetes by over 58% and is more effective than metformin. Despite facing a setback from a competing distributor, Fruit Street's program, which includes live group video chats with dietitians, food tracking, and partnerships with LabCorp and Modified Health, has received Medicare funding and a grant from the American Diabetes Association. Laurence emphasizes the importance of good science, patient experience, and prevention in healthcare and encourages providers and payers to support CDC-recognized diabetes prevention programs to reverse prediabetes. Tune in and learn how Fruit Street is making strides in diabetes prevention and public health! Resources:  Watch the entire interview here. Connect and follow Laurence Girard on LinkedIn. Learn more about Fruit Street on their LinkedIn and website.

What is MDPP coverage for Medicare? Why is it important to catch diabetes early? Does Medicare cover A1c for prediabetes? Does Medicare cover diabetes prevention program? Our guest is Colleen Barbero, PhD, MPPA, model lead with the Centers for Medicare & Medicaid Services Innovation Center, and Kate Kirley, MD, MS, director of chronic disease prevention and programs at the American Medical Association. AMA CXO Todd Unger hosts.

In this episode of iCantCU, I focus on web accessibility, the National Federation of the Blind of Pennsylvania, and a unique raffle ticket sale to support the NFB of PA.  I detail the raffle, explaining the process, the prizes, and the significance of the funds raised for the NFB of Pennsylvania. This initiative highlights the podcast's commitment to the visually impaired community and offers listeners a chance to contribute meaningfully. Most of the episode is dedicated to meeting ADA-Expert.com representatives and discussing advancements in web accessibility tools and strategies. I share insights from this meeting, emphasizing the importance of making digital spaces accessible to all. I shared my feelings with the group on how they should proceed to market with their accessibility widget.  Additionally, I provide a brief update on Ziggy, the Golden Menace. He seems to be doing well and wants to eat EVERYTHING. Show notes at https://www.iCantCU.com/258    Links Mentioned Support Stacie Leap in her effort to launch a nonprofit to support blind parents: https://www.venmo.com/stacieleap  Buy raffle tickets to support the NFB of PA! Tickets are $5. Email iCantCUPodcast@gmail.com  Find this episode on YouTube: https://www.youtube.com/@iCantCU Dr. Carolyn Peters's book on Amazon: https://amzn.to/49hz1aA  The new BenQ PD3420Q monitor I bought for my new Mac mini: https://amzn.to/4bAcOGv  Support iCantCU When shopping at Amazon, I would appreciate it if you clicked on this link to make your purchases: https://www.iCantCU.com/amazon. I participate in the Amazon Associate Program and earn commissions on qualifying purchases. The best part is, you don't pay extra for doing this! White Canes Connect Podcast Episode 097 In episode 097, Lisa and I explore the Diabetes Prevention Program with special guests Joani Schmeling from the Health Promotion Council and NFB of PA President Lynn Heights, a diabetes coach. The program, developed by the CDC, is designed to support individuals with pre-diabetes through lifestyle changes over a year, emphasizing the importance of diet, exercise, and stress management. Lisa told us that she would start the program this month and promised to give us regular updates on her progress.  Find the podcast on Apple Podcasts https://podcasts.apple.com/us/podcast/white-canes-connect/id1592248709  Spotify https://open.spotify.com/show/1YDQSJqpoteGb1UMPwRSuI IHeartRadio https://www.iheart.com/podcast/263-white-canes-connect-89603482/ YouTube Https://www.youtube.com/@pablindpodcast White Canes Connect On Twitter Https://www.twitter.com/PABlindPodcast My Podcast Gear Here is all my gear and links to it on Amazon. I participate in the Amazon Associates Program and earn a commission on qualifying purchases. Zoom Podtrak P4: https://amzn.to/33Ymjkt Zoom ZDM Mic & Headphone Pack: https://amzn.to/33vLn2s Zoom H1n Recorder: https://amzn.to/3zBxJ9O  Gator Frameworks Desk Mounted Boom Arm: https://amzn.to/3AjJuBK Shure SM58 S Mic: https://amzn.to/3JOzofg  Sennheiser Headset (1st 162 episodes): https://amzn.to/3fM0Hu0  Follow iCantCU on your favorite podcast directory! Apple Podcasts: https://podcasts.apple.com/us/podcast/icantcu-podcast/id1445801370/  Spotify: https://open.spotify.com/show/3nck2D5HgD9ckSaUQaWwW2  Audible: https://www.audible.com/pd/iCantCU-Podcast-Podcast/B08JJM26BT  IHeart: https://www.iheart.com/podcast/256-icantcu-podcast-31157111/ YouTube: https://www.youtube.com/davidbenj  Reach out on social media Twitter: https://www.twitter.com/davidbenj Instagram: https://www.instagram.com/davidbenj Facebook: https://www.facebook.com/davidbenj LinkedIn: https://www.linkedin.com/in/davidbenj Are You or Do You Know A Blind Boss? If you or someone you know is crushing it in their field and is also blind, I want to hear from you! Call me at (646) 926-6350 and leave a message. Please include your name and town, and tell me who the Blind Boss is and why I need to have them on an upcoming episode. You can also email the show at iCantCUPodcast@gmail.com.

In this episode of White Canes Connect, hosts  Lisa Bryant and David Goldstein explore the Diabetes Prevention Program with special guests Joani Schmeling from the Health Promotion Council and NFB of PA President Lynn Heights, a diabetes coach. The program, developed by the CDC, is designed to support individuals with prediabetes through lifestyle changes over a year, emphasizing the importance of diet, exercise, and stress management.  Lisa shares her commitment to participating in the program, highlighting its potential to prevent the progression from prediabetes to diabetes, a leading cause of blindness. The episode also addresses the flexibility and accessibility of the program, including virtual options and support for a wide range of participants.  Success stories from the program illustrate its effectiveness in improving health outcomes, such as significant A1C reductions. The discussion emphasizes that while the commitment may seem daunting, the potential health benefits far outweigh the perceived challenges, encouraging listeners to consider joining the program to take control of their health. Show notes at https://www.whitecanesconnect.com/097    Join the Program If you are interested in joining a Diabetes Prevention Program, reach out to Alexandra at info@accessiblepharmacy.com. More on Health Promotion Council  Call or text the Referral Hub at (215) 608-1477. You can also email programinfo@phmc.org.  An Easy Way to Help the NFB of PA Support the NFB of PA with every purchase at White Cane Coffee Company by going to https://www.whitecanecoffee.com/ref/nfbp. When you use that link to purchase from White Cane Coffee, the NFB of PA earns a 10% commission! Share the link with your family and friends! Listen to Erin and Bob Willman from White Cane Coffee on episode 072 of White Canes Connect. Donate to the NFB of PA If you would like to make a monetary donation to the National Federation of the Blind of Pennsylvania, go to https://www.NFBofPA.org/give/. Give Us A Call We'd love to hear from you! We've got a phone number for you to call, ask us questions, give us feedback, or say, "Hi!" Call us at (267) 338-4495. You have up to three minutes for your message, and we might use it on an upcoming episode. Please leave your name and town as part of your message.  Follow White Canes Connect Apple Podcasts | Spotify | Amazon | YouTube Connect With Us If you've got questions, comments, or ideas, reach out on Twitter. We are @PABlindPodcast. You can also email us at WhiteCanesConnect@gmail.com.

Pre-PA Club Podcast Interview: Joy Moberly Discusses the Joint PA and Public Health Degree Program at Touro University, CaliforniaIn this episode of the Pre PA Club Podcast, host Savannah Perry is in conversation with Joy Moberly, the program director of Touro University, California. They delve into the unique offerings of the university's physician assistant (PA) program and its inclusivity towards all students. Besides offering public health field study opportunities in areas like criminal justice, community health, and global health, Touro stands out for its joint PA and public health degree program. The institution also uniquely equips all its students as lifestyle coaches via the Diabetes Prevention Program. On the flip side, Joy, as a practicing PA, talks about her own journey from aspiring to be a physical therapist to becoming a passionate advocate for diabetes education. She also discusses the value of self-reflection for PA students during their application process and interview phase. Savannah ends by probing into Joy's thoughts on the future of PA education.00:00 Introduction and Welcome00:18 About the Host and the Podcast01:51 Introduction to the Pre PA Academy04:06 Interview with Joy Moberly Begins04:11 Joy's Journey to Becoming a PA09:19 Joy's Transition into Academia11:49 Joy's Continued Practice as a PA15:14 Unique Aspects of Touro University's PA Program21:00 The Importance of Authenticity in PA Programs21:56 Understanding the Mission of Your Chosen Program22:43 Being Genuine and True to Your Career Goals23:23 The Role of Personal Mission in Choosing a Specialty24:45 Overcoming Imposter Syndrome in PA School25:24 The Art of Self-Reflection in PA Applications26:32 The Importance of Being Different in Your Application27:10 Understanding the Interview Process28:55 Reevaluating Your Application: What to Do If You Don't Get In32:20 The Future of PA Education: Thoughts on Doctorate Programs38:14 Getting Involved in Your State Society38:55 Closing Thoughts and Contact InformationPre-PA Academy - https://thepaplatform.thrivecart.com/pre-pa-academy/ Touro University California Admissions website: https://tu.edu/programs/mspas-mph/admissions/Info sessions: https://tu.edu/news--events/events/search/?types[]=Open%20House&keywords=physician%20assistantMappd - https://app.mappd.com/register?code=paplatform Pre-PA Workbook - https://amzn.to/3H80G1O PA School Interview Guide - https://www.thepaplatform.com/book PA School Personal Statement Guide - https://www.thepaplatform.com/pa-school-personal-statement-guide Pre-PA Essay Review - https://thepaplatform.thrivecart.com/pre-pa-essay-review-2500-5000/ Mock Interview - https://www.thepaplatform.com/mock-interview Pre-PA Counseling -

In this episode of the "This is Y" podcast, we talk about all things diabetes prevention. Host and Muskegon YMCA CEO Gabe Gerlach talks with Ashley Brage, program director of the Diabetes Prevention Program, and Kathy, a program participant. Hear Kathy's story and learn more about the things you can do to delay or prevent the onset of type 2 diabetes. Ashley speaks to the Diabetes Prevention Program at the Muskegon YMCA, which is a main provider of the program across the state of Michigan. Learn how you can get involved by visiting muskegonymca.org.

In the US, approximately 37.3 million people have been diagnosed with diabetes, and 96 million more have pre-diabetes. Proper management can help prevent diabetes, and even reverse pre-diabetes. Linh Gordon, a certified diabetes care and education specialist at Sarasota Memorial, talks about the Diabetes Prevention Program at SMH.You can also watch the video recording on our Vimeo channel here.For more health tips & news you can use from experts you trust, sign up for Sarasota Memorial's monthly digital newsletter, Healthe-Matters.

Episode 100: Diana Fransis, RD | Becoming an Empowered Eater Show Notes: On this episode of the Alix Turoff Nutrition podcast, Alix sits down with Diana Fransis, RD. Diana Fransis is a registered dietitian and lifestyle coach, specializing in empowering individuals to make informed choices about properly fueling their bodies. Holding a bachelor's degree in Nutritional Sciences from Rutgers University, she completed her dietetic internship at the University of Medicine and Dentistry of New Jersey (now Rutgers). In addition, Diana has earned a certification as a lifestyle coach from the Diabetes Prevention Program. With extensive experience and a commitment to guiding others toward optimal well-being, she started her career as a corporate dietitian for a major grocery chain and has now established her own private practice. Residing in New Jersey with her husband and three children, she values family time and delights in sharing her expertise by creating delicious recipes.   Some of the topics we covered in this episode include: How parents can model a positive body image for their kids Navigating the balance between wanting to lose weight but also having to work through disordered eating How to break the generational cycle of yo-yo dieting How to talk to your kids about their own weight …and more!   Connect with Diana on instagram (@wellnessfromwithinrd)   Resources: Submit your questions for upcoming podcast episodes Get the 5 week Flexible Nutrition Starter Kit Apply for Alix's 12 week small group coaching program Apply for Alix's 1:1 coaching program Follow Alix on Instagram  Join Alix's private Facebook group Download your FREE Happy Hour Survival Guide Buy Alix's book on Amazon Shop my favorite products on Amazon Contact Alix via email   Be sure you're subscribed to this podcast to automatically receive your episodes!!!    If you enjoyed today's episode, I'd love it if you would take a minute to leave a rating and review! Subscribe to The Alix Turoff Nutrition Podcast   Discount Codes: Built Bar: Use the code ALIX for 10% off your order Legion Athletics: Use the code Alix for 20% off your order  

In today's episode with Dr. Melody Hartzler, you'll hear us take a deep dive on: 1. What is type 2 diabetes, and what causes it? 2. What is insulin resistance? 3. Medications and lifestyle interventions for type 2 diabetes 4. The role of gut health in type 2 diabetes 5. Nutrients and natural remedies in the management of type 2 diabetes Dr. Hartzler has developed a passion for functional medicine and treating the underlying causes of disease. Her focus areas are functional gastrointestinal disorders, nutritional deficiencies, metabolic conditions, and autoimmune conditions. She is also a nationally recognized speaker on diabetes and functional medicine. Dr. Hartzler is currently Board Certified Ambulatory Care Pharmacy Specialist (BCACP) and is Board Certified in Advanced Diabetes Management (BC-ADM). She is also the owner of PharmToTable and the Director of Clinical Services for Profero Team. Order tests through Rupa Health, the BEST place to order functional medicine lab tests from 30+ labs - https://www.rupahealth.com/reference-guide

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-335 Overview: In this episode, we review recent updates from the Diabetes Prevention Program (DPP) trial and Diabetes Prevention Program Outcomes Study (DPPOS). Join us as we discuss the impact of the updates on diabetes prevention strategies for cardiovascular outcomes. Episode resource links: Goldberg RB, Orchard TJ, Crandall JP, Boyko EJ, Budoff M, Dabelea D, Gadde KM, Knowler WC, Lee CG, Nathan DM, Watson K, Temprosa M; Diabetes Prevention Program Research Group*. Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. Circulation. 2022 May 31;145(22):1632-1641. doi: 10.1161/CIRCULATIONAHA.121.056756. Epub 2022 May 23. PMID: 35603600; PMCID: PMC9179081. Galaviz KI, Weber MB, Suvada K BS, Gujral UP, Wei J, Merchant R, Dharanendra S, Haw JS, Narayan KMV, Ali MK. Interventions for Reversing Prediabetes: A Systematic Review and Meta-Analysis. Am J Prev Med. 2022 Apr;62(4):614-625. doi: 10.1016/j.amepre.2021.10.020. Epub 2022 Feb 10. PMID: 35151523. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato

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-335 Overview: In this episode, we review recent updates from the Diabetes Prevention Program (DPP) trial and Diabetes Prevention Program Outcomes Study (DPPOS). Join us as we discuss the impact of the updates on diabetes prevention strategies for cardiovascular outcomes. Episode resource links: Goldberg RB, Orchard TJ, Crandall JP, Boyko EJ, Budoff M, Dabelea D, Gadde KM, Knowler WC, Lee CG, Nathan DM, Watson K, Temprosa M; Diabetes Prevention Program Research Group*. Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study. Circulation. 2022 May 31;145(22):1632-1641. doi: 10.1161/CIRCULATIONAHA.121.056756. Epub 2022 May 23. PMID: 35603600; PMCID: PMC9179081. Galaviz KI, Weber MB, Suvada K BS, Gujral UP, Wei J, Merchant R, Dharanendra S, Haw JS, Narayan KMV, Ali MK. Interventions for Reversing Prediabetes: A Systematic Review and Meta-Analysis. Am J Prev Med. 2022 Apr;62(4):614-625. doi: 10.1016/j.amepre.2021.10.020. Epub 2022 Feb 10. PMID: 35151523. Guest: Jillian Joseph, MPAS, PA-C   Music Credit: Richard Onorato

Lindholt JS, Søgaard R, Rasmussen LM, et al. Five-year outcomes of the Danish cardiovascular screening (DANCAVAS) trial. N Engl J Med 2022;387(15):1385-1394.     Study design: Randomized controlled trial (nonblinded) Looking to see if intensive screening protocol for cardiovascular disease reduce cardiovascular events or mortality in older men? Danish study, 46,611 men aged 65 to 74 years were randomly assigned to receive an invitation to screening or usual careThe screening program included non-contrast electrocardiographically gated CT to measure coronary artery calcium, look for aneurysms, and detect atrial fibrillation; ankle-brachial index measurements for peripheral arterial disease (PAD) and hypertension; and blood tests for diabetes and hyperlipidemiaThose who accepted screening were more educated, more likely to be employed, and had a somewhat lower rate of hospitalization for cardiovascular events in the previous 5 years. (the rich white gullible ceo male)The screened group was more likely to be given lipid-lowering drugs and antithrombotics, and they were more likely to have repair of an aortic aneurysm.In the entire population, stroke was less likely (HR 0.93; 0.86 - 0.99) but there were no significant differences in myocardial infarction, aortic dissection, or aortic rupture. The authors estimated that 97.4% of men who received preventive therapy of some kind as a result of screening experienced no mortality benefit after almost 6 yrs of follow up. This is basically a really small absolute benefit which we could also see in just placing a pt on a statin. We don't need vip medicine we need pcp that have time to calculate risk and place pt on statin when indicated.     Goldberg RB, Orchard TJ, Crandall JP, et al, for the Diabetes Prevention Program Research Group. Effects of long-term metformin and lifestyle interventions on cardiovascular events in the diabetes prevention program and its outcome study. Circulation 2022;145(22):1632-1641. Study design: Randomized controlled trial (nonblinded) What is the long-term impact of treating prediabetes on mortality and cardiovascular outcomes? Go way back original Diabetes Prevention Program study randomized 3234 overweight or obese adults with impaired glucose tolerance ("prediabetes") to receive metformin 850 mg twice daily, an intensive exercise program, or placebo and followed them for 3 years Patients were invited to participate in a long-term open-label follow-up study This article reports long-term cardiovascular and mortality outcomes for each group. Patients in the intervention groups were less likely to have been given a diagnosis of T2DM (55% for metformin and 53% for lifestyle vs 60% for placebo; P = .001; number needed to treat [NNT] = 17) There was no difference between either intervention group and placebo with regard to the risk of cardiovascular death, nonfatal stroke, or nonfatal myocardial infarction. There was also no significant difference in the composite of all 3 outcomes for the original metformin group versus the placebo group (hazard ratio [HR] 1.03; 95% CI 0.78 - 1.37) or for those in the original lifestyle group versus the placebo group (HR 1.14; 0.87 - 1.50). More is less or rather more meds is less diagnosis but no difference in things we actually care about     Skjerven HO, Lie A, Vettukattil R, et al. Early food intervention and skin emollients to prevent food allergy in young children (PreventADALL): a factorial, multicentre, cluster-randomised trial. Lancet 2022;399(10344):2398-2411. Study design: Randomized controlled trial (single-blinded) Does the early introduction of allergenic foods prevent the development of food allergy? investigators randomized healthy newborns, singletons or twins, with at least 35 weeks' gestational age (concealed allocation) to receive no intervention (n = 597), a skin intervention (n = 575), a food intervention (n = 642), or a combined intervention (n = 583). The skin intervention consisted of 5- to 10-minute baths with added petrolatum-based emulsified oil followed by topical cetirizine cream applied to the face. This intervention was to occur at least 4 days per week from age 2 weeks to 8 months, The food allergy intervention consisted of sequentially adding allergenic foods (peanuts, cow's milk, wheat, then eggs) to the infants' regular diet at weekly intervals starting at age 3 months. Overall, 95% of the infants in each group were breastfed at 3 months The researchers had final data on 99.9% of the participants!   based on structured parental interviews, skin testing, and oral challenges  The researchers classified the development of food allergy at 36 months as probable, none, or unclear.  There was no significant difference, however, between the infants who were exposed to skin interventions and those who were not exposed (2.1% vs 1.6%). BUT BUT BUT Food allergy occurred in 1.1% of infants in the interventions using food (food intervention and combination intervention) compared with 2.6% in not using food (no intervention and skin intervention; number needed to treat = 63; 95% CI 37-196).   Lewis E, Merghani K, Robertson I, et al. The effectiveness of leucocyte-poor platelet-rich plasma injections on symptomatic early osteoarthritis of the knee: the PEAK randomized controlled trial. Bone Joint J 2022;104-B(6):663-671. Study design: Randomized controlled trial (double-blinded) Allocation: Concealed recruited adults with at least 4 months of knee pain (with or without swelling) who had mild degeneration on their x-rays (if plain x-rays found no signs of degeneration, they used magnetic resonance imaging to confirm the diagnosis). The participants were randomized to receive 3 weekly saline injections (n = 28), or a single PRP injection followed by 2 weekly saline injections (n = 47), or 3 weekly PRP injections (n = 27). . The clinician performing the injections was unmasked but had no other involvement in the study procedures. the participants were evaluated at 6 weeks, 12 weeks, 6 months, and 12 months after enrollment Using intention-to-treat analysis looking at pain, function, and quality of life, at no point in the study were PRP injections, singly or serially, superior to saline injections.

Prediabetes is one of the least discussed yet most common conditions in the world! We're going over what the heck prediabetes means, who is most likely to get it, and what this diagnosis means for your health. We're also discussing if its possible to keep prediabetes from developing into type 2 diabetes and any treatments that can help people with prediabetes. Plus Dr. E tells us about his 10-year study with the NIH called the Diabetes Prevention Program and what he learned. Questions We'll Cover in This Episode: What causes prediabetes? What are the symptoms of prediabetes? How do you diagnose prediabetes? Who is at increased risk of developing prediabetes? Is diabetes genetic? What are the risks associated with prediabetes? Are there any treatments for prediabetes? Can you keep prediabetes from turning into type 2 diabetes? What are our recommendations for someone diagnosed with prediabetes? Show notesGLP 1 Receptor Agonists: Ozempic, Mounjaro, Trulicity SGLT2 Inhibitors: Jardiance, Farxiga ★ Support this podcast ★

Today on the podcast, Paul talks with John Abramson, American physician, lecturer at Harvard, and author of the books, Overdosed America: The Broken Promise of American Medicine and Sickening: How Big Pharma Broke American Health Care and How We Can Repair It. They have the important conversation about the problems with profit-driven pharmaceutical companies, conflicts of interest in the medical world, and how changing medical education and the system at large is integral for a patient-focused path forward. A note from Paul: Throughout my training and practice as a physician I have come to one very disappointing conclusion:  Western medicine isn't helping people lead better lives. Now that I've realized this, I've become obsessed with understanding what makes us healthy or ill. I want to live the best life I can and I want to be able to share this knowledge with others so that they can do the same. This podcast is the result of my relentless search to understand the roots of chronic disease. If you want to know how to live the most radical life possible I hope you'll join me on this journey. Time Stamps: 00:09:57 Podcast begins  00:10:58 John's backstory as a physician 00:17:40 The inner workings of pharmaceutical companies 00:28:00 John's experience with the FBI 00:29:30 Details on the Vioxx case 00:37:35 Directed consumer marketing of pharmaceuticals 00:44:10 Details about the most recent Vioxx trial  00:46:10 Conflicts of interest in the medical world and thoughts on Statins 00:51:30 The Diabetes Prevention Program 00:59:45 Pharmaceutical companies' spending 01:10:10 What is the way forward and how can we change medical education? Get in touch with John at john_abramson@hms.harvard.edu Sponsors: Heart & Soil: www.heartandsoil.co Carnivore MD Merch: www.kaleisbullshit.shop Make a donation to the Animal Based Nutritional Research Foundation: abnrf.org  White Oak Pastures: www.whiteoakpastures.com, use code CarnivoreMD for 10% off your first order or Carnivore5 for 5% off subsequent orders Higher Dose: www.higherdose.com/paul, or use code PAUL for 15% off your order Lets Get Checked: 20% off your order at www.TRYLGC.com/paulsaladino for 25% off Colima Salt: drpaulsalt.com, for a free bag of Colima Sea Salt

This week, please join author Ronald Goldberg, Editorialist Hertzel Gerstein, and Guest Editor Rury Holman as we discuss the article "Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study" and the editorial "Shouldn't Preventing Type 2 Diabetes Also Prevent Its Long-Term Consequences?" Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast summary and backstage pass to the journal and its editors. We're your co-host. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Centre and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor, Director of the Pauley Heart Center at VCU Health in Richmond, Virginia. Dr. Carolyn Lam: Today. Oh, this feature discussion involves the glance of diabetes. Truly this interview, I felt like I was sitting among gurus and just learning so much about diabetes, the history and the whole topic is about long term metformin and lifestyle interventions on cardiovascular events in the Diabetes Prevention Program and its outcome study. Now, way more than that, we discussed. You have to have to listen. But okay, before that, let's summarize today's issue for our listeners. Shall we, Greg? Dr. Greg Hundley: You bet Carolyn. So the first paper that I've got to discuss today really comes to us from the world of interventional cardiology and it's led by Dr. William Fearon from Stanford University Medical Center. Well, Carolyn previous studies have shown quality of life improves after coronary artery revascularization, more so after coronary artery bypass grafting than after PCI. Now this study aimed to evaluate the impact of fractional flow reserve guidance, and current generation zotarolimus drug-eluting stents on quality of life after PCI compared with CABG. Dr. Greg Hundley: Now the study emanates from fractional flow reserve versus angiography for multi vessel evaluation or the fame three trial. And Carolyn, that's a multicenter international trial that included 1500 patients with three vessel coronary artery disease who were randomly assigned to either CABG or FFR guided PCI. Now, what did they assess? So quality of life was measured using the European Quality of life Five Dimensions. And we're going to abbreviate that EQ-5D questionnaire baseline, one, and then 12 months following the procedure. Also, Canadian cardiovascular class angina grade and working status were assessed at the same time points, and then also an additional time point in six months. And the primary objective was to compare the EQ-5D summary index at 12 months, and secondary endpoints included angina grade and work status. Dr. Carolyn Lam: Ooh, interesting Greg. So quality of life in the theme three trial. All right. So what did they find? Dr. Greg Hundley: Right, Carolyn. So the EQ-5D, so that... European Quality of life Five Dimensions summary index at 12 months did not differ between the PCI and CABG groups, but the trajectory over the 12 months at the one month time interval between PCI and CABG did differ. Now, the proportion of patients with the Canadian cardiovascular class or CCS2 or greater angina 12 months was 6.2% versus 3.1% respectively in the PCI group compared with the CABG group. Additionally, a greater percentage of younger patients, so those less than 65 years old were working at 12 months in the PCI group compared with the CABG group. So in summary, Carolyn, in the fame three trial, quality of life after fractional flow reserve guided PCI with current generation DS compared with CABG was similar in one year. And the rate of significant angina was low in both groups and not significantly different. However, the trajectory of improvement in quality of life was significantly better with PCI as was working status in those less than 65 years old. Dr. Carolyn Lam: Wow. Thanks Greg. Hey, guess what? It's time for Greg quiz. The next paper is about the Chocolate Touch Study. So, Greg, is this about, A, the benefits of eating chocolate? B, the benefits of chocolate mud baths? Or C, the benefits of a second generation drug coated balloon? Dr. Greg Hundley: So, Carolyn, I just have one question. Where in the world do we get the benefits of chocolate mud bath? I don't think that's right. I do love eating chocolate, but I am going to go with the benefits of the second generation drug coated balloon. Dr. Carolyn Lam: Yeah, yeah, yeah. I made it easy for you. All right. So first generation drug coated balloons have significantly reduced the rate of restenosis compared to balloon angioplasty alone. However, high rates of bailout stenting and dissections persist. The chocolate touch drug coated balloon is a nitinol constrained balloon designed to reduce acute vessel trauma and inhibit neointima formation and restenosis, so you were right, Greg. In today's study led by Dr. Shishehbor, from University Hospital's Harrington Heart and Vascular Institute at Cleveland, Ohio. They studied 313 patients with claudication or ischemic rest pain, and superficial femoral or popliteal disease. And randomized them one to one to the chocolate touch or Lutonix Drug Coated Balloon at 34 sites in the United States, Europe and New Zealand. The primary efficacy endpoint was drug coated balloon success defined as primary patency at 12 months. The primary safety endpoint was freedom from major adverse events at 12 months. A composite of target limb related death, major amputations, or reintervention. Both primary endpoints was assessed for non-inferiority and have met sequential superiority testing for efficacy was pre-specified. Dr. Greg Hundley: Interesting, Carolyn. So this nitinol constrained balloon designed to reduce acute vessel trauma. So, what were the results of this study? Dr. Carolyn Lam: So in this trial, the second generation chocolate touch drug coated balloon met both non-inferiority endpoints for efficacy and safety. And was more effective than the Lutonix Drug Coated Balloon at 12 months for the treatment of femoral popliteal disease. Cool, huh? Dr. Greg Hundley: Very interesting. Great summary, Carolyn. So Carolyn, my next paper comes to us from the world of preclinical science. And the impact of three dimensional chromatin topology on transcriptional dysregulation and pathogenesis in human dilated cardiomyopathy remains elusive. And so these authors led by Professor Lei Jiang from Guangdong Provincial People's Hospital, and Guangdong Academy of Medical Science, generated a compendium of 3D epigenome and transcriptome maps from 101 biobank human dilated cardiomyopathy, and non-filing heart tissues and mouse models to further interrogate the key transcription factor implicated in 3D chromatin organization, and transcriptional regulation in dilated cardiomyopathy pathogenesis. Dr. Carolyn Lam: Oh, wow. Sounds like a lot of work. What did they find, Greg? Dr. Greg Hundley: Right, Carolyn. So they found that enhancer promoter connectomes are extensively rewired in human dilated cardiomyopathy, which reside in pre accessible chromatin size and also hand one drives the rewiring of enhancer promoter connectome to induce dilated cardiomyopathy pathogenesis. Dr. Carolyn Lam: Okay, Greg. So what are the clinical implications? Dr. Greg Hundley: Right, Carolyn. So first, dilated cardiomyopathy enriched enhancer promoter loops identified in this study could be developed as novel 3D genomic biomarkers for dilated cardiomyopathy. And then second Carolyn, targeting hand one might be used as a novel approach for therapeutic intervention in patients with dilated cardiomyopathy. Dr. Carolyn Lam: Oh, nice. Greg. Well, also in today's issue, there's an On My Mind paper by Dr. Brook, entitled, “The Doctor is Out, New Tactics and Soldiers For our Losing Battle against Hypertension.” In another paper, we have Molly Klemarczyk bringing us highlights from the Circulation Family of Journals. Dr. Greg Hundley: Right, Carolyn. And also from the mailbag, there's a Research Letter from Professor Baggish, entitled, “Cardiovascular Outcomes in Collegiate Athletes, Following SARS-CoV-2 Infection: The 1-Year Follow Up From the Outcomes Registry for Cardiac Condition in Athletes.” Well, Carolyn, how about now we get onto that feature discussion and learn a little bit more about the long term metformin and lifestyle interventions on cardiovascular events in the Diabetes Prevention Program. Dr. Carolyn Lam: Hold on to your seats, everyone. Here we go. We know that lifestyle intervention and metformin have been shown to prevent diabetes. However, what is their efficacy in preventing the cardiovascular disease associated with diabetes development? Well, guess what? We're going to have data on that through today's feature paper and what a star crowd I'm talking to today. We have Dr. Ron Goldberg and he's a first end corresponding author from the University of Miami Diabetes Research Institute. We have the editorialist Dr. Hertzel Gerstein from McMaster University Population Health Research Institute. And a guest editor for this paper, Dr. Rury Holman from University of Oxford. I have to admit I'm starstruck. You gentlemen have totally defined the field. I cannot wait to learn more, but shall we start with you, Dr. Goldberg? Could you tell us a little bit more about your paper, what you did, what'd you found? Dr. Ronald Goldberg: So the background is that the Diabetes Prevention Program started in 1996 was a Diabetes Prevention Program to test the effects of intensive lifestyle intervention versus metformin, versus placebo on the prevention of diabetes in over 3000 individuals with impaired glucose tolerance, a form of prediabetes. And after demonstrating the efficacy of those interventions over about three years, we went on to do a follow up study in which the metformin group continued to receive it. Everybody got lifestyle because it worked so effectively. And we are now reporting after a further 18 years of follow up on the question of whether these interventions, now 21 years later, had any effect on cardiovascular outcomes. The background to that of course, is that people with prediabetes have a somewhat increased risk for heart disease and that rate increases as diabetes develops, particularly with severity of hyperglycemia and duration of diabetes. So, that was the study and we're now reporting on whether these interventions had a significant effect on the major cardiovascular. Dr. Carolyn Lam: Well, first Dr. Goldberg, congratulations on the foresight to get the informed consent and to plan ahead to be able to get these valuable data. But because I know this is going to be a critical point later. Could you tell us a little bit about the completeness of follow up and perhaps surveillance for outcomes before you share the results? Dr. Ronald Goldberg: Absolutely. So, 86% of the original randomized group of participants agreed to continue with a follow up study, so there was a loss at that point. And then of course, over 18 years of follow up, there's going to be a further loss. Some due to death and some due to loss to follow up. But despite that, I would say the group that entered the follow up study, we were able to maintain follow up in 85%. Dr. Carolyn Lam: Fantastic. And the results? Dr. Ronald Goldberg: The findings were that we found no significant effect of either of the two active interventions on our primary cardiovascular outcome, which was nonfatal myocardial infarction, stroke and fatal cardiovascular disease. We also had an extended outcome with more events in it, and similarly found no significant benefit or harm from either of those two intervention. Dr. Carolyn Lam: Oh, I love that paper. What a great, great, perhaps surprising conclusion that Dr. Gerstein loved the title of your editorial, you crystallize it. Shouldn't preventing type two diabetes also prevent long term consequences? So please tell us what was your thoughts when you saw this paper and how you frame it? Dr. Hertzel Gerstein: Thanks very much, Carolyn. And first of all, I was very impressed by the extensive amount of work and analysis done by Dr. Goldberg and his team. I thought that it's wonderful to see this sort of long term follow up. I've had the privilege in the past of speaking together with the DPP team on their trial and in their long term follow up. And I continue to be impressed by the extensive amounts of work and data collected and a rigor and academic value of the analysis. So, that was my very first impression and obviously it's a pleasure to write on this. I think the findings are clearly important and they both highlight the importance of long-term follow up as well as highlight the difficulties of long-term follow up in a study like this. Dr. Hertzel Gerstein: So this was a study done in a trial, originally done in a fairly young cohort of individuals who had very low risk for cardiovascular events. And over their 18 year follow up that Dr. Goldberg Ron described, the actual annual event rate for the primary outcome was 0.6% per year in that ballpark. Now, anybody... I've had the privilege as Ron Avery of doing many cardiovascular trials and we all know that we would never start a trial recruiting people with an event rate of 0.5% per year, 0.6% per year, because we would have to recruit 30,000 people and follow them for seven years in order to accrue enough events to be able to detect a clinically relevant benefit of the therapy. So because of this low event rate, the advantage was the long term follow up, the 26th year, I think it was in the end follow up. No, it was a 21 year median follow up period, because of the long follow up, you get a little bit away from the advantage of the low event rate. Dr. Hertzel Gerstein: But even then, over the course of the 21 years, there were only about 310 first cardiovascular events and most cardiovascular outcomes trials, for instance, we need close to at least a 1000, 500 to a 1000 is what we like to see. So that being said, it's perhaps not surprising that we didn't see a benefit of diabetes prevention because even if diabetes reduces the risk of a cardiovascular event by a quarter, by 25%, there would've only been a 50, 50 chance of detecting that with this particular cohort of people. Dr. Hertzel Gerstein: So I would say that the most conservative assumption is that diabetes prevention doesn't reduce the event rate by 25% or less or 30, but it's certainly... pardon me, by 25% or more, it could reduce it by 20%, 15% we would not have detected at all, or Ron would not have detected and his team would not have detected it with this thing. So I think that to me is the most important caveat in interpreting this does not mean that diabetes prevention has no effect on cardiovascular outcomes. Dr. Hertzel Gerstein: It means that diabetes prevention doesn't have a moderate or smaller effect. So, that's I think the most important message to take and as is even mentioned in the paper by Ron and the team is that there has been at least one diabetes prevention trial conducted in China many, many years ago that showed clearly that people who were randomly assigned to the diabetes prevention arm, 26 years later did have lower cardiovascular events and even death than people who were in the control arm. So, I think this adds to the story but it's clearly like everything, not the final word in this, but it certainly adds a lot of important data. Dr. Carolyn Lam: Oh, I would love to hear Dr. Goldberg's response to that. But before that, Dr. Holman, could I ask you to weigh in as well? Dr. Rury Holman: Yes. Sure. So, I agree with Hertzel that this is underpowered, but this is a question I've long wanted to see the answer to. And I congratulate Ron and his team for actually doing the work. All major studies should have long term follow up. People should be consented for life so that we can answer these questions. And Hertzel even though the power is perhaps minimal, we still need to do this analysis. Dr. Rury Holman: And if there had been a dramatic result, then we'd have all been very excited. I think one of the issues... one, if I could just bring it up, you mentioned the look ahead study in your discussion as being a negative dietary intervention. But I have a slightly different take on that. When you look at that paper in detail, what you see is that the people in the usual care group forgot quite a lot more risk factor reduction medications, and that's because their usual care physicians spotted the fact that their risk factor levels were higher than in the intensive care group, of course it was blinded at that point. But there's a whole point here is, in your paper you show an increase in the statin proportion, which is higher in the placebo group compared with the metformin and your intensive lifestyle, significantly so for the lifestyle one. So I'm just wondering whether even the low power was further blunted by the drop in effects of these other medications. Dr. Ronald Goldberg: Thanks very much for those comments guys, I think they're spot on. Let me first respond Hertzel with my thoughts on this, and then go over to your point, Rury. I think it's really interesting to look back over time and realize how much medical management has changed. And that goes right to your point, Rury, that doing a clinical trial like this where the primary care physicians are informed about what we're doing, what... communicated with on a regular basis, particularly when their patients develop diabetes, it just heightens the entire level of medical management. And I think you're absolutely right, but it's interesting to see what's happened to cardiovascular disease over the last 25 years, both in the general population and in the prediabetic population, the risk of cardiovascular disease has gone down. And then on top of that, we've got this very intensive cardio prevention intervention by primary care physicians, with high rates of statin usage, high rates of any hypertensive treatment, even the placebo group to your question, really lost weight. Dr. Ronald Goldberg: And they knew full well what was... and this was a very hands on type of study where our participants were really followed now for all these years, really became integrated with the research team. And so everybody knew what everybody else was doing. And so I'm sure the placebo effect was very strong, but I think nevertheless... Oh, and the last point I wanted to make was of course, the severity of the diabetes, even though 60% are developed diabetes, the severity of the diabetes was relatively mild. Even in those who developed diabetes, we know their average A1C was only about 6.7. And so I think that has a lot to do with blunting the acceleration effect of diabetes on cardiovascular disease. So, I think all of these factors contributed together to produce a negative result. But I think an important message, nevertheless. Dr. Hertzel Gerstein: I can highlight that point, that Ron was saying is that if diabetes prevention is going to prevent cardiovascular outcomes, it's going to do that because of a difference in glycemic exposure. The diabetes is by definition a disease of an elevated blood sugar. So if diabetes prevention prevents cardio, it means that the blood sugar's going to be lower than it would otherwise be. So if there's very little difference over the long term follow up in blood sugar because of co-intervention and therapy of all the treatment groups, then that would eliminate a lot of the benefits of diabetes prevention, because these are patients who are in this trial, who are being scrutinized even more than they would be if they were out there free range without being involved in any follow up. So, that's a spot on point. Rury, you wanted to comment. Dr. Rury Holman: Yeah. So, Hertzel just to expand on that. Obviously the glycemic impact on macrovascular disease is relatively modest compared to the impact on microvascular disease, which of course is what we all saw originally with type 2 diabetes. In fact, in KPDS35, when we looked or calculated what 1% reduction in A1C would do, it would only reduce stroke or MI by about 12 to 14%. So it's quite a shallow slope if you like. And your point is spot on is if that glucose levels are kept low by good treatment and good management role tell us about the great team they have. Then there was no room for a glycemic impact in this particular study. It's another question, whether you think metformin acts by different mechanisms to reduce cardiovascular disease, that's another question I had for Ron that he might like to address, is if there was a magic effect of metformin, why didn't we see that? Dr. Ronald Goldberg: And that's a really interesting question, Rury, because you may be aware that we published a paper a few years ago on our assessment of coronary calcification in a subgroup, in about 60% of the population who agreed to do this and who were eligible. And interestingly found that metformin did was accompanied by a reduction in the prevalence of coronary calcium in men, not women. Dr. Ron Goldberg: And the effect was actually when we did subgroup analysis, we found it was particularly strong in young men. And actually that gave us some sense of optimism that we might see something when we came to actual events. And of course, as you all know, metformin has beneficial effects on several cardiovascular risk factors. And so the question is whether there is some effect of metformin that might yet be identified, a coronary calcium after all is a surrogate of events and may take time, or it may be that... And we are really interested in the idea that both prediabetes and diabetes are heterogeneous. There's more and more interest in looking at subgroups of individuals who may be more predisposed. And it may be that metformin might have beneficial effects in some of those subgroups. Dr. Hertzel Gerstein: But also remember on the other hand, there was a lot of co-intervention with metformin in all groups after the trial was over. So all groups were offered metformin, et cetera. So even if metformin had an effect, it could have easily been washed out by the exposure of all the other groups to metformin during follow up. But Ron, you also touched on both the hope and the frustration too, because if we start thinking about subgroups, we can always think of subgroups. Yeah. But then the problem with subgroups is you have a study, let's say you have a cohort study with 7,000 or 10,000 people and it followed for five years and, oh, well the effect isn't in all 10,000, it's only in 20% of them. So now you have a study of 2000 people, that's not enough to detect an effect in a subgroup. Dr. Hertzel Gerstein: So, subgroups just eat away at power in an exponential, not a linear way, so that you just rapidly lose any ability to detect anything. And so, yes, this is going to work in people with these three snips on this gene, in this subpopulation. Good luck, that's the difficulty and the challenge of... We need to find sometimes better or more efficient ways of identifying outcome protective therapies, because we can't keep drilling into some groups because we just don't have the resources to find it really. I don't know what other people feel about that, but. Dr. Carolyn Lam: I'm personally so enjoying this conversation as I know the audience is and we covered a lot. I'm sure everyone wants to pick up the paper and the editorial. Now, we talked about being underpowered for the number of studies. We talked about profitable dilution of things like statins, antihypertensive agents, even the crossover of potential treatment in the placebo arm and so on. And then we started talking about, or is it the how you got there and the drug that was used. And here, please don't shoot me, but I just know I have the answers on behalf of everyone else's thinking it. What do you say of people who go, "Well, it's because it's metformin. What if it was an SGLT2 inhibitor? What if it was a GLP-1 receptor agonist?" And as you know, a lot of people say those would in spite of the effect on glucose. Dr. Hertzel Gerstein: I can quickly jump in. It's very clear. We've learned this in the last 10 years, is that there are glucose lowering drugs and there are glucose lowering drugs with benefits. And the GLP-1 receptor agonist and the SGLT2 inhibitors are glucose lowering drugs with benefits. They lower glucose, but they seem to have a separate cardioprotective effect. And with the SGLT2 inhibitors that cardioprotective effect does not seem to be related to the glucose lowering. There are a few meta regression analyses that suggest that with the GLP-1 receptor agonist, part of the cardioprotective effect is related to glucose lowering and part is not. And clearly mediation analysis with some of the trials have shown the same thing with the GLP-1 receptor agonist, not really with the SGLT2 inhibitors. So, maybe, that's my spin on this. Dr. Carolyn Lam: Dr. Holman. Dr. Rury Holman: Yeah. I was going to echo what Hertzel said in that regard, these other agents do have multiple effects. They change weight, they change blood pressure. And so other risk factors are brought into play other than glucose lowerings. We've already agreed, glucose lowering impact on cardiovascular disease is quite modest. I'd rather have it than not, but it wouldn't be my primary way to treat cardiovascular disease. And coming back to Ron's study, which is crucial today, the issue here is whether we could untangle an impact particularly of metformin, which has been foundation drug for type 2 diabetes for so long. Dr. Rury Holman: But clearly within the dataset we have here, underpowered it is. There are no clear messages in that respect, which is disappointing, but it doesn't mean that there isn't an effect. With longer follow up, with more data than you might see it. When the study... I'm coming for you Hertzel, was stopped for futility then the hazard ratio has changed, that often the way, not for the right way, but it's often what happens when you stop studies. I wondered if you wanted to comment on that aspect, because I know it's something that you've talked a lot about. Dr. Carolyn Lam: Dr. Gerstein. Did you want to? Dr. Hertzel Gerstein: I agree with what Rury said. I think the point you're making Rury goes back to power, and the ability to have enough people and enough events to detect and effect and that's clearly true, so... Dr. Carolyn Lam: Well, I hate to be the one to break the party up, but we have gone over time and intentionally so, there's just so much learning here. But Dr. Goldberg, could I give you the last say please? What do you think is the important clinical take home message of your paper? Dr. Ron Goldberg: Well, I think that the fact that we demonstrated that our study has been able to maintain really low levels of cardiovascular risk factors, low levels of A1C, even though that likely contributed to the negative finding still leaves the physician where the recognition that it is important to identify individuals with prediabetes to Institute Diabetes Prevention Programs, because I think it's entirely possible as I said earlier, and we've begun to identify them, subgroups of individuals who do progress more rapidly and who do warrant a more effective treatment, which would come from an early intervention program. Dr. Carolyn Lam: Wow. Thank you so, so much for that. Thank you so much. All three gentlemen for this amazing discussion. Well, audience, you heard it right here on Circulation on the Run from Greg and I thank you for joining us today and don't forget to tune in again next week. Speaker 6: This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

Much attention has been paid recently in both scientific circles and in the media to a drug for weight loss newly approved by the FDA. A flurry of articles in the media hailed this drug as a breakthrough. This was prompted by the publication of a landmark article in the New England Journal of Medicine addressing the impact of this medication in a large clinical trial. Today's guest is one of the authors of that paper. Another flurry of media attention occurred as the drug became available, with news that supply couldn't keep up with demand. Dr. Thomas Wadden is the Albert J. Stunkard Professor and former Director of the Center for Weight and Eating Disorders at the University of Pennsylvania School of Medicine. He is one of the most highly regarded experts on treatments for obesity, having done some of the most important research on very low-calorie diets, a variety of medications, bariatric surgery, intervention in primary care settings, and more. Interview Summary   You and I grew up together in this profession, having spent some early years together working on treatments for obesity. You're one of the people in the field I admire most, both for the quality of your work and the breadth of your knowledge across various treatments for obesity. So let me begin by asking something regarding our former mentor, Albert Stunkard. So one of the most famous quotes of all time in our field came from Mickey Stunkard in 1959, no less, way before the field was really paying attention to obesity. He wrote that "most obese persons will not stay in treatment. Most will not lose weight. And of those who do lose weight most will regain it." There was a stark honesty to this, and it motivated Stunkard to help overweight people. So if we fast forward to today, do you think this is essentially still true?   Well, first, let me say that Dr. Stunkard's statement sounds somewhat critical. Today, we might say stigmatizing people with obesity. You know, they won't stay in treatment, they won't lose weight, they'll regain it. And Stunkard, as you know perhaps better than anybody, was an extremely compassionate, empathic person. To clarify that, he knew that the limitations to success were with the treatments available and not with the people who had obesity. So to answer your question, the first two parts of Stunkard's statement that people won't stay in treatment and people won't lose weight were probably no longer true by the early to mid-1980s. And pioneers like yourself showed that if you gave people a structured program of diet and physical activity, and most importantly, if you gave them behavioral strategies to improve their treatment adherence, then 80% of people would stay in treatment for 16 to 26 weeks. They'd lose an average of 6% to 10% of their weight. So what remained, however, and remains today, was that people have trouble maintaining the weight loss. And that's something that still challenges us.   Well, it's nice to start on that optimistic note with the hope that people will go into treatment. Let's talk about the drug. So what is the new drug, and how does it work?   Well, the new drug is called semaglutide. It comes in a dose of 2.4 milligrams and is injected subcutaneously once per week. The drug at the retail level is known as Wegovy. Some people will know about semaglutide for the management of type 2 diabetes. It is used at a dose of 1.0 milligrams and it's called Ozempic. So Ozempic was approved first many years ago. Now, semaglutide is a glucagon-like peptide 1 receptor agonist, and that's a mouthful. But glucagon-like peptide 1, GLP-1 for short, is a naturally occurring hormone that is released by the body when food, particularly carbohydrates, hits the stomach. GPL-1 is released by cells in the small intestine, and it does several important things. First, it signals the pancreas to release insulin to pick up the glucose that's coming in. And then it also slows gastric emptying, which as you know, leads to greater feelings of fullness. And then finally, these GLP-1 receptor agonists are hitting a part of the hypothalamus that stimulates fullness or what's known as satiation receptors, so people feel full earlier when they're eating and don't eat as much food. I think you may remember, Kelly, that naturally occurring GLP-1 has a very short life when it's released. It's active for about two to three minutes, so you have a temporary feeling of fullness. But these new drugs, semaglutide 2.4 milligrams, have a seven-day half-life. So people are feeling greater fullness and less hunger sort of around the clock, and as a result, they are just eating less. And to use your terms, they are less responsive to all the cues in the toxic food environment that are saying come on, it's time to eat more. It's time to have a large serving of ice cream or sugar-sweetened beverages, whatever it is. People don't seem to be as vulnerable to the toxic food environment.   I really appreciate that you've taken a pretty complex subject, namely the physiology of this drug, and made it come alive in terms that most of us can understand. So thanks for that. So before you talk about the weight losses that the drug produces, you mentioned that some treatments are producing weight loss of 5-6% of body weight. Can you place that in context for us? I mean, is that enough to produce medical benefits? Are the people losing weight happy with that degree of weight loss?   Sure, most individuals who go through a behavioral treatment program will lose about 7% to 8% of their weight on average. And those weight losses are associated with significant improvements in health. The landmark study in this area is the Diabetes Prevention Program published in 2002. People with pre-diabetes lost seven kilograms, about 7% of their weight, and they exercised 150 minutes per week. And those individuals with pre-diabetes reduced their risk of developing diabetes over 2.8 years by 58% compared to the control group. So that's a really important finding that modest weight loss, and modest physical activity prevents the development of type 2 diabetes. And weight loss is also going to improve blood pressure, and it can improve sleep apnea, so modest weight losses have benefits. But two things. First, larger weight losses have greater improvements in health. That's important to know. It's in a linear relationship there. The more you lose usually, the better the health improvements. And two, most people seeking to lose weight want to lose about 20% of their body weight. So if you're a 200-pound female, a 250-pound male, you want to lose 40 to 50 pounds, respectively. And so, larger weight losses are highly desired.   So how do you deal with that psychologically when somebody's goal is far beyond what treatment typically produces? Can people come around to the fact that the smaller weight losses are really good for me, and I've accomplished a lot even though I may not get to my goal?   Well, I always tell people, I know you want to lose 40 pounds. So let's start with the first 15 to 20. Let's focus on that because you have to go through 15 to 20 to get to 40, and let's see how you feel after you've lost the initial weight. And I can't promise you you're going to get to 40 pounds for potential genetic or biological reasons, but let's try to achieve what we can achieve and focus on larger weight loss. And many people are more satisfied than they'd imagined with a more modest or moderate weight loss, even though the dream is to lose more than that.   Okay, so back to the drug then. This big clinical trial you were involved with, published in the New England Journal of Medicine, can you quickly explain the trial and tell us what you found?   There were four big clinical trials of this medication that were presented to FDA for approval, but the seminal paper published in New England Journal treated about 1,961 participants. And everybody got lifestyle modification every month with a dietician for 15 to 20-minute visits. And then on top of that, half the participants got assigned semaglutide 2.4 milligrams, and the other half got a placebo. And they were followed for 16 months. And the reason it's a 16-month trial is that you have to introduce the drug slowly over four months to control gastrointestinal side effects. So as you start to take this drug, you're likely to experience a little bit of nausea. About 45% to 50% of people do so. So some patients, about 20%, will experience vomiting. Constipation and diarrhea also occur in response to the drug. So if you slowly introduce the drug, you can prevent some of those symptoms. And so it's not till four months that you're on the full dose of the drug, and that's why they run the trial for 16 months, so people have been on the drug for one year. And so what happens at the end of these 16 months is that the participants who get lifestyle light with placebo lose 2 1/2 percent of their weight. That's about what we'd expect. Those who get semaglutide, lose 15% of their body weight. So a remarkably robust weight loss. And when you break it down a little bit further, what happens is that 69% of the people on semaglutide are losing 10% or more of their weight. And then 50% are losing 15% or more of their weight. So that's a substantial loss. And this is something that I'd never seen in this kind of a trial. One-third have lost 20% of their body weight. And those weight losses are cumulative. So the 69% who lost 10% of their weight include the people who lost the 15% and 20% of their weight. But as you well know, those are substantial losses where the average loss is 15%, and that's achieved by 50% of the people. That is double what we get with our best behavioral treatment, and it's about double what you get with most weight loss drugs.   Yeah, that's pretty darn impressive to double the impact. I mean, most people will be excited with a a little bit of improvement. That's a lot of improvement. So certainly, we have to take note based on that. When you talked about the side effects, you were talking about the fairly immediate side effects of beginning to take the drug. And then it takes four months for people to get up to the full dose. Are there side effects that exist beyond those four months?   Well, most people will be through those gastrointestinal side effects within the four months. But, if you go out to 16 months, there will be a small percentage of people who have nausea, diarrhea, et cetera, throughout the trial. And you try to help those people with their side effects by doing things like chewing their food more thoroughly, eating smaller meals but more of them, and drinking more water. All of that can help them control their nausea if it's persistent. I think that the most serious side effect, Kelly, is that about 4% of people will develop gallstones or need to have a gallbladder removed. That is just a consequence of the large weight loss. Anytime you have large weight loss, whether it's from a very low calorie diet, from bariatric surgery, or these medications, you will find that a small percentage of people have gallstones and will need attention.   And what about the fact that people need to get this by injection? Are people able to do that okay, or is that a deterrent for people using it on a broad scale?   It's an excellent question. I can tell you that I have injected myself on several occasions just to see what it's like. You find a fat fold in the stomach and inject yourself. The needle is so small that you can't feel it. So once people try it, there's really very little hesitancy. I think certainly some people would think, "I don't want to be injecting myself with this thing," They may not even come in, but once you try it, there's no problem. And right now, there is an oral version of Ozempic. It's called Rybelsus. So it's the same medication for type 2 diabetes but in oral form rather than sub-q injection. And a trial is currently underway to see if we can make an oral version of semaglutide injectable drug, and I think that's going to prove acceptable. So that barrier should be eliminated over time.   So what happens if people stop taking the drug?   I think you know the answer. People who stop taking the medication are vulnerable to regaining their weight. And some people would say, well, that illustrates the drugs a failure because you take it and you lose weight, and you regain it, and you're no better off. But I am on a medication for high blood pressure and on a medication for high cholesterol. I can assure you that if I stop taking those medications, my cholesterol and blood pressure would go up. So this speaks to a very important issue which we have to look at obesity is probably a majority of persons as being a chronic health condition for which they're going to need long-term ongoing care and you would need to take these medications indefinitely just like I take my hypertensive or cholesterol medication indefinitely.   You know, the description of the cholesterol and blood pressure drugs is a great example. And I think this really speaks to the issue of obesity stigma, doesn't it? Because if you have these blood pressure, cholesterol drugs, and lots of others, if people are taking them and they're effective and then they stop taking them and then the medical condition comes back, it's even more evidence that a drug works. But in the case of some of these obesity drugs, people say, well, if you stop taking it and you regain the weight, it's proof the drug doesn't work. So how do you think that might be bound up with kind of general social attitudes about people with obesity?   It's such an important point. So persons with obesity are still stigmatized, as you, Rebecca Puhl, and many people have shown. And there's just so much unrelenting stigmatization of people saying, you know you should be able to control your weight by exercising more, cutting down on what you eat, push back from the table. You see, it's your problem, your shortcomings in self-control. So people with obesity are stigmatized. Similarly, obesity medications are stigmatized. Anytime I give a talk to physicians, I'll ask how many would consider prescribing an obesity medication? And only about 10% of hands go up at most. Then I'll ask, would you prescribe a drug for hypertension or cholesterol? Everybody's hand goes up, and I say, what's the difference here? And people invariably say, well, people should be able to control their eating and exercise with their willpower. And I say, well, it's an illness, it's a disease partly caused by this toxic food environment, so why are you treating that differently? You allow diabetes medications. That's caused by eating behavior to some extent. So I think you're correct. There's this profound stigmatization of people with obesity and of the medications. And I think that view is beginning to change. One of the most important things about this new medication semaglutide, and there'll be a new drug from Eli Lilly called tirzepatide, is that doctors, endocrinologists, and primary care physicians, are comfortable with these glucagon-like receptors because these are diabetes drugs that they prescribe. They're willing to prescribe that long-term. Now they may be willing to recognize obesity disease, which requires long-term treatment. They feel comfortable with the drug and that it's not going to have adverse side effects. So I hope this is a turning point in stigmatizing persons with obesity and obesity drugs.   Tom, how much does the drug cost, and is it covered by insurance? And what about people on Medicare and Medicaid?   This medication, if you go to your pharmacy and ask for it, I think is currently priced at about $1,300 per month. And so that is a very high barrier to the vast majority of people who would want to take this drug. It's possible, and I hope that the price will come down, but I haven't seen any indication of that. Some insurers and some employers cover the medication so that some people will benefit from it. But I think, as you know, Medicare and Medicaid do not cover any obesity medications at this time. There's a very important piece of legislation in the Senate and in the House called the Treat and Reduce Obesity Act, and part of that bill is to get Medicare to cover obesity medication. So even though they've got a terrific new medication, most people who would benefit from it, and particularly people of color who have higher rates of obesity, minority members, will have a very difficult time getting this drug to use it appropriately.   You mentioned that Eli Lilly may be coming out soon with a competitor drug. Do you think the competition will reduce the cost?   I would hope it would reduce the cost, but I can't say that I have any advanced knowledge of that or any assurance that that will happen. Eli Lilly has put a lot of money into producing their medication. Their medication tirzepatide looks like it will be as effective as semaglutide if not more effective by two or three percentage points. So I think probably the best bet for having a cost reduction is that another medication very similar in its mechanisms of action to semaglutide, it's called liraglutide 3.0 for obesity. It is a GLP-1 receptor agonist, it's just not as effective, it produces an 8% weight loss, it's going off patent, I believe in 2023 or '24 and when it goes off patent, I think that there will be generics to at least make that drug available at a very reasonable cost. I believe that that drug currently is at about $600 to $700 per month, but it should come down dramatically when it goes off-patent, and there are generics.   And for people who have health insurance, are insurers covering the drug?   A smattering of people are covering the drug. I don't think there's universal coverage. If you're under Blue Cross Blue Shield or whatever your company may be, remarkably, the University of Pennsylvania is covering some of these medications, which I'm delighted to see. But you would have to check your insurance plan carefully. For people who do have coverage, there are coupons to get your costs down to as little as $25 a week. So it's really worth looking into. And I know that Novo Nordisk, which manufactures semaglutide, is trying to work with insurers to get more to pick up the coverage of the drug. Let's hope that they reach some insight that'd be important to reduce the cost of this drug to make it more available to people who really need it.   Let me ask a big picture question to end our conversation. So where does this drug fit in the broad scheme of various options for treatments for obesity and how would someone or their physician know if this medication would be a good option to pursue?   Sure, if we follow just the FDA guidance and the guidance of expert panels, this drug is appropriate for people who have a body mass index of 30. So you can go, and your doctor will measure your weight, calculate your height, and tell you what your BMI is. So at a BMI of 30, you're eligible for this drug if you've tried diet and exercise, which just about everybody will have, and you haven't been successful with that alone. I think that the drug is most appropriate for people with a body mass index of 30 or greater who have significant health complications, meaning they have type 2 diabetes or hypertension, or sleep apnea. If the drug's going to be limited in availability because of it's cost, I would try to get it to the people who have the most benefit in terms of improving their health. That's the primary reason to seek weight reduction, I think. Technically, to address your question, the drug's available to people with a body mass index of 27 who have a comorbid condition such as hypertension or type 2 diabetes. And if you've got a BMI of 30, you would like to get this drug to people who have the highest BMIs and have the greatest benefit to health. Those individuals with higher BMIs at 35 who have a comorbid condition are eligible for bariatric surgery, which is the most effective obesity treatment. If you look at the most popular surgical treatment right now, it's called sleeve gastrectomy, where you remove 75% of the stomach so you can't eat as much food, and it does have improvements in appetite-related hormones such as ghrelin, the hunger hormone. That is dramatically suppressed by the operation so people are less hungry, have less desire to eat. And so that operation produces about a 25% reduction in body weight in one year. And at three to five years, people still have 20% off. So a person who's got a BMI of 35 or more with a comorbid condition such as type 2 diabetes wants to talk with his or her physician and see if they might benefit from bariatric surgery. If the doctor and patient don't think that's the option, you would like to consider an obesity medication to help you just control your feelings of appetite, hunger, and satiation, to make it easier to eat a lower calorie diet, to make it easier to want to get out there in physical activity. So that is the big picture of the options: Diet and physical activity for people who have overweight and obesity without health conditions. And then you add medications for people at a BMI of 27, 30, or greater who have health complications. And then you add bariatric surgery when medications don't work.   Bio   Thomas A. Wadden, Ph.D. is Professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. He served as director of the Center for Weight and Eating Disorders from 1993 to 2017 and was appointed in 2011 (through 2021) as the inaugural Albert J. Stunkard Professor in Psychiatry. He received his A.B. in 1975 from Brown University and his doctorate in clinical psychology in 1981 from the University of North Carolina at Chapel Hill. Wadden's principal research is on the treatment of obesity by methods that have included lifestyle modification, very-low-calorie diets, physical activity, medication, and surgery. He has also investigated the metabolic and psychosocial consequences of obesity and of intentional weight loss, the latter as represented by findings from the 16-year long Look AHEAD study. He has published over 500 scientific papers and book chapters and has co-edited seven books, the most recent of which is the Handbook of Obesity Treatment (with George A. Bray). His research has been supported for more than 35 years by grants from the National Institutes of Health.  

Mary Luebbert, a certified diabetes care educator, leads a discussion on what lifestyle changes you can make to help manage your diabetes.

Eric Harley interviewed Julie Dillon, Health and Wellness Manager for the St. Christopher Truckers Development and Relief Fund. She is promoting this year's Diabetes Prevention Program See omnystudio.com/listener for privacy information.

If your blood sugar levels are high, but not high enough to be considered type 2 diabetes, your doctor may tell you that you have prediabetes. When you hear that news, you have a choice. You can stay on a path that may lead to type 2 diabetes, and all the complications that come with it. Or you can use the news as a catalyst for making healthy changes in your life. Led by Arna Vanebo, RD, and Melissa Morris, RD, CDE, Columbia Memorial Hospital's new Diabetes Prevention Program starts on July 14, 2021. This program is CDC-recognized and based on research. It is focused on healthy eating and physical activity. In Episode #33 of Hands on Health, Arna and Melissa talk about prediabetes and what you can do to prevent it from progressing to full-blown diabetes. # # # Diabetes Prevention Program You are eligible for this program if you: Have been diagnosed with prediabetes based on a blood test completed in the last year, Are a woman and have been diagnosed with gestational diabetes during pregnancy, or Have a positive screening for prediabetes based on the CDC Prediabetes Screening Test. CORRECTED: Starting July 14, 2021, this lifestyle-change program will be offered in-person. This first yearlong cohort will not be billed for the classes, so this is a good time to take advantage of working to improve your overall health and well-being. Call 503-338-7592 with questions, or to sign up. Learn more about CMH Diabetes Education. # # # "Hands on Health" is the podcast all about living your healthiest life on the coast. If you have a question or a comment, please call 503-338-4654 to leave us a message. We may include your question in an upcoming episode! Listen on: Anchor Apple Podcasts Google Podcasts Spotify Overcast CMH news

ResourcesFor additional resources on individualized care, visit DiabetesEducator.org/MinorityHealthMonth.To learn more about the Community Council of Greater Dallas visit ccadvance.org/community-wellness.

To learn more about becoming a National DPP or MDPP provider, visit DiabetesEducator.org/DPP.