Podcasts about diabetology

In this special episode on Early Identification and Delay of Type 1 Diabetes, Dr. Neil Skolnik this emerging area with Dr. Jay Shubrook. This special episode is supported by an independent educational grant from Sanofi. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Jay Shubrook, D.O.  - Professor and Director of Diabetes Services, Touro University. Past  Chair, The American Diabetes Association Primary Care Advisory Group, Past Chair of the American College of Diabetology.   Selected References and Resources referred to the in the Podcast: Webinar Registration (Apr 28, 2025 10:00 AM): Early Detection Saves Lives: Implementing Type 1 Diabetes Screening in Pediatric and Primary Care References: Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care 2024;47(8):1276–1298 An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med 2019;381:603-613 Resources for Auto-antibody Testing: Type 1 Diabetes TrialNet Centers of Excellence Locations Type 1 Risk test         Trialnet  

Michael See MS, ACSM-CEP, NBCHWC, CDES joins the Huddle to share his expertise and experiences in bringing physical activity to people with type 2 diabetes who also have physical limitations. He covers topics like how to assess physical limitations, their prevalence in people with type 2 diabetes, and how to use a motivational interviewing approach in conversations with your clients. This episode was made possible with support from Lilly, A Medicine Company. Learn more about this topic in our latest patient/client handout (support for the development of this handout was provided by Lilly, A Medicine Company): adces_tipsheet_physical_activity2.pdf ReferencesAmerican Diabetes Association Professional Practice Committee; 5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S77–S110.Ahmad E, Sargeant JA, Yates T, Webb DR, Davies MJ. Type 2 Diabetes and Impaired Physical Function: A Growing Problem. Diabetology. 2022; 3(1):30-45. https://doi.org/10.3390/diabetology3010003Angulo, J., Assar, M. E., Álvarez-Bustos, A., & Rodríguez-Mañas, L. (2020). Physical activity and exercise: Strategies to manage frailty. Redox Biology, 35. https://doi.org/10.1016/j.redox.2020.101513Colberg SR, Sigal RJ, Yardley JE, et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079. doi:10.2337/dc16-1728O'Neill D, Forman DE. The importance of physical function as a clinical outcome: Assessment and enhancement. Clin Cardiol. 2020;43(2):108-117. doi:10.1002/clc.23311Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports. 2015;25 Suppl 3:1-72. doi:10.1111/sms.1258136-Item Short form survey instrument (SF-36). Available at: https://www.rand.org/content/dam/rand/www/external/health/surveys_tools/mos/mos_core_36item_survey.pdf (Accessed: 21 October 2024). Physical activity vital sign. Available at: https://www.exerciseismedicine.org/wp-content/uploads/2021/04/EIM-Physical-Activity-Vital-Sign.pdf (Accessed: 21 October 2024).  Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.Learn more about ADCES and the many benefits of membership at adces.org/join.

India is fast becoming the diabetes capital of the world and the concern is on a red alert now. This episode of the xMonks drive is primarily based around raising awareness for the same.We have with us Dr. Jasjeet Wasir who is the Director of Endocrinology and Diabetology in the world-renowned Mendanta. Join us in this educational dialogue and learn from the very best Dr. Jasjeet Wasir about the how's and why's of Diabetes.Follow us on our Instagram: https://www.instagram.com/xmonks.ecosystem/Follow me On YouTube:https://www.youtube.com/channel/UCHsytOG-7i57hrSwB7fNkcwFollow me On LinkedIn:https://www.linkedin.com/in/gauravaroragrv/

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Go online to PeerView.com/PQU860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Type 2 diabetes (T2D) is a progressive disease that is largely preventable and entirely treatable. Timely intensification of therapy is a foundational principle of contemporary management of people with T2D since this strategy is associated with better long-term health outcomes. In conjunction with intensified therapy, modest weight loss has been shown to improve overall and long-term health outcomes. In this activity, based on a series of Project ECHO® workshops and produced in collaboration with the American College of Diabetology, you'll learn best practices for individualizing patient care and intensifying therapy with evidence-based pharmacologic management of T2D with non-insulin glucose-lowering therapies. Now is the time! Watch today to begin adding these practical strategies to your toolbox! Upon completion of this activity, participants should be better able to: Intensify treatment in people with T2D consistent with the latest guidelines, available evidence, and shared decision-making principles to control glycemia and weight to optimize outcomes and avoid long-term complications; Explain the rationale for targeting weight and establish personalized weight loss goals as a treatment priority for comprehensive T2D management; and Counsel people with T2D about the relationship between obesity and diabetes and the importance of achieving and maintaining a healthy weight as a T2D treatment priority.

Wrapping up our Diabetology 2 parter encore, diabetic diabetologist and wonderful person Dr. Mike Natter, MD is back with a little introduction covering some stuff that wasn't on the radar back in 2019, like what's the deal with this Ozempic stuff you've heard about, and then Natter from the past goes on  to answer all of your questions about blood sugar, the cost of insulin, pancreas transplants, keto, glucagon, how exercise can save your life, his most meaningful interactions with patients, pudding theft, and the best place to cry at work. Also: why you should always keep frosting in your purse.This episode is swear-free and okay for all ages, and a bleeped version of Diabetology Part 1 can be found at this link.Follow Dr. Mike Natter at Instagram.com/mike.natter or at Twitter.com/mike_natterA donation went to: JDRF.org More links at alieward.com/ologies/diabetologySmologies (short, classroom-safe) episodesSponsors of OlogiesTranscripts and bleeped episodesBecome a patron of Ologies for as little as a buck a monthOlogiesMerch.com has hats, shirts, masks, totes!Follow @Ologies on Twitter and InstagramFollow @AlieWard on Twitter and InstagramEditing by Mercedes Maitland of Maitland Audio Productions and Jarrett Sleeper of MindJam Media and Mark David Christenson Transcripts by Emily White of The WordaryWebsite by Kelly R. DwyerTheme song by Nick Thorburn

Dr. Mike Natter hosts this encore episode of Ologies (hosted by Alie Ward), it's a classic 2 parter: Diabetology about the happy, moody-, sweaty-, unconscious-, and possibly even homicidal-making sugar in our blood. In this episode, Dr. Mike Natter dishes about how blood sugar works, what insulin does, and how prevalent diabetes is in all of its various forms. Also: keto vs. vegan, hypoglycemia, cyborg organs, owl hoots, gestational diabetes, type 1 vs. type 2 and ... does Gwyneth drink her own pee? Also: the emotional side of the disease and how to help those in your life who are diabetic.Next week, the doc addresses your questions, from diets to diagnoses to infuriating insulin prices.Follow Dr. Mike Natter at Instagram.com/mike.natter or at Twitter.com/mike_natterA donation went to: beyondtype1.orgSponsor links: thegreatcoursesplus.com/OLOGIES; ZOLA.com/ologies (code:SAVE50); betterhelp.com/ologiesMore links at alieward.com/ologies/diabetologyTranscripts & bleeped episodes at: alieward.com/ologies-extrasBecome a patron of Ologies for as little as a buck a month: www.Patreon.com/ologiesOlogiesMerch.com has hats, shirts, pins, totes and STIIIICKERS!Follow twitter.com/ologies or instagram.com/ologiesFollow twitter.com/AlieWard or instagram.com/AlieWardSound editing by Jarrett Sleeper of MindJam Media & Steven Ray MorrisTheme song by Nick ThorburnSupport the show: http://Patreon.com/ologies

Today's podcast is a continuation of our series exploring the safety of non-sugar sweeteners in both food and beverages. In 2022, the World Health Organization conducted a systematic review of the most current scientific evidence on the health effects of non-sugar sweeteners. This analysis of 283 studies reveals that non-sugar sweeteners can impact health conditions such as cardiovascular disease, type 2 diabetes, adiposity, bladder cancer, and preterm birth. In 2023, the WHO released a guideline on the use of non-sugar sweeteners based on this 2022 review. Our guests today are Dr. Jason Montez, scientist with the World Health Organization, and technical lead on the systematic review and guideline. And, the director of the Department of Nutrition and Food Safety at the World Health Organization, Dr. Francesco Branca. Interview Summary   This is really important work, so let's get right down to it. So, Francesco, let's begin with you. Would you help our listeners understand why the WHO, developed this guideline, and what do you hope to accomplish now?   Francesco: So our interest in the topic really came after the release of the WHO Guideline: Sugars Intake for Adults and Children in 2015. That recommendation was, of course, to reduce the amount of sugar to less than 10% of energy, and better if less than 5% for weight control and for dental hygiene. At the time, there was an interest, particularly from the food and beverage manufacturers, to consider the use of non-sugar sweeteners as part of the interventions in reducing sugar intake. This has been taken up by consumers since, and the availability of non-sugar sweeteners has increased. We thought it was important to review the evidence in a systematic manner, and to see whether this move was actually achieving the intended aim to control weight gain. So we thought of looking at non-sugar sweeteners use through the WHO guideline development process. Our hope, first of all, is to make sure that people achieve their intended health benefit, but also to avoid an unintended consequence on health.   I remember how much impact that report on sugar had, back when WHO released it. And boy, the same thing seems to be happening with the guideline that We are talking about today. So Jason, can you walk us through the key findings of the systematic review?   Jason: Sure. So the top line results of the systematic review are that in short term randomized controlled trials mostly lasting three months or less, those consuming higher amounts of non-sugar sweetener, compared to lower amounts or no non-sugar sweetener, has slightly lower body weight. So around 700 grams. And, slightly lower BMI; about 0.2 units. However, in long-term prospective cohort studies, many with several years of follow-up, body weight was either unchanged, or greater in those consuming higher amounts of non-sugar sweeteners. In addition, associations were also observed between non-sugar sweetener intake and increased risk of type 2 diabetes, cardiovascular diseases, and premature mortality. For diabetes, for example, we found about a 25% increase in risk. In RCTs - markers of these diseases - such as blood glucose, insulin, cholesterol, blood pressure, were largely unaffected by non-sugar sweetener use. In addition, we saw an increased risk of bladder cancer coming from case control studies and it was primarily driven by saccharin. Also, a 25% increase in risk of preterm birth in pregnant women in terms of body weight, and the risk of non-communicable diet-related diseases. We essentially have seemingly opposing results between the short-term randomized controlled trials and the long-term cohort studies.   Those are really concerning findings. Somebody in their own calculus might say, "Well, I'm willing to accept the risk for those things as long as it helps with my body weight." But, you are talking about greater weight in people using the non-sugar sweeteners.   Jason: Right. In terms of long-term impact on body weight, there is not a lot of evidence. This is all coming from cohort studies, and cohort studies have caveats associated with them. But, what we see in those studies is it is either really not much of an positive impact, but we did see some increased risk. For example, there was an increased risk of incident obesity in one study. They looked at people at baseline without obesity using standard WHO cutoffs. Then they followed them up over time. They counted the number of people who transitioned over the obesity threshold, and they found that it was higher in those using non-sugar sweeteners. So there is some evidence, but I think we need additional evidence to be really sure about that in the other associations.   So Jason, you alluded to this earlier that there were differences in the health outcomes reported in randomized controlled trials versus observational studies. Can you explain why this might be?   Jason: Yes. So it is a bit nuanced and I think a lot of it has to do with the nature of the studies. To really understand this, we need to unpack that high-level evidence a bit. I think I'll start just by talking about what is maybe the elephant in the room and that is reverse causation because it has been frequently invoked as a reason for the associations observed between non-sugar sweeteners and body weight and disease outcomes. Basically, reverse causation suggests that those already at elevated risk of disease initiated or increased the use of non-sugar sweeteners because of their risk status, rather than non-sugar sweeteners leading to the increased risk in otherwise healthier low risk individuals. That would make sense in this case. However, researchers who conducted the individual studies that we included in the review were also well aware of the potential for both reverse causation and residual confounding. Most of them really went to great lengths to minimize the possible interference of these phenomenon and they adjusted extensively for confounding variables and all the lifestyle variables. Quite often, they adjusted for other dietary variables. They looked at body weight, they stratified, and they did sensitivity analysis where they would limit the analysis to individuals with normal body weight. They also removed from the analyses, in some cases, those at risk for disease at baseline. Many of them did a sensitivity analysis where they excluded the first several years of assessing the outcome, just to make sure that someone who wasn't already really at risk to develop a disease right away was not part of the analysis. You know, in some cases the effect was attenuated. But, for the most part, the associations were not affected. Certainly, that is the case for type 2 diabetes. So I think that reverse causation might have contributed, but, really the lengths that the study authors took to address it I calms us a bit in terms of whether or not We are worried about it.   It is very helpful to know that. You know, we've gone for years and years thinking that these things are safe, or at the worst have neutral effects. Now the studies are showing the negative effects. Partly, it is just because the science has marched ahead. There are many more studies now. People have been more careful with the design of the studies. More sweeteners have been studied. This seems like just kind of a natural progression of the scientific process.   Jason:  Yes, that is how it works. We continually add. There is still a lot to look at in terms of the differences. Another really important thing to remember is that in the RCTs, a variety of interventions were employed. A lot of the studies took people who were consuming a normal diet, and they just gave them, for example, a sugar-sweetened beverage, or non-sugar sweetened beverage. They wanted to look at what the effects of a sugar-sweetened beverage are. Very few actually looked at individuals who were habituated to sugar, mostly sugar-sweetened beverages. They then asked study participants to replace the sugar with non-sugar sweetener. When you look at just those small number of studies, the results really get attenuated for both body weight and for BMI. That is another reason why if you look at it that way, the results between the long-term and short-term tend to gravitate towards each other.   One last thing - I don't want to overdo it here, but it is important - there are likely big, big differences in terms of how non-sugar sweeteners are used in these highly experimental randomized controlled trial settings and cohort studies, which are really more like real world use. In a randomized controlled trial, you're instructed to do this, or that. Drink this, take that. You get quite a bit of support from the study team. You'll get counseling, follow up, etc. Everyone knows they are in a scientific study. Quite often, they actually know which arm they are in. Whereas in the cohort study, in the real world, people use non-sugar sweeteners in a variety of ways. Sometimes they do it as a conscious replacement for sugars. But quite often, they just consume beverages containing non-sugar sweeteners or foods containing non-sugar sweeteners because they have a diet label on them, and they just perceive that those types of products to be healthy. Sometimes they use them as a way of having something sweeter or something that maybe they shouldn't have later on in the day. It is much more complex in the real world and obviously the real world is how these things are used. So how sweeteners are used also can contribute to these differences between what we see in highly experimental randomized controlled trials and the real world.   - [Kelly] So how do these non-sugar sweeteners cause these negative health effects?   - [Jason] We don't know for sure. Let me just say that upfront. But we have ideas and the scientific community has ideas. A lot of mechanisms have been put forth to explain how this might be happening. A lot of them are actually linked to the expression of sweet taste receptors. They are expressed in the mouth, obviously, that is how we perceive things to be sweet. But they are also expressed elsewhere in glucose sensing cells, such as the gastrointestinal tract and pancreas. So there are a number of different ways that this might work. There could be effects on taste perception, sweet taste preference, a threshold of sweet taste sensitivity, and eating behavior as it impacts on hunger or appetite. There could be other neural responses. There is this whole discussion about the hedonic response to any sweet taste. Also, there might be release of metabolic hormones, and other biological molecules, in response to non-sugar sweetener intake. Then, of course, There is a lot of buzz around potential alterations to the gut microbiome, which is a really interesting area. But There is a lot of understanding still to be gained there. Also, as noted, in terms of potential mechanism, it could be that the behavioral component we just spoke about, in terms of how people actually use non-sugar sweeteners in the real world, could also contribute to the association between non-sugar sweetener use, and body weight, and disease outcomes.   A vast number of effects happen once these things get into the body. So Francesco, let me come back to you. What is WHO recommending? I know some recommendations that have been made are conditional. What does this mean?   Francesco: So the recommendation reads that the WHO suggests that non-sugar sweeteners not be used as a means of achieving weight control, or reducing the risk of non-communicable diseases. It is a very simple one. It is basically saying that you're using the sweeteners, but they are not going to help you in weight control, or reducing the risk of that related non-communicable disease. So Kelly, as you said earlier, would I take the risk potentially associated with non-sugar sweeteners if I knew that this would benefit my weight? But in this case, what we are saying is, "Well, look, it is not going to benefit your weight control." We are leaving it there, because the purpose of this review was, particularly, to look at weight control. We were not looking at other aspects of safety - which is actually the task of other regulatory/advisory bodies, although we had to consider in the recommendation when we called the balance of benefits and harm. So here, the recommendation was clearly to say, "Well, you shouldn't use it, because there is no demonstrated benefit, and there might be some harm."   Now, WHO can make two types of recommendations. Recommendations can be strong or conditional. The decision on whether to go for the stronger condition is based on a number of factors - certainty in the supporting scientific evidence, and the balance of desirable and undesirable consequences. A strong recommendation is the recommendation for which WHO gathering group is confident that the desirable consequences of implementing the recommendation outweighs the undesirable consequences. In most situations, this would be something that government can take on immediately and use in their policymaking. A conditional recommendation is a situation where the WHO guide group is less certain about that balance between the desirable and undesirable consequences. Therefore, we are basically saying, you need to consider the context, and then decide what to do with this particular recommendation. So, in this case, why did we go for conditional? There is an element related to the balance and the evidence that Jason described earlier on. There is also an issue about short term versus longer-term consumption. We have been trying to explain why not using does not create a problem. The action also depends on the context of use of this particular product. For example, the levels of consumption in different age groups in the population. So, in a sense, our understanding of the issue, is still not complete. We believe that we need to have more science on the topic. We decided to take a bit of a conservative approach. That is why we end up saying conditional, which means we still recommend that people not use non-sugar sweeteners. But in terms of making use with this recommendation, we would like governments to also do their own assessment on how to translate this into policy practice.   So Francesco, on one hand, we have sugar being a bad actor and now the replacements for sugars can be bad actors. So how does this get balanced out? Should people go back to sugar? Should they just get used to things being less sweet? How does this work?   Francesco: So definitely people should not go back to sugars because we know that consumption of free sugars has been linked to unhealthy weight gain, type 2 diabetes, cardiovascular disease, and dental caries. We definitely maintain the recommendation that we should limit free sugar intake. But unfortunately, non-sugar sweeteners are not producing a good benefit if we replace them with sugar. What they are saying is that both free sugars and non-sugar sweeteners should be limited. So yes indeed we would need to adjust our own taste to consuming products which are less sweet. We should also ask the producers to reduce the sweetness in their product.   So Jason, do you have some thoughts you'd like to share about this?   Jason: Yes. Again, from a scientific evidence standpoint, it is interesting. If you look at the literature, and you look at the studies, and we have lots of studies now, and a lot of systematic reviews, and umbrella reviews that really tried to make sense of all of this. But if you look at some of the impacts, associations between sugar intake, and diet-related noncommunicable diseases, especially type 2 diabetes, and you look at the actual magnitude of associations, the increased risk, they are really in line with what they are for non-sugar sweeteners. In fact, some recent modeling published in 2022, modeling in the prospective cohort studies, shows that when you replace sugar with non-sugar sweetener, you basically end up with a no result. Which means that non-sugar sweeteners, at least in terms of type 2 diabetes, are just as bad for you as sugar-sweetened beverages. These studies are all looking at beverages. It is interesting that we have to keep in mind that they may both be bad actors as you indicated, Kelly.   What an amazing picture. Francesco, so do you think that non-sugar sweeteners should not be used as a harm reduction mechanism to help people reduce their sugar intake?   Francesco: Yes, that is what our recommendation basically says. We are encouraging individuals, but also government, to think of other ways to reduce sugar intake that does not require the use of sweeteners as a replacement. There are ways to do that. I mean, certainly, there are unsweetened variants of the same food or drink. There are alternatives in diet patterns. You don't necessarily have to have a dessert at every meal. You can have fruit. We know that the fruit sugars do not have the same metabolic effect as free sugars. We know that, for example, certain countries, like in the UK have given options to companies to use sweeteners instead, to avoid the sugar levy. Probably, we would ask those countries to have an assessment of what has happened and see whether that policy is still a useful one, or if it should be revised.   So Jason, I'd like to ask you about diabetes. Does the recommendations apply to people with diabetes, and can people with diabetes use these non-sugar sweeteners?   Jason: I'll tell you, that is a question we are getting a lot of. Our guidance really is for preventing the development of disease, and not for treating, or managing existing disease, including diabetes. In terms of the process, making recommendations for preventing disease is very different than making recommendations for managing disease. Different scientific evidence needs to be reviewed. In the case of diabetes, some of the evidence is overlapping. But we really do need to look at a different body of evidence and a different assessment of potential risks and benefits needs to be made. This is all in the context of a larger plan of treatment, which may also include medication, and other lifestyle changes. Therefore, managing disease requires greater input from clinicians. Something else to remember is that individuals without diabetes do have the option to include some sugar in the diet when something sweet is desired. But for many with diabetes, this isn't really an option. With that said, individuals with diabetes can certainly manage their disease without the use of non-sugar sweeteners. However, such decisions really should be made on an individual basis, and only in consultation with one's healthcare provider.   So Jason, let me ask you a question about Stevia in particular. So there are some thinking that because it is natural, unlike the artificial sweeteners, it is somehow different. So why doesn't the recommendation make distinctions between different non-sugar sweeteners?   Jason: That is a great question. Although all non-sugar sweeteners have unique chemical structures, and consequently may differ in their sweetness intensity, organoleptic properties, and routes of processing by the body, we don't make a distinction in our guidance between individual sweeteners or between so-called natural sweeteners, like Stevia, and artificial sweeteners. This is because all sweeteners, including sugar, use the same biological pathway when it comes to how we perceive them as sweet tasting, so the sweet taste receptor I mentioned earlier. And, consequently, how they might impact weight and risk of disease. Also relevant is the possibility that we discussed before, which is that people may use these in ways that promote weight gain and disease, irrespective of what type of non-sugar sweeteners being used. We feel that the evidence for a class effect is sufficient to include them together in our recommendation.   That is very helpful to know. So Francesco, some organizations, for example, the Food and Drug Administration in the US, have declared over the years that these non-sugar sweeteners are safe for use. If those organizations feel they are safe, then why is WHO recommending that they not be?   Francesco: In a sense, it is a different issue. Before any of these compounds are used in food, it has to go through this safety assessment. You mentioned the Food and Drug Administration. FAO and WHO are managing a joint expert committee on food additives that is providing advice to the Codex Alimentarius. And all these bodies, basically what they are saying is, they look at the toxicology of the products and they use animal studies. In some cases, they look at human studies. But they are basically looking at acceptable daily intakes that provide usually short term impacts. We are also encouraging these bodies to consider longer-term epidemiological studies to look at other kinds of effects. For example, at the moment there is a big debate going on because both the International Agency for Research on Cancer, and the JECFA, are looking at the safety of aspartame and considering, for example, certain longer term epidemiological human studies. These bodies are talking about certain aspects of safety and looking at the very high levels of intake. Just to give you an example, at the moment the acceptable daily intake for aspartame is about 40 milligrams per kilogram per day, which is 2.8 grams for an average individual. That is about what you would get from 14 cans of a commonly consumed drink. That is a lot. We are saying maybe that is something that can be moderated. So these bodies talk about safe or maximal levels of intake of individual sweeteners. Here, in our recommendation, we are saying this practice of replacing sweeteners with sugars is not going to lead you to improved health gains, but you're getting into an area of risk that even if it is within the agreed safety level, is something that you may want to avoid.   That is helpful context. So, what are the policy implications of all this?   Francesco: Some countries are already considering giving a warning on the content of non-sugar sweeteners in products. For example, what you have in Mexico. Some countries might decide to give the same warning if it is something that should be at least not encouraged. So that could be a way to do it. Other countries, while using nutrient profiling system, for example, for front of the pack labeling, or for marketing regulation, may decide to include sweeteners in the list of food that should be avoided. That is also happening, again, in South American countries. From our point of view, I think we would really like to give the message that the sweetness of food should be reduced. The same way we are having a dialogue with the food industry about reduction of the sugar content of food, particularly in foods that are intended for young children. We would really like to give a message that we should reduce the content of sweeteners. That is possible. And not relying entirely on sweeteners as an alternative for the reduction of sweetness or, reduction of calories, but really looking at a change in the strategies in peoples' daily diets.   Thank you, I appreciate that. You know to the extent one person can be instructed in this, 11 or 12 years ago, or so, I stopped drinking diet beverages because of the very concerns we were talking about today. I just switched over to tea with no sweetener in it at all. I'm completely accustomed to that now and I find it very enjoyable. I also find the things that I used to drink to be completely oversweet now. So people can get calibrated at different levels of sweetness, can't they?   Francesco: Absolutely. In a sense, this is the same discussion we've had with salt. I mean our capacity to adapt is there and it happens relatively quickly. People can enjoy foods without having that enormous level of sweetness. As we know, sometimes the excess presence of other salts, or sugar, or sweeteners, is some have a way to cover the lack of good taste from the other ingredients. So good foods and drinks can certainly happen without the unnecessary addition of this compound.   Bios   Jason Montez is a Scientist in the Department of Nutrition and Food Safety at the World Health Organization (WHO) in Geneva, where he works on the development, dissemination and implementation of nutrition guidance. Prior to joining WHO, Dr Montez was a consultant to WHO and other international organizations and co-founder of a biotechnology start-up. He received a PhD in Biomedical Sciences from The Rockefeller University and MPH from New York University, both located in New York, USA.  Francesco Branca is the Director of the Department of Nutrition and Food Safety at the World Health Organization (WHO), Geneva. He graduated in Medicine and Surgery and specialized in Diabetology and Metabolic Diseases at the Università Cattolica del Sacro Cuore, Roma. He obtained a PhD in Nutrition at Aberdeen University. He was a senior scientist at the Italian Food and Nutrition Research Institute (INRAN). He was President of the Federation of the European Nutrition Societies from 2003 to 2007. Rios-Leyvraz, Magali; Montez, J. “Health Effects of the Use of Non-Sugar Sweeteners: Systematic Review and Meta-analysis,” World Health Organization. https://www.who.int/publications/i/item/9789240046429 WHO guideline on use of non-sugar sweeteners https://www.who.int/publications/i/item/9789240073616

Surfing NASH returns to review the second Innovations in NAFLD Care Workshop (INCBCN) which concluded on 27 May in Barcelona. Conference founders and directors Jeff Lazarus and Jörn Schattenberg discuss highlights and takeaways of the event with Louise Campbell and Roger Green.00:00 Introduction06:14 Holistic thinking and expanding the community of practice08:00 NASH-NIT Real World Evidence Summit09:48 Louise on FibroScan proficiency 15:02 The Fatal Triple18:52 Alcohol consumption and consensus around standards of drink24:12 Exploring ideas of preventative hepatology31:38 Session 2: Endocrinology and Diabetology in the early diagnosis and management of NASH35:43 Poster presentations37:02 Session 3: NAFLD Diagnostics40:42 Session 4: NAFLD Treatment and Care 47:13 Closing question: any surprising audience responses?Listen on to discover the details as revealed in the full episode. If you have questions or interest around the Innovations in NAFLD Care Workshop 2023, we kindly ask that you submit reviews wherever you download our discussions. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

In this episode of Dia-Logue: The Diapoint Podcast, we continue our discussion about Continuous Glucose Monitors (CGMs) use in people without diabetes. In part 2 of this conversation, we speak with the team from Glucare Health, a diabetes clinic based in Dubai, UAE. Dr. Yousef Said, a specialist in Internal Medicine and Diabetology, and Ihsan Almarzouqi, the Co-Founder and Managing director of Glucare, join Pam to go deeper into the discussion. Not only is Ihsan an expert in diabetes, but he is also a former Olympic athlete, so he shares his special insights with us. Both of these diabetes experts bring a fresh perspective to the question, "If you don't have diabetes, do you need a CGM?" Looking for Part 1 of this conversation on CGMs? Join the Diapoint mailing list for exclusive insights and offers: diapointme.com/join-the-diapointme-mailing-list/ Visit the D-Shop where we offer beautiful, practical diabetes supplies and lifestyle accessories: https://www.diapointshop.com/  Home study program for parents of school-aged children with Type 1 Diabetes: https://www.diapointlearning.com/courses/the-ultimate-type-1-diabetes-school-game-plan    Diabetes resources: https://www.diapointme.com/diabetes-wellness-resources/  Diapoint is the place for people touched by diabetes. For more information and full details of our work, visit diapointme.com where you'll also find our social media links and any resources mentioned in the episode. Subscribe to the podcast so you get notifications for all our episodes, and please share it on social media or with anyone you think could benefit from this free content.

The story of the discovery and development of insulin is a tale full of twists and turns, Nobel prizes and fierce rivalries. Scientists in the late 19th Century established the connection between the pancreas and diabetes, isolated the hormone insulin, and even patented the extract that lowered blood sugar. But it was not until a Canadian team published results in 1922 of their attempts to inject insulin into a patient that diabetes was transformed from a fatal condition to a manageable one. Bridget Kendall is joined by science historian Dr Alison Li, who has studied the life of one of insulin's early pioneers in her book J.B. Collip and the development of medical research in Canada; Dr Viktor Joergens, a retired diabetologist who for more than two decades was the executive director of the European Association for the Study of Diabetes. He is also the co-author of Unveiling Diabetes: Milestones in Diabetology; and Dr Kersten Hall, visiting fellow in the Department of History and Philosophy of Science at the University of Leeds, and the author of Insulin - The Crooked Timber: A History From Thick Brown Muck to Wall Street Gold. Producer: Fiona Clampin (Photo: Charles Herbert Best, Canadian physiologist who assisted Frederick Banting to isolate Insulin, in his laboratory. Credit: Universal History Archive/Getty Images)

Dr. Nihar Mehta is a leading Consultant Cardiologist in Mumbai with over 10 years of experience. He is a specialist in Interventional Cardiology, Structural Heart Disease Intervention, NonInvasive Cardiology, Heart Failure & Hypertension. He completed his MBBS and MD (Medicine) from KJ Somaiya Hospital & Research Centre, followed by his C. Diabetology from the College of Physicians & Surgeons, Mumbai. He later pursued DNB (Medicine) from the National Board of Examination, New Delhi, and DNB (Cardiology) from the Jaslok Hospital & Research Centre, Mumbai. He did his Fellowship in Interventional Cardiology & Cardiovascular Imaging. He has completed various certificate and training courses from many prestigious institutions, around the world.

In this episode, Per-Ola Carlsson joins us to discuss his latest research. Dr. Carlsson's work focuses on developing means to intervene with the development of type 1 diabetes mellitus and find treatment strategies to restore glucose homeostasis in patients with type 1 using cell therapy. Want to read more about his work? Checkout a recent publication, Better HbA1c during the first years after diagnosis of type 1 diabetes is associated with residual C peptide 10 years later

Priya Mishra, Exante's CEO, sits down with Dr. V.Mohan to talk about the Healthcare industry. At $ 8 trillion, it is the largest industry in the world. It is also a very sophisticated industry with a high degree of research and innovation. Yet, in the current pandemic of Covid-19, thousands of people across the world have failed to receive adequate hospital care and medical attention. ABOUT DR. V.MOHAN Dr V Mohan is an internationally renowned Indian diabetologist. He is the Chairman and Chief of Diabetology at Dr. Mohan’s Diabetes Specialities Centre, a WHO Collaborating Centre for Noncommunicable Diseases Prevention and Control and an IDF Center of Education. Dr. Mohan is also President and Director of Madras Diabetes Research Foundation. He worked at the Royal Post Graduate Medical School, London as a Wellcome Research Fellow and at the Alexander Von Humboldt Fellow at the University Of Ulm, West Germany. He has over 1200 publications in peer-reviewed journals like Lancet, British Medical Journal, Journal of Clinical Endocrinology & Metabolism, Diabetic Medicine, Diabetes Research, and Clinical Practice. Dr. Mohan was awarded the Padma Shri (Fourth highest civilian award in the Republic of India)

In this episode, ITB's new host Pranay Bonagiri breaks down some diabetes questions with Dr. Shubrook! Dr. Shubrook is a board-certified family medicine physician and diabetologist. He attended University of California, Santa Cruz for undergrad and Ohio University College of Osteopathic Medicine for medical school. Dr. Shubrook then went on to complete his residency at Firelands Regional Health System in Sandusky, OH. After working in primar care for a decade, Dr. Shubrook went back to OU to complete his diabetology fellowship. Dr. Shubrook then spent many years as the Director of the Clinical Division at the Diabetes Institute at Ohio University and Director of Clinical Research and Director of the Diabetes Fellowship at OU-HCOM. He now serves as a professor in the Primary Care Department at the Touro University California College of Osteopathic Medicine as well as the Director of Clinical Research and Director of Diabetes Services. Additionally, he has served on numerous national committees developing diabetes care guidelines and has been published extensively in the field of diabetology. ITB Audio Qbank and iOS Beta App The Audio Qbank by InsideTheBoards mobile app has both free and premium features and is available on both Android and iOS.  To get started, first, create a Boardsinsider Account on our website insidetheboards.com Free Features  All of our podcasts in one place organized into playlists for easy studying (also with less ads and exclusive content)  Mindfulness meditations designed specifically for medical students  A monthly offering of high yield content (questions dissections, audio qbank samples) available only on our mobile app.  Premium Features Subscribe to an ITB premium account and get additional features  Access to 500+ audio optimized board style practice questions in our Audio Qbank. The Step 1 version is powered by Exam Circle and the Step 2 Version is powered by OnlineMedEd. New questions added each month.  High Yield Pharmacology (powered by Lecturio) with 100 of the top pharm questions you need to know for both Step 1 and Step 2  Audio Flashcards (coming soon)  Our audio qbank is THE PERFECT companion for studying for the boards on the go. And we're adding content and improving it all the time.   Learn more about the Audio Qbank by InsideTheBoards mobile app here USMLE Step 2 Secrets is now an InsideTheBoards Podcast  As a book, USMLE Step 2 Secrets, by Theodore X. O’Connell, MD, ITB's Chief Content Officer and (among many other things) author of Crush Step 1: The Ultimate USMLE Step 1 Review, is recognized as an effective, high-yield study tool for the USMLE Step 2 and COMLEX Level 2. Plus....BONUS...it fits easily into a "short white coat" pocket. Check out all of ITB's Podcasts on our BRAND NEW Website Legal Stuff and Credits InsideTheBoards is not affiliated with the NBME, USMLE, COMLEX, NBOME or any professional licensing body. InsideTheBoards and its partners fully adhere to the policies on irregular conduct outlined by the aforementioned credentialing bodies.

Join our experts in cardiology and diabetes discussing latest updates and practical guidance for patients with T2D at increased CV risk.   Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/931511?src=mkm_podcast_addon_931511

Internal Medicine and Diabetology

Chairman and Chief of Diabetology, Dr. Mohan's Diabetes Specialities Centre

Diabetology and Cardiology, Shilpa medical centre in Dahisar, Mumbai

Join our experts in cardiology and diabetes discussing latest updates and practical guidance for patients with T2D at increased CV risk. Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/931511?src=mkm_podcast_addon_931511

What kind of masks should you wear? How many people have had COVID-19 and don’t know? Do antibody tests work? When will we have a vaccine? Is it okay to picnic? Will there be a second wave? You need updates and we’ve got ologists. The wonderful Dr. Shannon Bennett from the first Virology episode joins us again, as well as New York City physician Dr. Mike Natter from the Diabetology episode. These two warm, informed professions dispel rumors, explain what life has been like on the front lines, address medications, describe new symptoms, “proning,” rates of asymptomatic folks, where to wear a mask, how to use gloves and whether or not the balcony saucepan symphonies at 7pm every night delight or annoy them. We’re in this for the long haul folks, but we’ve got each other.  Follow Dr. Mike Natter at Instagram.com/mike.natter or Twitter.com/mike_natter Dr. Shannon Bennett at twitter.com/microbeexplorer and Instagram.com/microbeexplorer Donations went to Food Bank for New York and California Academy of Sciences  Check out the podcast Science Vs.  More Ologies Coronasodes: Virology, All (Washed) Hands on Deck More links at alieward.com/ologies/virology2 Transcripts & bleeped episodes at: alieward.com/ologies-extras Become a patron of Ologies for as little as a buck a month: www.Patreon.com/ologies OlogiesMerch.com has hats, shirts, pins, totes and STIIIICKERS! Follow twitter.com/ologies or instagram.com/ologies Follow twitter.com/AlieWard or instagram.com/AlieWard Sound editing by Jarrett Sleeper of MindJam Media & Steven Ray Morris Theme song by Nick Thorburn Support the show.

HypoparaExchange Special: Diagnosing the rare disease hypopara The fourth episode of our podcast series, HypoparaExchange, is a special release to coincide with Rare Disease Day 2020. In this episode, we hear from Professor Karin Amrein, from the Medical University of Graz, Austria, Division for Endocrinology and Diabetology, in conversation with Conor, a patient from Ireland who has lived with the condition since the age of three. The conversations discuss the rarity of hypoparathyroidism, with an in-depth view into one of the many rare non-surgical forms of the condition. As well as discussing the difficulty of diagnosis, Conor also shares his experience of living with a rare disease, with Professor Amrein sharing her perspectives on clinical care experience with newly diagnosed patients. The HypoparaExchange series is moderated by science writer, broadcaster and BBC journalist, Vivienne Parry. This podcast was produced and funded by Takeda and is available to the public for information purposes only; it should not be used for diagnosis or treating health problems or disease. It is not intended to substitute for consultation with a healthcare provider. Please consult your healthcare provider for further advice. The impact of the symptoms of hypopara described in this podcast are based on a single person's experience and perspective of living with the condition, described in their own words. Not all people living with the condition will experience the same symptoms. Job code: S53317 Date of preparation: January 2020

Diabetic diabetologist and wonderful person Dr. Mike Natter, MD is back to answer all of your questions about blood sugar, the cost of insulin, pancreas transplants, keto, glucagon, how exercise can save your life, his most meaningful interactions with patients, pudding theft, and the best place to cry at work. Also: why you should always keep frosting in your purse. This episode is swear-free and okay for all ages, and a bleeped version of Diabetology Part 1 can be found at this link.  Follow Dr. Mike Natter at Instagram.com/mike.natter or at Twitter.com/mike_natter A donation went to: JDRF.org  Sponsor links: LinkedIn.com/ologies; HelloFresh.com/ologies10 (code: ologies10) More links at alieward.com/ologies/diabetology Transcripts & bleeped episodes at: alieward.com/ologies-extras Become a patron of Ologies for as little as a buck a month: www.Patreon.com/ologies OlogiesMerch.com has hats, shirts, pins, totes and STIIIICKERS! Follow twitter.com/ologies or instagram.com/ologies Follow twitter.com/AlieWard or instagram.com/AlieWard Sound editing by Jarrett Sleeper of MindJam Media & Steven Ray Morris Theme song by Nick Thorburn Support the show.

Your blood sugar can make you happy, moody, sweaty, unconscious and possibly even homicidal. In this episode, Dr. Mike Natter dishes about how blood sugar works, what insulin does, and how prevalent diabetes is in all of its various forms. Also: keto vs. vegan, hypoglycemia, cyborg organs, owl hoots, gestational diabetes, type 1 vs. type 2 and ... does Gwyneth drink her own pee? Also: the emotional side of the disease and how to help those in your life who are diabetic.  Next week, the doc addresses your questions, from diets to diagnoses to infuriating insulin prices.  Follow Dr. Mike Natter at Instagram.com/mike.natter or at Twitter.com/mike_natter A donation went to: beyondtype1.org Sponsor links: thegreatcoursesplus.com/OLOGIES; ZOLA.com/ologies (code:SAVE50); betterhelp.com/ologies More links at alieward.com/ologies/diabetology Transcripts & bleeped episodes at: alieward.com/ologies-extras Become a patron of Ologies for as little as a buck a month: www.Patreon.com/ologies OlogiesMerch.com has hats, shirts, pins, totes and STIIIICKERS! Follow twitter.com/ologies or instagram.com/ologies Follow twitter.com/AlieWard or instagram.com/AlieWard Sound editing by Jarrett Sleeper of MindJam Media & Steven Ray Morris Theme song by Nick Thorburn Support the show.

Soundbites from the International Diabetes Federation Congress 2019, held in Busan, Korea. Hear from Julia Mader, Associate Professor of Medicine (Endocrinology & Diabetology) at the University of Graz, Austria Prof. Mader discusses: - What is 2 vs 8760? - Challenges of continuous glucose monitoring back in 2005 - Does iPDM add to the physician’s workload? Does it improve the patient-physician relationship? - The importance of teaching patients the advantages of iPDM and using new technologies - How some patients find it hard to stick with iPDM and adhere to their diabetes management program - Disease outcomes of patients using iPDM vs patients sticking with traditional care - What's next for drug development for type 1 and type 2 diabetes Follow me on twitter @JChanPharma Follow the Asia Healthcare Podcast! https://siryn.co/asia-healthcare-podcast https://anchor.fm/asiahealthcare

Type 2 diabetes is a complex systems disease, caused by interactions between lifestyle and genes. It is an illusion to believe that it can be cured by medication. Lifestyle change should always be at the heart of treatment. Hanno Pijl is an internist-endocrinologist and professor of Diabetology at the Leiden University Medical Center (LUMC) In Leiden, The Netherlands. He co-authored over 250 papers in peer reviewed scientific journals, primarily related to obesity and type 2 diabetes. He has been a member of the Dutch Health Council (standing committee on nutrition) from 2008-2016. He currently co-chairs the Dutch Innovation center for Lifestyle Medicine (www.nilg.eu), a joint effort of LUMC and the Dutch Organisation of Applied Science (TNO) focusing on lifestyle interventions in health care.   Esther van Zuuren is a dermatologist at the Leiden University Medical Centre, but apart from that and more relevant for now is that her expertise lies in Evidence Based Medicine. She has been with Cochrane for almost 20 years, has held the position of Key Editor and Methods editor for Cochrane Skin group for several years and conducted over 30 systematic reviews on a wide variety of topics. Furthermore, she is member of the GRADE working group, is a Recommendations Editor for DynaMed Plus (clinical evidence-based reference tool for clinicians) and Associate Editor for Systematic Reviews for the British Journal of Dermatology. In our 20 min conversation we discuss Dietary advice for people with type 2 diabetes The importance of other lifestyle measures Effects of lifestyle intervention in clinical practice Patient preferences

Contrary to the long held contention that low fat diets are best for people with type 2 diabetes (DM2), the totality of current evidence suggests that low carb diets are at least as effective in ameliorating metabolic health in DM2. In fact, low carb seems to be somewhat better, particularly in the short to medium term, although the evidence is of moderate certainty.   On this week’s episode Prof Hanno Pijl (@HannoPijl) and dr Esther van Zuuren (@Ezzoef) join Dr Aseem Malhotra (@DrAseemMalhotra) to discuss the most appropriate diet for people with DM2   Hanno Pijl is an internist-endocrinologist and professor of Diabetology at the Leiden University Medical Center (LUMC) In Leiden, The Netherlands. He co-authored over 250 papers in peer reviewed scientific journals, primarily related to obesity and type 2 diabetes. He has been a member of the Dutch Health Council (standing committee on nutrition) from 2008-2016. He currently co-chairs the Dutch Innovation center for Lifestyle Medicine (www.nilg.eu), a joint effort of LUMC and the Dutch Organisation of Applied Science (TNO) focusing on lifestyle interventions in health care.   Esther van Zuuren is a dermatologist at the Leiden University Medical Centre, but apart from that and more relevant for now is that her expertise lies in Evidence Based Medicine. She has been with Cochrane for almost 20 years, has held the position of Key Editor and Methods editor for Cochrane Skin group for several years and conducted over 30 systematic reviews on a wide variety of topics. Furthermore, she is member of the GRADE working group, is a Recommendations Editor for DynaMed Plus (clinical evidence-based reference tool for clinicians) and Associate Editor for Systematic Reviews for the British Journal of Dermatology   In our 20 min conversation we discuss   Efficacy of low fat versus low carb diets in the treatment of type 2 diabetes The method of weighing the certainty of evidence we used in our systematic review of the literature Dietary recommendations for people with type 2 diabetes https://academic.oup.com/ajcn/article-abstract/108/2/300/5051863

This  week,  I  welcome  Dr.  Jeff  Stanley  of  Virta  Health  back  to  the  podcast  to  discuss the  results  from  their  one-year  Cardiovascular  Risk  Factor  Assessment  clinical  trial.  The  results, which  are  published  in  the  peer-reviewed  publication  Cardiovascular  Diabetology,  include  some very  impressive  findings.  Findings that may just shake up conventional wisdom about a high fat diet. During  our  conversation,  we  discuss  the  details of the trial, and also explore practical implications of a ketogenic diet, intermittent  fasting,  macro  calculations,  and  beta-hydroxybutyrate  measurements. Dr Stanley and Virta health have already revolutionized the way we treat diabetes, and this latest trial only furthers that mission.   Key Takeaways:   [4:31] Virta Health's method is to safely and sustainably reverse type 2 diabetes. [9:08] New data will soon be published by Virta. [13:42] The guidelines and macro data Virta uses with patients. [19:25] Advice for people seeking information on a ketogenic diet from their doctor. [22:15] Obstacles patients face with staying compliant to treatment and lifestyle changes. [26:12] Virta's priority when discussing intermittent fasting is safety, safety, safety. [30:26] What does the cardiovascular intervention trial data show after one year? [51:55] What pushback is Virta experiencing after publishing their results?   Mentioned in This Episode: Low Carb Cardiologist Website Dr. Scher on Twitter Dr. Scher on Facebook Virta Health Low Carb Cardiologist Podcast with Dr. Jeff Stanley Episode #11 Low Carb Cardiologist Podcast with Dr. Victor Montori Episode #30   This Episode is Sponsored by:   Oura Ring Sleep Tracking Technology helps improve your understanding of the depth, quality, and length of your sleep. Visit OuraRing.com and at checkout use the code ‘LOWCARBCARDIOLOGIST' to get $50 off your order.

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil: data from the Brazilian Type 1 Diabetes Study Group. Diabetology & Metabolic Syndrome 2015, 7:87

Dr. Jean Louis Selam is at the Diabetes Research Center near Los Angeles, which does clinical studies on Type 1 and Type 2 diabetes. Dr. Selam received his undergraduate education and medical doctorate in France, University of Montpelier. He has been a specialist in internal medicine and endocrinology in France since 1979 and licensed in California since 1987. He has worked as an associate professor at University of California Irvine Diabetes Research Program 1986-90 then as an associate professor at University Medical School of Paris, dept of Diabetology 1990-2003. He was appointed in 2005 as Visiting Professor by the USC School of Medicine, Los Angeles. He is the Editor in Chief of the Journals Infusystems, which he founded in 1983, a world leading journal in the field of insulin delivery systems.

Dr. Jean Louis Selam is at the Diabetes Research Center near Los Angeles, which does clinical studies on Type 1 and Type 2 diabetes. Dr. Selam received his undergraduate education and medical doctorate in France, University of Montpelier. He has been a specialist in internal medicine and endocrinology in France since 1979 and licensed in California since 1987. He has worked as an associate professor at University of California Irvine Diabetes Research Program 1986-90 then as an associate professor at University Medical School of Paris, dept of Diabetology 1990-2003. He was appointed in 2005 as Visiting Professor by the USC School of Medicine, Los Angeles. He is the Editor in Chief of the Journals Infusystems, which he founded in 1983, a world leading journal in the field of insulin delivery systems.

Dr. Jean Louis Selam is at the Diabetes Research Center near Los Angeles, which does clinical studies on Type 1 and Type 2 diabetes.Dr. Selam received his undergraduate education and medical doctorate in France, University of Montpelier. He has been a specialist in internal medicine and endocrinology in France since 1979 and licensed in California since 1987. He has worked as an associate professor at University of California Irvine Diabetes Research Program 1986-90 then as an associate professor at University Medical School of Paris, dept of Diabetology 1990-2003. He was appointed in 2005 as Visiting Professor by the USC School of Medicine, Los Angeles.He is the Editor in Chief of the Journals Infusystems, which he founded in 1983, a world leading journal in the field of insulin delivery systems.

Dr. Jean Louis Selam is at the Diabetes Research Center near Los Angeles, which does clinical studies on Type 1 and Type 2 diabetes.Dr. Selam received his undergraduate education and medical doctorate in France, University of Montpelier. He has been a specialist in internal medicine and endocrinology in France since 1979 and licensed in California since 1987. He has worked as an associate professor at University of California Irvine Diabetes Research Program 1986-90 then as an associate professor at University Medical School of Paris, dept of Diabetology 1990-2003. He was appointed in 2005 as Visiting Professor by the USC School of Medicine, Los Angeles.He is the Editor in Chief of the Journals Infusystems, which he founded in 1983, a world leading journal in the field of insulin delivery systems.