Podcast appearances and mentions of diana isaacs

Dr. Tamara Ruggles (Host): www.linkedin.com/in/tamara-ruggles-491882251 Dr. Diana Isaacs (guest):  linkedin.com/in/diana-isaacs-pharmd-bcps-bcacp-bc-adm-cdces-45803426

Video Version Only on HCPLive! In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, break down new Phase 3 data from the ESSENCE trial examining semaglutide 2.4 mg (Wegovy) for metabolic dysfunction-associated steatohepatitis (MASH) with stage 2 or 3 fibrosis. With results published in The New England Journal of Medicine, hosts are joined by first author Arun J. Sanyal, MD, director of the Stravitz-Sanyal Institute for Liver Disease and Metabolic Health at Virginia Commonwealth University, to discuss key takeaways from part 1 of the ESSENCE trial, semaglutide's impact on liver outcomes and weight loss, and what the data could mean for the future of MASH treatment. ESSENCE Once-weekly semaglutide 2.4 mg significantly improved liver outcomes in patients with metabolic dysfunction–associated steatohepatitis (MASH) and stage 2 or 3 fibrosis, according to findings from the ESSENCE trial. In part 1 of the ongoing, double-blind, placebo-controlled trial, 800 patients were evaluated at 72 weeks for two primary endpoints: resolution of steatohepatitis without worsening fibrosis, and fibrosis improvement without worsening steatohepatitis. Spanning 253 sites in 37 countries, the full trial enrolled 1197 biopsy-confirmed patients between May 2021 and April 2023. At the interim analysis, semaglutide achieved both primary endpoints. Resolution of steatohepatitis without fibrosis worsening occurred in 62.9% of patients receiving semaglutide compared with 34.3% in the placebo group (difference, 28.7%; 95% CI, 21.1–36.2; P

Video Version Only on HCPLive! In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss the newly published findings from the CATALYST trial, a prospective, observational study establishing the prevalence of hypercortisolism among individuals with difficult-to-control type 2 diabetes (T2D). CATALYST enrolled 1057 adults with T2D and suboptimal glycemic control (HbA1c, 7.5–11.5%) despite treatment with ≥2 glucose-lowering agents. All participants underwent a 1-mg overnight dexamethasone suppression test (DST), and common confounders were excluded. Hypercortisolism—defined as a post-DST cortisol level >1.8 µg/dL—was identified in 23.8% of participants, with even higher rates among those with cardiac disease (33.3%) or on ≥3 antihypertensives (36.6%). Adrenal imaging revealed abnormalities in about one-third of affected individuals. Isaacs and Bellini emphasized how striking it is that such a high proportion of patients met criteria for hypercortisolism, a condition historically considered rare. The trial challenges that perception, revealing that clinical features like persistent hyperglycemia and hypertension—despite optimized therapy—could reflect underlying endocrine dysfunction. They noted that neither A1c nor body mass index (BMI) alone predicted elevated cortisol, although medication intensity and comorbid conditions did. The conversation explored how the recognition of hypercortisolism could alter clinical management. Future studies will assess whether targeted treatments—such as cortisol-lowering pharmacotherapy, including mifepristone (Korlym), or adrenal surgery—can reduce medication burden, improve glycemic control, and lower cardiovascular risk. Isaacs and Bellini pointed out that many patients with hypercortisolism present without the classic phenotype, underscoring the importance of broader screening criteria. Looking ahead, they called for greater awareness among clinicians to consider screening in patients on intensive diabetes and blood pressure regimens who still fail to reach therapeutic goals. Identifying and treating hypercortisolism could open a new pathway to improving outcomes in this population. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Key Episode Timestamps 00:00:01 Catalyst Trial Overview and Introduction 00:01:37 Patient Criteria and Initial Findings 00:04:18 Implications and Next Steps 00:05:23 Adrenal Imaging and Cardiac Disorders 00:07:22 Clinical Implications and Future Research 00:09:13 Demographic Differences and Future Directions

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

Join endocrine experts Lubaina S. Presswala, DO, FACOI, FACE; Diana Isaacs, PharmD, BCPS, BC-ADM, CDCES, FADCES; and Viral N. Shah, MD, FACE, as they explore the latest in continuous glucose monitors (CGMs) and automated insulin delivery (AID) systems for managing diabetes. In this episode, they discuss the practical applications of diabetes technology, patient selection, shared decision-making, and considerations for device use in specific populations, including athletes and pregnant individuals. This conversation provides valuable insights to help clinicians navigate device options and enhance outcomes across diverse patient scenarios.

In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, are joined by Rifka Schulman-Rosenbaum, MD, director of inpatient diabetes at Long Island Jewish Medical Center and co-author of Establishing Screening Programs for Pre-symptomatic Type 1 Diabetes: Practical Guidance for Diabetes Care Providers, a new paper in the Journal of Clinical Endocrinology and Metabolism. With Bellini as a co-author of the piece, experts explored the increasing clinical and operational momentum behind screening for pre-symptomatic type 1 diabetes (T1D) and what it takes to implement effective programs in real-world settings. The conversation centers on the rationale and logistics behind identifying individuals in stages 1 and 2 of T1D—autoimmune stages characterized by multiple islet autoantibodies before clinical onset. With the availability of teplizumab (Tzield), a disease-modifying therapy shown to delay progression to stage 3 of T1D, the importance of early detection and standardized screening protocols has become more urgent. Schulman-Rosenbaum outlined how her work on the JDRF Breakthrough T1D initiative led to the development of actionable guidance aimed at frontline diabetes care providers. She highlights barriers to implementation—such as limited provider awareness of T1D staging and screening protocols—and details her institution's ongoing efforts to educate primary care clinicians and endocrinologists, including distributing screening handouts and creating streamlined workflows using dot phrases and dedicated follow-up slots. The discussion emphasizes targeted screening for high-risk groups, such as first- and second-degree relatives of individuals with T1D and patients with autoimmune diseases like Hashimoto's or celiac. Schulman-Rosenbaum emphasized the opportunity for endocrinologists to screen these patients directly during routine care and the utility of a centralized handout to guide test ordering and family engagement. Drawing from their paper, experts outlined practical steps for launching autoantibody screening programs: nominating a program champion, forming an implementation team, and embedding screening into existing clinical systems. Experts stressed the importance of using appropriate ICD-10 codes for insurance coverage and referenced a diagnostic coding table in their publication. Schulman-Rosenbaum also addressed the widespread issue of misdiagnosis, particularly in adults mistakenly classified as having type 2 diabetes, and outlines best practices for using antibody and C-peptide testing to refine diagnosis. She detailed her hospital's approach to inpatient screening, noting an increased use of autoantibody testing and follow-up coordination for patients with suspected T1D or latent autoimmune diabetes in adults (LADA). Finally, the episode highlighted how to monitor individuals who test positive for a single antibody or exhibit mild dysglycemia, noting that many fall outside established risk categories. Experts called for more research in this area and advocate for individualized monitoring strategies based on clinical risk, family history, and emerging glucose patterns—often using continuous glucose monitoring (CGM) data. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Key Episode Timestamps 00:00:00 Introduction 00:02:18 Inspiration Behind the Paper 00:04:12 Challenges in Implementing T1D Screening 00:07:32 Educating Providers and Overcoming Barriers 00:09:32 Addressing Misdiagnosis of Diabetes 00:12:01 Inpatient Screening Practices 00:16:13 Support and Resources for Patients with Positive Antibodies 00:20:01 Conclusion and Final Thoughts

Video Version Only on HCPLive! In this episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, explored two key trial updates in type 2 diabetes (T2D) care at the American College of Cardiology (ACC) 2025 Annual Scientific Sessions. SOUL Trial SOUL, a double-blind, placebo-controlled, event-driven trial, was designed to assess the cardiovascular effects of oral semaglutide (Rybelsus) in patients with T2D and atherosclerotic cardiovascular disease (ASCVD) and/or chronic kidney disease (CKD). A total of 9650 patients aged ≥50 years were enrolled across 450 centers in 44 countries. Analyses showed oral semaglutide (Rybelsus) was linked to a 14% reduction in major adverse cardiovascular events (MACE) in high-risk patients with T2D. This reduction included the incidence of cardiovascular (CV) death, myocardial infarction (MI), or stroke compared to placebo (HR, 0.86; 95% CI, 0.77 to 0.96; P = .006) over a median follow-up of 47.5 months. A 26% reduction in non-fatal MI was the primary driver of benefit, while safety findings identified gastrointestinal adverse events as more common with oral semaglutide. Based on these results, Novo Nordisk announced plans to pursue regulatory approval for a label expansion of oral semaglutide to include MACE risk reduction in adults with T2D and established CV disease. STRIDE Trial STRIDE, a double-blind, randomized, placebo-controlled trial initiated in 2020, assessed the effects of semaglutide 1.0 mg (Ozempic) on functional outcomes, including walking distance, in patients with T2D and peripheral artery disease (PAD). Conducted across 112 sites in 20 countries, the trial randomized 792 patients to receive semaglutide or placebo for 52 weeks. Analyses showed semaglutide use was associated with improvements in maximal walking distance, quality of life, and ankle-brachial index (ABI). SOUL met its primary endpoint, with semaglutide favoring the ratio from baseline in maximum walking distance at 52 weeks (1.21 [interquartile range, 0.95–1.55] vs 1.08 [0.86–1.36]), with an estimated treatment ratio (ETR) of 1.13 (95% CI, 1.06–1.21; P = .0004). At week 57, the improvement in walking distance was higher with semaglutide (ETR, 1.08; P = .038). Quality-of-life scores (VascuQoL-6) at week 52 were significantly higher in the semaglutide group (median difference, 1.00; P = .011), as were improvements in pain-free walking distance (ETR, 1.11; P = .0046). Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Editor's Note: In this episode, there was an error in the discussion about the new dosing for Rybelsus in the SOUL trial. The corrected information is that the 14 mg dose is now 9 mg with the new formulation, due to improved absorption. The full corrected statement is: “Instead of 3 mg, the new dose is 1.5 mg; instead of 7 mg, it's 4 mg; and instead of 14 mg, it's 9 mg.”

Video Version Only on HCPLive! In this episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, reflect on major announcements and product updates from the Advanced Technologies & Treatments for Diabetes (ATTD) 2025 annual conference. The conversation opens with insights into Medtronic's new Simplera CGM, emphasizing its single-use, disposable design and fully disposable on-body form factor. The hosts highlight improvements over previous iterations, such as the absence of an inserter and a more streamlined adhesive system. Although accuracy data have yet to be released, Medtronic has initiated a pivotal trial, and expectations are high for competitive MARD performance. They then turn to Tandem Diabetes Care's Tandem Mobi pump, recently launched in the US market. The pump's compact size and phone control interface are praised for improving convenience and discretion. Bellini underscores how Mobi shifts the paradigm for pump wearability, with early feedback from patients indicating high satisfaction. Later, the hosts discuss Beta Bionics' insulin-only iLet Bionic Pancreas system, which has expanded availability in the U.S. They review recent clinical updates and ongoing efforts to integrate real-world user data. The system's unique algorithm, which doesn't require manual carb counting or standard pre-programming, continues to generate interest across clinical settings. Additional topics include anticipated innovation from Lilly's new pump platform, the competitive implications for CGM integration, and an emphasis on patient-centered device design. The episode closes with Isaacs and Bellini reflecting on the rapid evolution of diabetes technology and how practitioners can stay current with emerging tools and evidence-based practices. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Editor's Note: Control-IQ+ technology is cleared by the FDA for use in adults with type 2 diabetes in the United States, as of February 25, 2025. The podcast episode erroneously positioned the indication as forthcoming. On March 18, 2025, Tandem Diabetes Care announced the commercial launch, making Control-IQ+ available for people with type 1 diabetes ages 2 years and older and adults with type 2 diabetes.

Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, joined Over the Counter to discuss pharmacists' role in counseling patients on GLP-1s as well as the common trends, challenges, and successes she's seen among her patient population. 

Video Version Only on HCPLive! In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center speak with Laurel Messer, PhD, RN, senior director of medical affairs at Tandem Diabetes Care, about the latest advancements in Control-IQ+, the company's next-generation automated insulin delivery (AID) technology. With clearance received from the US Food and Drug Administration (FDA) in February 2025, Tandem announced on March 18, 2025, that the Control-IQ+ hybrid closed-loop algorithm is now available for use in adults with type 2 diabetes (T2D) aged ≥18 years alongside people with type 1 diabetes (T1D) aged ≥2 years. Enhancements to the algorithm included a broader weight range (20–440 lbs) and insulin dosing parameters (5–200 units), representing a more inclusive algorithm. In this episode, Messer highlighted other new features in the updated algorithm, such as temp basal rate adjustments for exercise or illness and an extended bolus option of up to eight hours, which enhances flexibility in insulin management during meals. Messer also emphasized that Control-IQ+ offers a unique advantage: the ability to fine-tune correction factors, allowing providers to tailor insulin delivery for improved glycemic control. With the AutoBolus feature, Control-IQ+ predicts and corrects hyperglycemia every hour, significantly benefiting individuals who struggle with consistent mealtime bolusing. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Important Safety Information: RX ONLY. Indicated for patients with type 1 diabetes, 2 years and older and for patients with type 2 diabetes, 18 years and older. BOXED WARNING: Control-IQ+ technology should not be used in anyone under the age of 2 years old with type 1 diabetes or under the age of 18 years old with type 2 diabetes. It should also not be used in patients who require less than a total daily insulin dose of 5 units of insulin per day or who weigh less than 20 pounds, as those are the required minimum values needed for Control-IQ+ to operate safely. Safety info: tandemdiabetes.com/safetyinfo.

If I take Ozempic, Wegovy, Mounjaro, Zepbound, or any other GLP-1 weight loss drug, will I need to take it forever? What are the side effects of Ozempic? Do we know the long term effects of these weight loss drugs?Can Ozempic be prescribed for women in perimenopause or menopause? What can women do to create sustainable weight loss? How can we lose the weight and keep it off?Diana Isaacs, an endocrinology clinical pharmacy specialist answers the questions above and many others, as they pertain to the safety, sustainability and effectiveness of GLP-1 drugs. Diana serves as the Co-Director of Endocrine Disorders in Pregnancy and the Director of Education and Training in Diabetes Technology at the Cleveland Clinic Endocrinology and Metabolism Institute.From this educational conversation, I learned that certain GLP-1 medications can be used to lower blood pressure, help with cardiovascular disease, kidney disease, and sleep apnea!To be connected with Diana Isaacs, please email Vera Kessler, host of America's Top Rebbetzins at atrebbetzins@gmail.com

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss a pair of recently published studies examining the use of diabetes technology in adults with type 2 diabetes. SECURE-T2D A single-arm prospective study conducted at 21 US clinical centers, SECURE-T2D assessed the impact of automated insulin delivery (AID) on glycemic control in adults with type 2 diabetes using insulin for at least 3 months. The study enrolled 305 participants (mean age, 57 years; 57% female), with a diverse racial and ethnic representation, including 24% Black and 22% Hispanic or Latino. Following a 14-day standard therapy phase, participants used the Omnipod 5 AID system for 13 weeks. HbA1c decreased from 8.2% (SD, 1.3) at baseline to 7.4% (SD, 0.9) (mean difference, -0.8 percentage points; 95% CI, -1.0 to -0.7; P

Video Version Only on HCPLive! In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, explore the updated American Diabetes (ADA) 2025 Standards of Care, focusing on therapeutic advancements in diabetes management. Hosts discussed the significant changes to treatment algorithms and new guidance designed to enhance outcomes for people with diabetes and related conditions. One of the major updates discussed is the expanded flexibility in the treatment algorithm for type 2 diabetes (T2D) and chronic kidney disease (CKD), including glucagon-like peptide-1 receptor agonists (GLP-1 RA), such as semaglutide, as an alternative to patients who may not tolerate sodium-glucose co-transporter 2 (SGLT2) inhibitors. Isaacs and Bellini emphasized the complementary benefits of combining these therapies, particularly for kidney protection and glucose management. The episode also highlighted updates on the use of GLP-1 RAs for patients with obesity-related heart failure with preserved ejection fraction (HFpEF), underscoring the evolving role of these medications beyond glucose lowering. The discussion then shifted to the introduction of recommendations for metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH). GLP-1 RAs, dual GLP-1/GIP agonists, and combinations with pioglitazone are now recognized as promising treatment options to mitigate these risks. Hosts delved into the importance of identifying disease severity using FIB-4 scores and how these guidelines aim to address the rising prevalence of fatty liver disease among people with diabetes. Another noteworthy update focused on screening for type 1 diabetes (T1D), particularly in first-degree relatives of individuals with the disease. Isaacs and Bellini review the new staging framework, which classifies T1D progression into three distinct stages, and the inclusion of ICD-10 codes for accurate diagnosis. They also discussed the role of teplizumab (TZIELD) in delaying disease progression in individuals aged ≥8 years and what this could represent for early intervention. With practical insights and real-world applications, this episode provided a comprehensive look at how these updates from the ADA's 2025 Standards of Care will shape therapeutic decision-making and improve care for people with diabetes. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Key Episode Timestamps 00:00 Updates to 2025 ADA Standards of Care 03:06 GLP-1 Agonists and SGLT2 Inhibitors Combination Therapy 04:34 Heart Failure Stratification and Obesity-Associated Heart Failure 07:04 Introduction of Liver Disease into Algorithms 10:28 Screening for Type 1 Diabetes and New Guidelines 13:57 Guidelines for Pre-Symptomatic Type 1 Diabetes 17:35 Nutrition and Medication Adjustments 20:45 Vitamin D Monitoring and Supplementation 22:12 ADA Standards of Care App

Welcome back to Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives! Video Version only on HCPLive! In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, explore the updated American Diabetes (ADA) 2025 Standards of Care, focusing on technology advancements in diabetes management. The discussion highlighted significant advancements and updated recommendations in diabetes care, particularly surrounding continuous glucose monitoring (CGM) and automated insulin delivery (AID) systems. In particular, hosts pointed to stronger ADA recommendations for CGM use, including for individuals with type 2 diabetes (T2D) not on insulin therapy, and emphasized the importance of CGM for all patients on insulin therapy to reduce hypoglycemia risks. They also touched on the potential of over-the-counter CGMs to guide medication adjustments and lifestyle changes for prediabetes and T2D. A notable topic is the ADA's revised stance on open-source AID systems, explicitly asking clinicians to support and guide patients who use these open-source systems. In particular, the organization recognized its potential to improve outcomes and urged providers to understand the underlying algorithms as they continue to advance. Isaacs and Bellini also highlighted the role of CGM and AID systems during pregnancy, emphasizing the early initiation of technology to achieve personalized glycemic targets and optimize outcomes. The discussion expanded on the seamless integration of CGM during hospital discharge programs, as well as ADA recommendations that AID systems become the preferred insulin delivery method for people with type 1 diabetes (T1D), with growing support for their use in T2D on basal or multiple daily insulin injections. They addressed challenges such as Medicare restrictions on pump coverage for T2D, and insurance denial of test strips for CGM users, emphasizing the critical need for test strips as backups during CGM failures. Their conversation also zeroed in on the ADA's new guidance on allowing insulin pump use during hospitalization when clinically appropriate. Bellini stressed the importance of patient independence and education, advocating for hospitals to enable pump use if patients or caregivers can manage them. Hosts underscored the importance of patients bringing sufficient supplies to hospitals, as most facilities do not stock them. Throughout the episode, Isaacs and Bellini emphasized the transformative potential of diabetes technology, urging clinicians to embrace and adapt to advancements to better support patients. They advocated for empowering individuals to manage their care, educate healthcare providers, and push for policy changes that improve access, equity, and outcomes in diabetes management. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Key Episode Timestamps 00:01 Introduction, Updates on CGM for Type 2 Diabetes 03:14 Support for Open Source AID Systems 09:14 Improved Guidelines for AID and Pregnancy 13:34 Early Initiation of CGM and AID 18:46 Advocacy for CGM and Test Strips 21:52 Insulin Pumps During Hospitalization 25:35 Conclusion

In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, are joined by Allison Evert, MS, RD, CDCES, and Savitha Subramanian, MD, co-authors of a recent publication on the evolving role of registered dietitian nutritionists (RDNs) in incretin-based therapies and obesity care, titled "Incretin-Based Therapies and Lifestyle Interventions: The Evolving Role of Registered Dietitian Nutritionists in Obesity Care". The conversation explores how combining GLP-1 receptor agonists with lifestyle interventions can enhance long-term outcomes in diabetes and obesity management, focusing on the integral role of RDNs in addressing medication adherence, side effects, and patient education. Evert and Subramanian highlight key findings from their paper, including strategies for mitigating side effects such as nausea, constipation, and diarrhea, which contribute significantly to high discontinuation rates during the first year of therapy. They stress the importance of counseling patients on appropriate dietary adjustments to prevent nutrient deficiencies and muscle loss during rapid weight loss, recommending an emphasis on protein intake and nutrient-dense food choices. The discussion also delves into the practical challenges of integrating RDNs into care teams, particularly in systems with limited resources. To address this gap, the authors provide actionable tools in their paper, including figures and resources to guide clinicians in patient education and medication management. The hosts and guests agree that team-based care, including the use of pharmacists, advanced practice providers, and clinical protocols, is critical to improving outcomes and ensuring the long-term success of these therapies. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. References: Gigliotti L, Warshaw H, Evert A, et al. Incretin-Based Therapies and Lifestyle Interventions: The Evolving Role of Registered Dietitian Nutritionists in Obesity Care. J Acad Nutr Diet. Published online November 7, 2024. doi:10.1016/j.jand.2024.10.023

Video version only on HCPLive! In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, speak with Eran Atlas, chief executive officer of DreaMed Diabetes, on the evolution and current functionality of his company's automated insulin technology, originally developed within a prominent diabetes treatment center in Israel, and now integrated with Medtronic's 780G system. Atlas Described how DreaMed Diabetes started focusing on automated insulin delivery but has expanded into developing a comprehensive digital care platform. This platform, called endo.digital, is designed to optimize insulin therapy for people with diabetes using AI-driven algorithms. It can gather data from various devices, including continuous glucose monitors (CGMs) and insulin pumps, analyze it, and offer tailored insulin recommendations to providers, which can be automatically integrated into the patient's medical records. Atlas further explained how the platform supports both insulin pump users and those on multiple daily injections (MDI). Hosts discussed how this algorithm could detect potential issues, such as incorrect carb ratios, missed insulin doses, or improper basal insulin adjustments, and subsequently provide actionable recommendations for providers. These insights are aimed at improving the quality of care and increasing accessibility to expert care for people with diabetes, especially in settings where endocrinologists are not readily available. Currently, the system is FDA-cleared to work with glucose data and doesn't require direct insulin data input, as it can infer insulin events from glucose trends. The company's platform is currently deployed in multiple health systems, including the Yale University health system and Boston Children's Hospital, with a focus on increasing its reach to primary care providers. Atlas indicated one key benefit of the platform is its ability to save providers significant time by automating documentation and visit summaries, which has already resulted in hundreds of hours saved in health systems. Looking forward, Atlas described how DreamMed Diabetes is expanding its offerings, including working on solutions for basal-only insulin patients and enhancing the platform's capabilities to include other diabetes therapies, such as GLP-1 medications. Atlas emphasized the company's mission to improve care access and outcomes, particularly in underserved populations. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. Episode Highlights 0:00 Introduction and Background of DreaMed Diabetes 1:46 Current Functionality and Features of DreaMed Diabetes Platform 4:44 Algorithm Capabilities and Insights 7:06 Cloud-to-Cloud Integration and User Engagement 9:37 Onboarding Process and Data Analysis 21:00 Financial Benefits and Budget Neutrality 25:31 Future Enhancements and Broader Applications

Video Version only on HCPLive!  In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center explore the increasing focus on the connection between obesity and diabetes, including the latest advancements in glucagon-like peptide-1 (GLP-1) receptor agonist therapies, the use of inhaled insulin, and the recent addition of hypercortisolism to the “Ominous Octet”, creating the “Noxious Nine.” Although obesity rates in the US have been rising steadily globally, hosts pointed to a recent CDC report reporting a slight decrease in obesity rates. They suggest that this may be partially attributed to the impact of GLP-1 drugs, which have become increasingly popular in managing obesity and related metabolic disorders, including type 2 diabetes (T2D). With these drugs continuing to show promising results, the hosts express optimism about their potential to reduce obesity and improve long-term patient health outcomes. Their conversation shifted to a detailed discussion of the INHALE-1 trial, which evaluated the effectiveness of inhaled insulin in children with type 1 diabetes (T1D) and T2D. The trial, designed to evaluate the non-inferiority of inhaled insulin compared to traditional subcutaneous injections, found that inhaled insulin provided similar efficacy without significant differences in lung function or hypoglycemia occurrence. Isaacs and Bellini highlighted the implications of these findings, emphasizing that inhaled insulin could offer an alternative treatment option for pediatric patients, particularly those who struggle with needle phobia or the burden of multiple daily injections (MDIs). The episode concluded with a deep dive into the Catalyst study, which explored the use of mifepristone in patients with T2D complicated by hypercortisolism. The second phase of the Catalyst trial found a significant reduction in HbA1C levels, showing a 1.5% decrease in patients treated with mifepristone compared with the placebo group. Isaacs and Bellini discussed the potential clinical applications of these results, particularly for patients with difficult-to-control diabetes who may have an underlying hormonal issue contributing to their condition. Overall, hosts encouraged clinicians to consider hypercortisolism in their differential diagnosis for patients with challenging diabetes cases, noting the promise that mifepristone could offer as an adjunctive treatment. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

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

Welcome to this special edition of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosted by Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center. Included as part of the HCPLive This Year in Medicine series, this episode recaps headlines and practice updates related to continuous glucose monitoring (CGM) from the past year, with a focus on regulatory news from Medtronic, Dexcom, Abbott, and Senseonics. In recognition of the 25th anniversary of the first US Food and Drug Administration (FDA) approval of a CGM device in 1999, hosts also provide historic context for each company spotlighted during the episode. Medtronic To begin the episode, hosts start where the journey began: the FDA approval of the MiniMed in June 1999. In the 25 years since, MiniMed was acquired by Medtronic but has continued to remain among the leaders in CGM technology. During their conversation, hosts spend time discussing early experiences with CGM as well as newer advances from Medtronic, including the 2024 approval of the Simplera CGM. Dexcom Conversation around Dexcom ranges from the company's STS sensor in 2006 to the current G7 model as well as integration with pumps like the OmniPod 5, T:slim X2, and the Islet. When discussing news from 2024 from Dexcom, hosts call attention to the partnership with the Oura Ring and the launch of Stelo, the first FDA-approved over-the-counter CGM. Abbott Next, hosts dive into advancements from Abbott—starting with the Navigator and advancing to the Libre, including the Libre 3 plus, which features real-time data and 15-day wear. The hosts also celebrate Abbott's collaborations with Tidepool and major insulin pump manufacturers as well as the FDA clearance of the Lingo and Libre Rio. Senseonics The episode concludes with a discussion of Senseonics' Eversense CGM, the only FDA-approved implantable CGM. As the hosts highlight, Eversense has progressed over the years from a 90-day sensor to the groundbreaking 365-day wear system, which received approval in 2024. The hosts also highlight the potential of future developments, such as eliminating the external transmitter for a fully implantable design. Key Timestamps 00:00 - Start 01:37 - 25 Years of CGM 02:20 - Medtronic CGM History & Updates 05:01 - Dexcom CGM History & Updates 10:06 - Abbott CGM History & Updates 15:48 - Eversense CGM History & Updates

Video Version only on HCPLive! In celebration of the podcast surpassing 100 episodes, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down for a special edition episode with Irl Hirsch, MD, professor of medicine at the University of Washington. Discussion within the episode reflects on continuous glucose monitoring (CGM) and its revolutionary impact on diabetes care as well as its transformative history, beginning with its introduction by MiniMed in 1999. Hirsch recounts his first CGM experience and how it fundamentally changed his approach to managing hypoglycemia and diabetes complications. The conversation transitions to pivotal milestones, such as the JDRF CGM study and the push for Medicare coverage, which advanced CGM accessibility and integrated it into diabetes care standards. Hirsch also highlights the evolution of CGM technology, including the adoption of factory calibration, non-invasive sensors, and over-the-counter options, while addressing challenges like patient misconceptions about device accuracy. The trio also explore CGM's potential beyond glucose monitoring, including ketone detection, that could revolutionize diabetes management and broader healthcare applications. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.Relevant disclosures for Hirsch include Abbott Diabetes Care, Roche, Hagar, Tandem, and Mannkind. Chapters: 00:00 - Start 01:37 - Early Experiences with CGM 07:44 - Early Resistance and Advocacy  14:33 - Impact of CGM Advances 25:32 - Emerging Metrics and Biomarkers Beyond A1C 31:01 - Future Directions in Glucose Monitoring

In this episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, take a deep dive into 3 pieces of news related to diabetes management and incretin therapies, including the BPROAD trial, tirzepatide in heart failure with preserved ejection fraction with obesity, and an NHANES analysis suggesting more than 50% of US adults qualify for semaglutide. BPROAD Presented at the American Heart Association (AHA) Annual Scientific Sessions 2024, BPROAD examined the effects of 120 mmHg vs 140 mmHg blood pressure goals among a cohort of 50 years of age or older with type 2 diabetes, elevated systolic blood pressure, and an increased risk of cardiovascular disease at 145 clinical sites across China. With a follow-up period lasting up to 5 years, the trial's primary outcome was a composite of nonfatal stroke, nonfatal myocardial infarction, treatment or hospitalization for heart failure, or death from cardiovascular causes. Upon analysis, results suggested the mean SBP levels in participants at the 4-year visit were 120.6 mmHg in the intensive treatment group and 132.1 mmHg in the standard treatment group. Those receiving the intensive treatment regimen experienced a 21% lower relative risk of major cardiovascular events during the follow-up period, compared with those on standard treatment (HR 0.79; 95% Cl, 0.69 to 0.90; P

In this episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, explore the recent updates surrounding GLP-1 receptor agonists, particularly focusing on long-term tirzepatide (Mounjaro/Zepbound) data and the current status of GLP-1 shortages. The hosts begin the episode by highlighting the FDA recently reported a stabilization in the GLP-1 supply, may reduce the use of compounded, unapproved versions of these drugs, which the FDA now cautions against in the absence of official shortages. Turning specifically to tirzepatide, the hosts discuss findings from the SURMOUNT-1 trial, now with a 3-year follow-up, which demonstrated sustained weight loss for doses up to 20% in patients with obesity. Additionally, tirzepatide showed a 94% reduction in progression from prediabetes to type 2 diabetes, which hosts highlight as a promising outcome given the increasing diabetes prevalence. The hosts anticipate further research that could reveal even longer-term benefits, especially as tirzepatide continues to show positive outcomes in sleep apnea and heart failure metrics. Isaacs and Bellini encourage clinicians to consider tirzepatide's sustained metabolic effects and urge a continued focus on personalized medicine as more data emerges. They conclude with a call to stay informed as GLP-1 research progresses, with the potential for further applications in chronic disease prevention and treatment. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

Launched on November 14, 2024 to celebrate World Diabetes Day, this episode tackles a flurry of recent news and updates related to semaglutide (Ozempic/Wegovy/Rybelsus), including Novo Nordisk declaring an end to the shortage of the drug, which began in early 2022. In the episode, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss the latest developments in GLP-1 receptor agonists, with a particular focus on semaglutide. They begin by examining topline results from the SOUL trial, which demonstrated a 14% reduction in major adverse cardiovascular events with oral semaglutide (Rybelsus) in patients with established cardiovascular disease. According to hosts, this finding may expand options for patients who prefer oral medications over injections, although they emphasize proper administration techniques to maximize efficacy. The conversation then turns to new data presented at Obesity Week, showcasing oral semaglutide's effectiveness in weight loss for higher doses—25 and 50 mg—demonstrating 14% weight loss at 25 mg. They also highlight semaglutide's impact in specific comorbidities in recent trials, with use eliciting a significant reduction in osteoarthritis pain and potential benefits for kidney disease, even in patients without diabetes. Isaacs and Bellini discuss the SELECT trial results, where semaglutide showed a reduced rate of hospitalizations and adverse events, suggesting an anti-inflammatory benefit that could further support its use in managing obesity and type 2 diabetes. The episode concludes with a call to payers to support wider coverage, given the compelling data on reduced hospitalization and improved patient outcomes. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

This episode spotlights news in diabetes technology from the latter half of October 2024. In the episode, hosts breakdown updates from multiple companies related to continuous glucose monitoring and insulin delivery. A brief overview of announcements covered in the episode by hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, can be found below: Abbott's FreeStyle Libre 3: On October 30, 2024, Beta Bionics Inc announced the integration of the iLet Bionic Pancreas with Abbott's FreeStyle Libre 3 Plus sensor. According to hosts, the new compatibility broadens choice for patients and offering flexibility in CGM usage. Additionally, this sensor has also been approved for use during MRI and CT scans, eliminating the need to remove the device, which adds convenience for patients requiring frequent imaging. Integration with Tidepool: On October 28, 2024, Tidepool announced a new data integration with Abbott. With this integration, the Libre 3 now connects with Tidepool, allowing data from multiple CGMs to be consolidated in a single platform, streamlining data review for clinicians and patients and reducing training requirements. Omnipod 5 for iOS: on October 29, 2024, Insulet Corporation announced the full market release of its Omnipod 5 App for iPhones in the US. Now available for iPhone users (using Dexcom G6), the update allows features like preset meal settings, a valuable tool for patients who use flexible carb counting approaches. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

On September 17, 2024, Ascensia Diabetes Care and Senseonics announced the US Food and Drug Administration's (FDA) clearance of the Eversense 365 system for people with type 1 and type 2 diabetes aged 18 years or older—the world's first 1-year continuous glucose monitor (CGM). A fully implantable, long-term CGM option, the Eversense 365 offers a 12-month sensor survivability and implantable sensor, which allow for fewer data interruptions, less waste, and lessened burden on quality of life, according to the release from Ascensia and Senseonics. Other features highlighted by the companies include a silicone-based adhesive that can be changed daily, a removable transmitter that can be taken on and off without wasting a sensor or adding a warmup period, and on-body vibration alerts to keep patients notified when away from their phone. Ascensia and Senseonics also pointed out Eversense 365 had been cleared as an integrated CGM system, which allows for integration with compatible medical devices, including insulin pumps as part of an automated insulin delivery system. “Managing diabetes can be stressful and it is important for technology to disrupt life as little as possible to limit this burden,” said Brian Hansen, president of CGM at Ascensia Diabetes Care, a subsidiary of PHC Holdings Corporation (TSE 6523). “Eversense 365 allows people with diabetes to focus on living their lives, rather than managing the limitations that many experience with short-term CGMs. We are very excited about Senseonics' ability to once again bring true innovation to the CGM space and are working closely with our partner to make Eversense 365 commercially available as soon as possible.” In this special edition of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, Hansen joins hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, for a deep dive into the Eversense 365 and what clearance means for people with diabetes. During the episode, key points of discussion include the product's features like reduced calibrations, the convenience of the transmitter's USB charging, and its suitability for active patients. During the discussion, Hansen emphasizes the role of patient choice in design and future direction for Eversense. Hansen notes Eversense is currently working to expand inserter networks and pursue pump partnerships, with future goals to include a fully implantable sensor without a transmitter. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others. References: Campbell P. FDA clears Eversense 365, marking First 1-year CGM option in diabetes. HCP Live. September 18, 2024. Accessed October 15, 2024. https://www.hcplive.com/view/fda-clears-eversense-365-marking-first-1-year-cgm-option-in-diabetes. Senseonics. Eversense 365 receives FDA Clearance: The World's first one year CGM. Senseonics. September 17, 2024. Accessed October 15, 2024. https://www.senseonics.com/investor-relations/news-releases/2024/09-17-2024-120118174. Key Timestamps and Highlights 00:00 - Introduction and Guest Introduction 02:04 - Overview of Eversense 365 07:20 - Details on the Transmitter 08:44 - Patient Candidate and Use Cases 13:55 - Medicare Coverage and Integration with Insulin Pumps 17:01 - Future Goals and Patient Choice 28:38 - App and Remote Patient Monitoring

In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, take a deep dive into their experience with the Dexcom Stelo. The Dexcom Stelo is the first FDA-cleared over-the-counter glucose sensor. Cleared by the FDA on March 05, 2024, the Stelo is indicated for use by anyone 18 years and older who does not use insulin, such as individuals with diabetes treating their condition with oral medications, or those without diabetes who want to better understand how diet and exercise may impact blood sugar levels. Dexcom announced availability of the device via Stelo.com on August 26, 2024. In a previous episode, Isaacs an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Bellini, provide insight to their experiences with the system after the first 24 hours of use. In this episode, describe their continual experience with the device itself as well as the app. During the episode, hosts discuss the app setup process, which differentiates between users with and without diabetes, setting appropriate target glucose ranges. Later, the hosts praise the app's educational "nuggets" and the spike detection feature, which prompts users to reflect on potential causes of glucose changes. Bellini notes her appreciation of the app's ability to ask questions about real-time glucose fluctuations, highlighting how this could provide valuable insights to consumers, and Isaacs calls attention to the app's 15-minute data updates, though the underlying data is available every 5 minutes. Later in the episode, hosts discuss some of the early drawbacks of the system. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

In this episode of Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, discuss US availability of the Abbott Lingo and Embecta's announcement of US Food and Drug Administration (FDA) clearance for their tubeless patch pump with a 300-unit insulin reservoir. Abbott Lingo Availability On September 05, 2024, Abbott announced US availability of their over-the-counter continuous glucose monitoring system, the Lingo. Designed for consumers 18 years and older not on insulin, is priced at $49 for 1 biosensor worn for up to 14 days or $89 for 2 biosensors. The announcement of availability comes less than 2 weeks after Dexcom announced the availability of the Stelo and less than 3 months after Abbott announced the FDA clearance of the Rio and Lingo systems. Editor's note: During this episode, hosts reference a 15-day wear time for this system, the Lingo can be worn for up to 14 days, according to Abbott. Embecta Approval On September 03, 2024, Embecta Corporation announced the US FDA had granted 510(k) clearance for their disposable patch pump for insulin delivery for use in adults who require insulin to manage diabetes. Including both 1 and type 2 diabetes within this indication, the FDA clearance means patients will have access to a tubeless patch pup boasting a 300-unit insulin reservoir designed based on feedback from people with type 2 diabetes and healthcare providers. According to the company, the 300-unit insulin reservoir will offer a distinct advantage compared to other systems, citing a recent study finding a reservoir of this size would meet the needs of 64% of adults with T2D for three-day wear, while a 200-unit reservoir would only meet the needs of 38% of that same population. In their announcement, Embecta pointed out patch pump development program also includes plans for a closed-loop version including an insulin-dosing algorithm in a future FDA submission. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

This episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, our second related to the Association of Diabetes Care and Education Specialists (ADCES) 2024 annual meeting, spotlights new data and perspectives from the meeting brought forth by pharmaceutical and diabetes technology companies. Check out our first episode related to ADCES 2024. A large theme of the episode is discussion around data and interactions with Lexicon, which announced the resubmission of a New Drug Application for sotagliflozin (Zynquista) as an adjunct to insulin therapy for glycemic control among adults with type 1 diabetes and chronic kidney disease. According to the FDA, the agency considers the resubmission a complete response to its 2019 letter regarding sotagliflozin for type 1 diabetes.1 For this application, the FDA has assigned a Prescription Drug User Fee Act review date of December 20, 2024. On August 21, 2024, Lexicon Pharmaceuticals announced the FDA's intention to host an advisory board meeting regarding this application.2 Of note, sotagliflozin (Inpefa) has received approval in heart failure for reducing the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adults with heart failure or type 2 diabetes, chronic kidney disease, and other cardiovascular risk factors in May 2023.3 Following this, the conversation between hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, shifts to a discussion on Medtronic's collaboration with Abbott, with the hosts praising this partnership as a strategic move to improve sensor technology for patients. The episode then highlights the innovative educational approach to learning about the Sequel Twiist, with Sequel hosting a jeopardy-style game to engage attendees in learning about their upcoming pump product. Finally, the hosts explore the Diabetotech certificate program, which offers in-depth education on various diabetes technologies, and emphasize the importance of continuous learning and unbiased educational resources in the rapidly evolving field of diabetes management. Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

The Association of Diabetes Care and Education Specialists (ADCES) is an organization ahead of its time in the world of healthcare. Often, those in medicine find the field to be reactionary instead of proactive in addressing the rising burden of chronic disease. The ADCES, formerly the American Association of Diabetes Educators, was founded in 1973 to support and educate clinicians, care providers, and patients of the latest advancements to improve care and quality of life for people with diabetes. This mission, while important in the 1970s, has become crucial if health systems hope to combat a burgeoning diabetes crisis. In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, we celebrate the ADCES 2024 annual meeting through the perspective of hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center. The first of 2 scheduled episodes related to the meeting, this episode focuses on presentations and sessions Isaacs and Bellini were directly involved in from the meeting. Key topics include the challenges of using insulin pumps for type 2 diabetes, the role of DME companies in accessing CGM for people with Medicare, and the latest research on automated insulin delivery systems during pregnancy. The hosts also discuss interpreting ambulatory glucose profiles and time-in-range targets. Throughout the conversation, Isaacs and Bellini share their enthusiasm for the advancements in diabetes technology and the importance of effective patient education and counseling. Video Version: https://www.hcplive.com/view/diabetes-dialogue-navigating-adces-2024 

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, take a break from the Annual Conference of the Association of Diabetes Care and Education Specialists to discuss the latest news from Medtronic and what it means for practitioners as well as patients with diabetes. Video Version: https://www.hcplive.com/view/diabetes-dialogue-simplera-cgm-and-medtronic-partnership-with-abbott 

In this episode, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP,  welcome Muthiah Vaduganathan, MD, MPH, cardiologist and codirector of the Center for Cardiometabolic Implementation Science at Brigham and Women's Hospital, for a discussion around topline data updates from the SUMMIT and FINEARTS-HF trials, the latter of which Vaduganathan served on as a trial investigator. Video Version: https://www.hcplive.com/view/diabetes-dialogue-summit-and-finearts-hf-with-muthiah-vaduganathan-md-mph SUMMIT On August 01, 2024, Eli Lilly and Company announced topline data from the SUMMIT trial, which examined use of tirzepatide (Mounjaro; Zepbound) 5mg, 10 mg, or 15 mg in adults with heart failure with preserved ejection fraction (HFpEF) and obesity. The first primary endpoint of SUMMIT a composite endpoint of time-to-first occurrence of urgent heart failure visit, heart failure hospitalization, oral diuretic intensification and cardiovascular death to study completion and the second primary endpoint was change in the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS) from baseline to week 52. According to the announcement, results of the study indicate use of the dual GIP/GLP-1 receptor agonist was associated with statistically significant improvements in both primary endpoints, with a 38% relative risk reduction in time-to-first occurrence of heart failure outcomes relative to placebo therapy over 104 weeks of follow-up. Results also pointed to a statistically significant benefit on change from baseline in KCCQ-CSS (24.8 vs 15.0). FINEARTS-HF Less than a week later, on August 05, 2024, Bayer announced results from the phase 3 trial of their nonsteroidal mineralocorticoid receptor antagonist, finerenone (Kerendia), among patients with heart failure with mildly reduced or preserved ejection fraction. According to Bayer, FINEARTS-HF met its primary endpoint, with achieving a statistically significant reduction of the composite of cardiovascular death and total heart failure events relative to placebo therapy. The trial is due to be presented in a Hot Line session at the upcoming European Society of Cardiology Congress and Bayer plans to discuss the data and submission for regulatory approval with the US Food and Drug Administration. 

In this podcast, Diana Isaacs, PharmD, CDCES, talks about smart insulin pens and pen caps and how they can help patients with diabetes manage their insulin. Dr Isaacs discusses the benefits of using this technology, important education points for clinicians when implementing their use in care, and more.

In this special edition recorded at the 84th American Diabetes Association Scientific Sessions, Carol Levy, MD, director of the Mount Sinai Diabetes Center and Type 1 Diabetes Clinical Research, joins the podcast for a deep dive into the INHALE-3 trial and how to incorporate individual patient-level factors into the management strategy of patients with type 1 diabetes who could benefit from inhaled insulin (Afrezza). Their second on-site episode focused on the INHALE-3 trial, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, begin the conversation by focusing on the differences in safety and efficacy observed with use of inhaled insulin seen among those using automated insulin delivery systems relative to their counterparts using multiple daily injections. Later in the episode, the focus of discussion shifts to the potential of inhaled insulin in optimizing diabetes management among pregnant patients with type 1 diabetes.

On the opening day of the 84th American Diabetes Association Scientific Sessions, the ADA ushered in a new era for their organization with the announcement of the formation of the Obesity Association. Created more than a decade after the American Medical Association recognized obesity as a disease, the new subdivision of the ADA was created to further the organization's mission of advocating for and advancing treatment for patients. According to a news release, the ADA intends to develop a Standards of Care for Obesity and to leverage education, advocacy and evidence-based support to reduce barriers to optimal care for people affected by diabetes for people with and without diabetes. As part of the on-site coverage of ADA 2024, Diana Isaacs, PharmD, and Natalie Bellini, DNP, hosts sat down with Robert Gabbay, MD, PhD, the chief scientific and medical officer of the ADA, for more insight into the newly formed Obesity Association, future plans, and how this move reflects the changing landscape of metabolic health.

In this special edition episode from the 84th American Diabetes Association Scientific Sessions, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, are joined by Davida Kruger, NP, a certified nurse practitioner in the Division of Endocrinology at Henry Ford Health System in Detroit. During the episode, Kruger takes hosts on a deep dive into the latest in diabetes technology at the meeting, with a focus on advancement in automated insulin delivery and continuous glucose monitoring (CGM) technology. In the early half of the episode, Kruger discusses the results of the SECURE-T2D trial, which examined use of the Omnipod 5 in patients with type 2 diabetes using insulin, and, later in the episode, Kruger offers her perspective on the age of over-the-counter CGM in the wake of announcements from Dexcom and Abbott earlier this year. Video Version: https://www.hcplive.com/view/diabetes-dialogue-advances-in-aid-and-cgm-at-ada-2024-with-davida-kruger-np 

Despite being a chronic autoimmune disease, the burden of type 1 diabetes is often overlooked in public health discussions. Not only are patients with type 1 diabetes being tasked with understanding disease pathophysiology as an integral part of optimal management, but also with keeping up with advances in pharmacotherapy and technology. As a result, patient support programs, such as Blue Circle Health, have emerged to fill a vital role in the management teams for people with diabetes. Provided at no cost to patients through funding from the Helmsley Charitable Trust, the program is designed to free education and support programs in the form of a diabetes support coach, insurance navigation, peer coaching, and special programs, including programs dedicated to introducing patients to continuous glucose monitoring. The program is currently limited to adults with type 1 diabetes living in Florida but has disclosed plans for introduction into additional states. Patients are required to meet the following characteristics to participate: Be diagnosed with Type 1 Diabetes Be 18 years or older Speak English and/or Spanish Have access to the internet and a smart phone or computer to do video calls with the care team Have a primary care provider or are willing to be connected to one Are not currently pregnant As part of their on-site presence at the 84th American Diabetes Association Scientific Sessions, Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, invited Monica Gomberg, MD, Vice President, Clinical Care at Blue Circle Health, to take part in this special edition episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives.

At the 84th American Diabetes Association (ADA) Scientific Sessions, INHALE-3 was among the trials to take center stage. A phase 4 trial comparing the use of inhaled insulin (Afrezza) against standard care, results demonstrated use of inhaled insulin, in addition to insulin degludec, was associated with improved HbA1c in patients with type 1 diabetes, with an improvement of 0.5% or greater observed among 21% of those on inhaled insulin and 5% of those with usual care. At the meeting, study investigator Grazia Aleppo, MD, professor of Medicine and director of the Diabetes Center at Northwestern University, joined hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, for a discussion on the trial, results, considerations for practicing clinicians, and next steps for research. In the latter portion of the episode, Aleppo, who serves on the guideline writing committee for the ADA Standards of Care discusses recent updates in diabetes technology. Chapters 00:47 - Intro 01:15 - INHALE-3 08:00 - Reasons for Participating 10:40 - Results in AID Users 17:01 - Updates in Diabetes Technology

Less than a month after rebranding from JDRF to Breakthrough T1D, the leading type 1 diabetes advocacy organization has now released new consensus guidance related to the monitoring of early-stage type 1 diabetes. Debuted on the final day of the 84th American Diabetes Association Scientific Sessions, the consensus document seeks to fill a gap in guidance around autoantibody-positive individuals in early-stage type 1 diabetes as the community develops new means to delay or prevent progression of the disease. Proof of the document's significance, it has received endorsement from both the ADA and the European Association for the Study of Diabetes, with simultaneous publication in Diabetes Care and Diabetologia. “We are experiencing a paradigm shift in type 1 diabetes care, and we can now identify people in the earlier, presymptomatic stages of type 1 diabetes, before insulin is required, and intervene,” said Anastasia Albanese-O'Neill, PhD, APRN, associate vice president of Breakthrough T1D. “Until now, there was no consensus on how to care for these individuals in the clinical setting and provide appropriate education and psychological support. This new guidance should be used widely by healthcare providers to inform and guide the care of individuals in early stage T1D.” Presented in a special symposium dedicated to the new consensus guidance, the document clocks in at 29 pages in length and cites more than 170 references. Included within the guidance are specific sections dedicated to monitoring among children and adolescents, adult patients, and pregnant patients. Beyond guidance on monitoring, the document also dedicates space to outlining updated terminology on type 1 diabetes staging and how to provide psychosocial and educational support for affected individuals and families. To learn more about this new guidance and discuss the future of type 1 diabetes, hosts of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, Diana Isaacs, PharmD, and Natalie Bellini, DNP, sat down with Albanese-O'Neill at ADA 2024. During their conversation, hosts discuss the recent name change to Breakthrough T1D, the growing prevalence of adults being diagnosed with type 1 diabetes, and major takeaways from the consensus guidance.

In this podcast, Diana Isaacs, PharmD, CDCES, talks about continuous glucose monitoring (CGM) technology and how it can be used for medicine adjustments and lifestyle interventions for patients with diabetes. Dr Isaacs discusses how this technology has evolved over time, how clinicians can strategically use CGM technology in their practice, and more.

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, provide a June 2024 update focusing on a trio of topics across the spectrum of diabetes management. In the episode, hosts discuss the US Food and Drug Administration clearance of 2 new over-the-counter continuous glucose monitoring systems from Abbott, the renaming of JDRF to Breakthrough T1D, and the FDA clearance of the CamAPS FX for people with type 1 diabetes. Chapters:  00:00 - Intro 00:40 - Abbott OTC CGM 06:20 - Diabetes Technology Pipeline 10:45 - JDRF Rebrands as Breakthrough T1D 15:15 -  US FDA Clearance of CamAPS FX

To celebrate the FLOW trial and break down what it means for people with type 2 diabetes and CKD, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, recorded a special edition episode to discuss the clinical application of this trial, unmet need in CKD management, the future of incretin therapies, and more! Chapters: 00:00 - Intro  00:40 - FLOW Background 02:55 - FLOW Results 07:08 - Combination with SGLT2 Inhibitors 12:00 - Future Implications

In this episode, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, tackle a pair of related topics: what the STEP HFpEF DM trial from ACC.24 means for the diabetes community and the need for fair and equitable allocation of incretin-based therapies in the face of ongoing drug shortages and overwhelming demand.

The American College of Physicians has released new recommendations in favor of SGLT2i and GLP-1 RA and against the use of DPP-4i as second-line therapies to metformin in adults with type 2 diabetes and inadequate glycemic control. Released on the first day of the ACP's Internal Medicine Meeting 2024, the pair of recommendations reflect the findings from a systematic review and network meta-analysis and cost-effectiveness analysis assessing the value of these therapies as both monotherapies and in combination with metformin. Attendees at this year's meeting, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the ACP's latest recommendations in a special ACP 2024 edition of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives. Video Version: https://www.hcplive.com/view/diabetes-dialogue-2024-acp-type-2-diabetes-recommendations

I spoke with Pharmacist and Diabetes educator, Diana Isaacs about popular GLP-1 Drugs like Ozempic and Wegovy. We cover how they work, their impact on weight loss, how they help people with Diabetes, and the ever growing issue of cost and accessibility.   Get Skin Grip patches (10% off w/ JUSTIN10) Thanks to our sponsor, Skin Grip. Code won't combine with other promos.   Join Patreon for Exclusive Content   Fill out T1D Exchange Registry    Watch Video Podcast on Youtube    Check out Diana's Podcast | Acquired Podcast on Novo Nordic   Follow for more: Instagram | Tik Tok | YouTube | Facebook   Send us Feedback & Join the Newsletter   DISCLAIMER: This podcast is not medical advice. Always consult with your doctor before making changes to your health care. 

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the latest in diabetes technology from December 2023, with a spotlight on announcements surrounding use of Dexcom's G7 continuous glucose monitoring (CGM) system as well as the latest updates to the American Diabetes Association's Standards of Care. Episode Highlights 0:05 Intro 0:42 AID Integrations with Dexcom G7 7:02 ADA Standards of Care Updates 12:11 Diabetes and Pregnancy Updates 18:45 Artificial Intelligence in Retinopathy Screening 22:32 Outro

Join episode host, Todd Eury (founder and CEO of Pharmacy Podcast Network), as he discusses the indispensable role of pharmacists in T2D care with Diana Isaacs (endocrine clinical pharmacist), and Rohit Moghe (ambulatory care & and population health clinical pharmacist). These pharmacist experts will share insights on why the role of pharmacists is so important in T2D care, including reviewing data on how pharmacist involvement improves measurable outcomes for patients with T2D. To raise awareness, they will also review T2D treatment recommendations from major medical societies. Todd Eury, BS, Rohit Moghe, PharmD, MSPH, CDCES Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP  

This special episode is a compilation of conversations from the Association of Diabetes Care & Education Specialists (ADCES) 2023 conference in Houston. Joining Nancy on day 2 of the conference were a few very special guests. Alissa Heizler-Mendoza, a registered dietitian and certified diabetes care and education specialist dropped by the studio to discuss her role of leading the advocacy and government affairs team at Insulet. She empowers us to elevate our voices to influence change and help more people living with diabetes access life-changing technology. Sarah Yourman-Tota also stopped by to chat with Nancy about her work in pediatric endocrinology, and the positive impact technology can have for caregivers. Nancy was also joined by Jennifer Boyd, medical science liaison at Insulet. Jenn discusses some patient success stories from one year of Omnipod 5. Lastly, Nancy and Dena are joined by Dr. Diana Isaacs and Natalie Bellini to discuss common misconceptions people have about different AID systems. Diana Isaacs and Natalie Bellini have an ongoing commercial relationship with Insulet. Each guest's views and opinions are their own and not those of Insulet. Please speak with your Healthcare team before making any changes to your diabetes management. This podcast provides general information and discussions about health and related subjects. This information and other content provided in this podcast, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have heard in this podcast or read in any linked materials. The opinions and views expressed on this podcast and website have no relation to those of any academic, hospital, health practice or other institution. **Please consult the Omnipod® 5 Automated Insulin Delivery System User Guide for more information.

In anticipation of the Midyear Clinical Meeting, ASHP is hosting a series of podcasts focused on highlighting key sessions, hot topics and “can't miss moments.” Hosted by Cynthia Von Heeringen, Education Director on the National Meetings Team at ASHP. On today's episode we are sitting down with Drs. Jennifer Clements and Diana Isaacs and learning more about their session, Another Great Debate — Semaglutide versus Tirzepatide for Type 2 Diabetes and Obesity. If you haven't already, register for the Midyear clinical meeting today at midyear.ashp.org. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

At ADA 2023, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, sat down with ADCES President-Elect Jane Dickinson, RN, PhD, to discuss her work to address shortfalls of the current language used in the management of diabetes. Video version: https://www.hcplive.com/view/diabetes-dialogue-reforming-language-in-metabolic-disease-with-jane-dickinson-rn-phd 

Often overlooked and unrecognized, the mental health challenges accompanying type 1 diabetes are becoming a focal point of discussion for many in the field, including Mark Heyman, PhD, who joined Diana Isaacs, PharmD, and Natalie Bellini, DNP, for a special ADA 2023 edition of Diabetes Dialogue. Video version: https://www.hcplive.com/view/diabetes-dialogue-managing-addressing-mental-health-needs-in-diabetes

After a whirlwind conference packed with special episodes and late-breaking data, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, sit down to discuss their top takeaways from ADA 2023. Video version: https://www.hcplive.com/view/diabetes-dialogue-ada-2023-recap

In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, are joined by Steven Russell, MD, PhD, the chief medical officer of Beta Bionics, for a discussion around his journey to becoming CMO as well as a deep dive into the iLet Bionic Pancreas and its potential in diabetes management.

In the December 2022 episode, Diana Isaacs, PharmD, and Natalie Bellini, DNP, sit down to discuss recent developments in the field, with a spotlight on the Dexcom G7 CGM, key takeaways from the ADA's Standards of Care in Diabetes—2023, and perspective from the ADCES Diabetes Technology Conference 2022.

Part 1: Doctor Is In: Case Report with Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES and PwD

Part 2: Doctor Is In: Case Report with Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES and PwD

In this episode of Diabetes Dialogue, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP,  discuss the ongoing GLP-1 RA shortage and whether or not celebrities using these agents for weight loss is a real issue in the community as well as provide insight into their top takeaways from the ADA/KDIGO consensus report.

In the September 2022 episode of Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, provide their own perspective on DIY looping based on the results of a recent study published in the New England Journal of Medicine and also break down a new set of consensus recommendations for the use of automated insulin delivery (AID) systems in clinical practice published in Endocrine Reviews, which Isaacs helped compose as a member of the writing committee.

Part 3: Grand Rounds Cleveland Clinic: Role of BGM and CGM in Reducing Burden, Improving Outcomes in Diabetes: Accuracy • Confidence • Long-term Convenience with Diana Isaacs, PharmD, BC-ADM, CDCES, Bruce W. Bode, MD, FACE and Vinni Makin, MBBS, MD, FACE

Part 1: Grand Rounds Cleveland Clinic: Role of BGM and CGM in Reducing Burden, Improving Outcomes in Diabetes: Accuracy • Confidence • Long-term Convenience with Vinni Makin, MBBS, MD, FACE and Diana Isaacs, PharmD, BC-ADM, CDCES

In this episode of Diabetes Dialogue, which was filmed days after the conclusion of ADCES 22, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, take a deep dive into the conference, their favorite sessions, and how ADCES meetings have evolved to the changing role of diabetes care and education specialists over the years.

Insulet has paid the guest speakers of this podcast, Dr. Gregory Forlenza and Dr. Diana Isaacs, a fee to participate in this podcast. Dr. Gregory Forlenza and Dr. Diana Isaacs have an ongoing commercial relationship with Insulet and receive financial compensation for this relationship. Synopsis: In the second episode of Beyond the Bolus, Nancy and Dena examine the importance of the diabetes care team as they walk a day-in-the-life with Dr. Gregory Forlenza and Dr. Diana Isaacs. Over the episode, these experts discuss the value of a team approach within their practices, the benefits of shared medical appointments and telemedicine visits and practical tips for finding and utilizing a technology champion. Guest Bios: Dr. Gregory Forlenza, MD is a Pediatric Endocrinologist and Associate Professor at the Barbara Davis Center for Childhood Diabetes, University of Colorado, and his research is focused on technology to improve the health and lifestyle of people with type 1 diabetes. Dr. Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES is a Clinical Pharmacy Specialist and the Remote Monitoring Program Coordinator at the Cleveland Clinic Diabetes Center. Her primary clinical interests include medication management, diabetes education, running a robust CGM shared medical appointment program and insulin pump training. #DiabetesTechnology #CareTeam #Telemedicine #DayintheLife #PatientCare Please speak with your Healthcare team before making any changes to your diabetes management. This podcast provides general information and discussions about health and related subjects. This information and other content provided in this podcast, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. If you or any other person has a medical concern, you should consult your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have heard in this podcast or read in any linked materials. The opinions and views expressed on this podcast and website have no relation to those of any academic, hospital, health practice or other institution. **Please consult the Omnipod® 5 Automated Insulin Delivery System User Guide for more information.

In this edition of Diabetes Dialogue, which was filmed on-site at ADCES 22, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, sit down with Jennifer Clements, PharmD, following her sessions to discuss her work, her upcoming research interests, and ongoing trends in the field of diabetes management. During her time at the meeting, Clements was the primary presenter for a trio of sessions focus on U-500 insulin in the inpatient setting, treatment and prevention strategies for hypoglycemia, and clinical implications for SGLT2 inhibitors.

In this episode, the hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, sit down with ADCES 2022 Diabetes Care and Education Specialist of the Year Anastasia Albanese-O'Neill, PhD, to discuss her inspiration, her work within the field, and insight into the project she has decided to focus on during her year as ADCES Diabetes Care and Education Specialist of the Year.

In this special edition of Diabetes Dialogue recorded on-site at ADCES 22, our hosts are joined by Korey Hood, PhD, a staff pscyhologist and professor at Stanford University. Founder of DiabetesWise and DiabetesWisePro, Hood talks to Diana Isaacs, PharmD, and Natalie Bellini, DNP, about his efforts and how the online resources are pushing care forward. More information on these sites can be found at DiabetesWise.org and Provider.DiabetesWise.org.

For the July 2022 episode of Diabetes Dialogue: Therapeutics, Technology, and Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, sit down to provide perspective on the latest advances in the fight to cure type 1 diabetes and offer insight into their experiences at the Practical Ways to Achieve Targets in Diabetes Care Conference held in Keystone, CO in mid-July.

Join us today as we talk all things continuous glucose monitoring with a diabetes care and education specialist, Dr. Diana Isaacs. Learn more about the barriers and challenges associated with using CGM for your patients and strategies to overcome these challenges. In addition, Dr. Diana Isaacs walks us through the newest technologies and innovations in the diabetes management space as diabetes care has transformed drastically in the last decade.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Join us today as we talk all things continuous glucose monitoring with a diabetes care and education specialist, Dr. Diana Isaacs. Learn more about the barriers and challenges associated with using CGM for your patients and strategies to overcome these challenges. In addition, Dr. Diana Isaacs walks us through the newest technologies and innovations in the diabetes management space as diabetes care has transformed drastically in the last decade.   Learn more about your ad choices. Visit megaphone.fm/adchoices

Join us today as we talk all things continuous glucose monitoring with a diabetes care and education specialist, Dr. Diana Isaacs. Learn more about the barriers and challenges associated with using CGM for your patients and strategies to overcome these challenges. In addition, Dr. Diana Isaacs walks us through the newest technologies and innovations in the diabetes management space as diabetes care has transformed drastically in the last decade.   Learn more about your ad choices. Visit megaphone.fm/adchoices

In the fourth and final episode from ADA 2022, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, take a deep dive into the meeting from their perspectives as a clinical pharmacy specialist and a nurse practitioner, including their picks for the most exciting advances in diabetes technology to come from the year's largest diabetes meeting.

In our second special edition episode of Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives from ADA 2022, hosts Drs. Diana Isaacs and Natalie Bellini are joined by Gary Scheiner, MS, CDE. Clinical director of Integrated Diabetes Services, author of multiple books, and former Diabetes Educator of the Year, Scheiner joins Diabetes Dialogue to provide a deep dive into the largest diabetes meeting of the year from the view of a diabetes care and education specialist. 

In the third special edition episode of Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives from ADA 2022, Dr. Jasmine Gonzalvo, director of the Center for Health Equity and Innovation at the Purdue University College of Pharmacy, joins hosts Drs. Diana Isaacs and Natalie Bellini to discuss prevailing barriers in diabetes management, including access to new pharmacologic agents as well as newer diabetes technologies.

In the first of 4 special edition ADA 2022 episodes, hosts Drs. Diana Isaacs and Natalie Bellini take on the role of interviewers and discuss CGM uptake in primary care with Drs. Sean and Tamara Oser. Later in the episode, the pair provide perspective on their experiences with Beta Bionics's Insulin-Only Bionic Pancreas.

In this episode of Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, take a deep dive into what the tirzepatide (Mounjaro) approval, including discussions around the mechanism of action for the first-in-class agent, dose titrations, and where it might fit in the upcoming ADA standards of care. Later in the episode, hosts recap their experiences from AACE 2022, which saw the release of guidelines for diagnosis and management of nonalcoholic fatty liver disease (NAFLD) in primary care and endocrinology clinical settings. A video version of this podcast is available on EndocrinologyNetwork.com.

Primer on Pumps for Insulin-requiring Diabetes: Patient Considerations, Multidisciplinary Perspectives with Diana Isaacs, PharmD, BCPS, BC-ADM, BCACP, CDCES and Gary Scheiner, MS, CDCES

SDT Part 3: Primer on Pumps for Insulin-requiring Diabetes: Patient Considerations, Multidisciplinary Perspectives with Diana Isaacs, PharmD, BC-ADM, CDCES and Gary Scheiner, MS, CDCES

In this episode, Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCP, and Joshua J. Neumiller, PharmD, CDCES, FADCES, FASCP, discuss the use of mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes, including:Overview of chronic kidney diseaseGuideline recommendationsEvidence for finerenoneRole of the pharmacistPresenter:Diana Isaacs, PharmD, BCPS, BCACP, CDCES, BC-ADM, FADCES, FCCPEndocrine Clinical Pharmacy SpecialistCGM and Remote Monitoring Program CoordinatorEndocrinology and Metabolism InstituteCleveland ClinicCleveland, OhioJoshua J. Neumiller, PharmD, CDCES, FADCES, FASCPVice Chair and Allen I. White Distinguished ProfessorDepartment of PharmacotherapyCollege of Pharmacy and Pharmaceutical Sciences  Washington State UniversitySpokane, WashingtonReview the downloadable slideset and the full program at:https://bit.ly/3wxNAod

In this special edition ATTD Recap episode of Diabetes Dialogue: Therapeutics, Technology, & Real-World Perspectives, hosts Diana Isaacs, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and Natalie Bellini, DNP, FNP-BC, provide insight into their favorite sessions from the conference and clinical pearls they took away from their experience, including latest updates in the world of diabetes smart phone apps, smart insulin pens, and CGM systems. Also in the episode, our hosts react to Eli Lilly and Company's announcement of topline data from the SURMOUNT-1 trial in late April. 

In the April 2022 edition of Diabetes Dialogue: Therapeutics, Technology, and Real-World Perspectives, hosts Drs. Diana Isaacs and Natalie Bellini discuss the implications of semaglutide 2.0 mg (Ozempic)'s approval, the use of novel glycemic control metrics, and a preview of ATTD 2022.

The inaugural episode of Diabetes Dialogue features an introduction to hosts Diana Isaacs, BCPS, BC-ADM, BCACP, CDCES, FADCES, FCCP, and Natalie Bellini, DNP, FNP-BC, and a discussion around recent regulatory news surrounding CGM devices in the US and Europe.  

PQS Associate Director of Pharmacy Accounts, Nick Dorich, PharmD,  talks with Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES, FADCES, FCCP, Endocrine Clinical Pharmacy Specialist, CGM and Remote Monitoring Program Coordinator at the Cleveland Clinic Endocrinology & Metabolism Institute about continuous glucose monitoring.Isaacs defines continuous glucose monitoring (CGM) on the Quality Corner Show and explains the difference between personal versus professional continuous glucose monitoring. Isaacs also explains how pharmacists can be involved with CGM management.Pharmacist's Letter is offering CE credit for this podcast. Please log into your Pharmacist's Letter account and look for the title of this podcast in the list of available CE courses.

Resources:Share the barriers you identified and how you resolved them through the ADCES Technology Community of Interest:  www.adcesconnect.org/technology-coiMacLeod, J., Scher, L., Greenwood, D., Isaacs, D., Albanese-O'Neill, A., O'Neill, M. S., Golden, L., & Scalzo, P. (2021). Technology Disparities and Therapeutic Inertia: A Call to Action for the Diabetes Care and Education Specialist. ADCES in Practice, 9(5), 34–41. https://doi.org/10.1177/2633559X211032227Utilizing A Technology Framework to Reduce Disparities and Therapeutic Inertia, from the ADCES blog:  https://www.diabeteseducator.org/news/perspectives/aade-blog-details/adces-perspectives-on-diabetes-care/2021/09/28/utilizing-a-technology-framework-to-reduce-disparities-and-therapeutic-inertia.Thank you to the practice paper authors Janice MacLeod, MA, RD, CDCES, FADCES, LaurieAnn Scher, MS, RD, CDCES, Deborah Greenwood, PhD, RN, BC-ADM, CDCES, FADCES, Diana Isaacs, BCPS, BC-ADM, BCACP, CDCES, FADCES, Anastasia Albanese-O'Neill, PhD, APRN, CDCES, Megan S. O'Neill, PA-C, CDCES, Lisa Golden, MA, ED, HD, CRC, CDCES, and Patty Scalzo, MSN, NP, RN, CDCES.

It's getting hot out there and it's vital we keep insulin at the right temperature. However, that's something health care providers say isn’t always front of mind. Stacey talks to Diana Isaacs, a Clinical Pharmacy Specialist and a CDE at the Cleveland Clinic. We’ll get the real deal about insulin temperature and suggest some ways to keep your supply safe. In Tell Me Something Good… glamorous inspiration and a grateful mom – plus babies! And a big anniversary. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out VIVI-CAP www.tempramed.com - use promo code DIACON21 to save 10% off your purchase! (promo code valid through 8/31/2021)   EPISODE TEXT HERE... Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription below     Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:20 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week, it's getting hot out there a conversation about keeping your insulin at the right temperature. It's something healthcare providers say isn't always front of mind when we're troubleshooting tough diabetes days.   Diana Isaacs  0:39 Why are the blood sugars out of range this day? Why was it in range this day? And why? What's the difference? And this is really one of those pieces to the puzzle. And I think we spend so much of our time worried about other pieces like food that sometimes this really goes neglected.   Stacey Simms  0:55 Diana Isaac's is a Clinical Pharmacy specialist and a CDE at the Cleveland Clinic, we'll get the real deal about insulin temperature and suggest some ways to keep your supply safe in Tell me something good, glamorous inspiration, a grateful mom and babies plus a big anniversary. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I'm always so glad to have you here. We aim to educate and inspire about diabetes with a focus on people who use insulin. You know, My son was diagnosed 14 years ago, just before he turned to my husband lives with type two diabetes. I don't have diabetes, but I have a background in broadcasting. And that is how you get the podcast. I live in the southeast us in North Carolina. So it has been warming up for quite a while here. But pretty much all over the United States. We are seeing the warmer weather hot summer is coming. Shout out to our listeners in Australia and elsewhere in the world where summer is not coming please save this episode for a few months. But in addition to the advice here, I've got a thread going in the Diabetes Connections Facebook group about what to use not only to keep insulin cool, but to keep diabetes gear holding tight in the summertime CGM and pump sites as you know, tend to slide off in the wetness sweat. So please check that out. Lots of good suggestions. And as I mentioned, in my book, the world's worst diabetes mom, we really like stay put medical to hold stuff on. But I'll tell you in a pinch Benny will just slap a big waterproof bandaid over his Dexcom I really like the clear tegaderm stuff, but I mean he doesn't care yelled us anything and you can find that in a CVS. So if you're off to the beach and you don't have anything, it really comes in handy. Most of the rest of the stuff that's being suggested in that Facebook group thread has to be special ordered either Amazon or the website from the company that makes it okay quick housekeeping note, you will hear my guest mention a product called VIVI cap in this interview and I have a promo code for you if you want to buy it you'll get a discount if you use the code, but I'm not being paid by VIVI cap. Although we are talking about doing something together in the near future. My guest is not a paid consultant for VIVI cap. She really likes the product and they know that and they helped coordinate this interview that said this conversation is about a lot more than one product. So whatever you use, keeping insulin at the right temperature is really important that promo code for VIVI cap is DIACON21, which gets you 10% off the product@temperment.com I'm pretty sure you're not listening with a pen. So I will put that in the show notes and on the episode homepage at Diabetes connections.com. My guest this week is Diana Isaacs, she is a Clinical Pharmacy specialist and the remote monitoring program coordinator at the Cleveland Clinic Diabetes Center. She was the 2020 at CES Diabetes Care and Education Specialist of the year and a Cleveland Clinic. She does have a pretty unique CGM training program. And you'll hear about that during the interview as well. But first Diabetes Connections is brought to you by Dario health. And we first noticed Daario a couple of years ago at a conference and Benny thought being able to turn your smartphone into a meter was pretty amazing. I'm excited to tell you that Daario offers even more now, the Daario diabetes success plan gives you all the supplies and support you need to succeed. You'll get a glucometer that fits in your pocket, unlimited test strips and lancets delivered to your door and a mobile app with complete view of your data. The plan is tailored for you with coaching when and how you need it and personalized reports based on your activity. Find out more go to my daario.com forward slash diabetes dash connections. Diana Isaac's welcome. Thanks so much for joining me. I'm really interested to talk more about this. Thanks for being here.   Diana Isaacs  4:46 Great. Thank you so much for having me.   Stacey Simms  4:48 Or it is getting hot. I know that not everybody lives like I do in the south where it's been hot for a while. But let's start by talking about what you tell your patients.   Diana Isaacs  4:58 Yeah, so many people don't really The storage and the storage of insulin is so important. It's actually very fragile. And if it's not stored correctly, it actually most commonly it loses its potency. So it ends up you know that 10 units of insulin that you inject doesn't work like 10 units to work like seven units, like six units, you just don't know exactly, it's just will not be as potent.   Stacey Simms  5:18 When we're talking about storage of insulin. I know if I leave it in my hot car, and it gets to be, you know, above 110 degrees, it's going to lose its potency, but day to day, just kind of throwing it in the bag or having it with you, how do you need to store it,   Diana Isaacs  5:33 it's recommended any unused insulin pens or vials or cartridges should actually stay in the refrigerator, once it's been opened, then typically, it's good at room temperature for either 28 days, or some of the newer insulins are good up to 56 days, when it goes above that room temperature, that's when you really can't guarantee the potency anymore, and that's when it can break down and it is not going to be as effective. And in terms of Well, what's the danger of that? Well, a you really have no idea how much you're giving yourself. Because like suddenly, you know, what you usually give yourself isn't going to work as effectively. And you know, the real risk or the big risk would be a complication like diabetes ketoacidosis, where you're just not getting enough insulin and that could be you know, a life threatening complication,   Stacey Simms  6:23 what is considered room temperature   Diana Isaacs  6:25 78.8 degrees, it should be it should not go over 78.8 degrees Fahrenheit or 26 degrees Celsius,   Stacey Simms  6:32 you mentioned that the newer insolence can be out of the fridge for 56 days which insolence.   Diana Isaacs  6:37 So specifically, the ultra long acting like tresiba, insulin degludec, and then toujeo, which is insulin collaging. You 300 those lasts a little bit longer at room temperature.   Stacey Simms  6:49 Do you have any idea why I know those are made up a little differently from like, you know, Lantus or levemir.   Diana Isaacs  6:54 Yeah, the you know, they're just, they're made a little bit differently, which allows them to act longer in the body. And that's how they were studied to show that the potency, you know, still really maintains a fact at that point. And I mean, it's good also, because there's larger pens that holds more units. And so you know, that way a person, if they needed it for 56 days could have that the reality is a lot of people with the doses that they're on, you know, will go through a pen, you know, much faster than been 28 days. All right,   Stacey Simms  7:26 we're gonna do some True Confessions here, because I gotta tell you, we have kept insulin a lot longer than 20 days. And we have, and again, I'm not a diabetes educator, and endocrinologist. So you know, I'm just telling you what we have done as you listen, not just for you. But for example, Benny had a vial of insulin, my son that he took in and out of the fridge at school for almost an entire year, it was like a backup. So he would use it if he needed it. And when he was in elementary school, he used like, drops of insulin. It's not like now and he's a teenager. So we would put it in the fridge at the beginning of the school year, and then he would like take it out, use it, put it back in, take it out music, put it back in. Now, I know that's not advised. But it does work. So I mean, how delicate really is insulin, if we can get away with doing something like that.   Diana Isaacs  8:08 So Oh, man, you're burning my ears as a pharmacist? Oh, I hear that. But yeah, I mean, we know that that is reality that people are doing that. I think, you know, as long as it has maintained its room temperature, or refrigeration, probably a lot of insulins have at least close to the near potency for longer. It's just it really can't be guaranteed beyond that point. Because how it studied, I think, where things become different, or when it's exposed to too much heat, like we know for a fact that when it's exposed to high temperatures, or direct sunlight, it mean it loses its potency almost immediately. And if you've ever had you know, the insulin just sitting in the sun and then try to inject it, I I'm willing to bet it would be different. It wouldn't it would not work as well.   Stacey Simms  8:53 Right? And I think with that example that I gave, it never got below the refrigerator temperature because it was out and in so quickly. But I give that example because I know people who once they take it to the fridge, they think that's it. And it's just it was probably out for less than three minutes.   Diana Isaacs  9:08 Yeah. So I mean, that's interesting, right? So it's still you use it, but right, it wasn't out as much. So obviously, it's not ideal. We can't confirm how you know that it's so potent, but it sounds like in your case it was I have seen a lot of situations though, where people use insulin for example, longer in their pumps, like usually we say to change it out, you know, every three days and an insulin pump and people go five days, seven days and a lot of people notice as they go further out from those three days that it seems like they are needing more insulin that it is losing some of its potency.   Stacey Simms  9:39 I will say one of the only times we had an I refer to it very scientifically, skunky insulin. The only time we had skunky insulin was we had come home from summer camp and had unpacked the car but we had not seen like one of the bags kind of worked its way into the corner. And of course that was the bag that had two vials of insulin and two or three days later in our house. Summer car. We this was years and years ago, we used it anyway, of course, it did nothing. It was like sailing, or it was really bad. So that was a realization like, oh, it really does get terrible.   Unknown Speaker  10:12 Yeah. All that precious insulin law. I know. I know,   Stacey Simms  10:17 well, once we know, it's been 14 and a half years, so it happens, it happens. What do you advise patients then to do I mean, obviously, we can change out pump insulin more often. But as you said, Nobody wants to waste precious insulin like that. What are the tips that you give people to keep their insulin cool in the summertime, whether it's in a pump in a vial, that kind of   Diana Isaacs  10:42 thing? Yeah, so I'm a really big fan of something called the Vivi cap. And this is actually can go over like, it can replace the cap of an insulin pen, and you put it on there, and it guarantees that it stays at room temperature, even if it's exposed to, you know, a really hot car, really extreme temperatures, that is something that I've really been recommending for my patients, because it's just, it's a simple tool. And that way, you don't have to stress about like trying to, you know, I see a lot of people trying to get ice packs and things and that, that's risky, because you could accidentally freeze your insulin. So some a tool like the vivie cap, I find is really, really helpful,   Stacey Simms  11:20 you want to take us through a little bit of what it does.   Diana Isaacs  11:23 Sure, basically, it replaces the cap. So essentially, you know, like, let's say you have a novolog pen, right that you're using for your meal time injection. So you would go ahead and you would take off the cap. And instead, you would go ahead and you would put this Vivi cap directly on it, and you would replace that. And then you honestly, you can just throw it in your purse, in your bag, or whatever. And when you want to be sure that the insulin, you know, let's say you were in extreme temperatures, it was in your 100 degree car, and you're not sure if this insulin is going to be effective or not, there's a button at the top of it, and you go ahead and you press it. And if that button becomes green, then you know that that insulin was stored properly, it is a safe temperature, and it is safe to be able to use it if the D button would turn red, that would tell you Oh, there was an issue, the insulin is not safe. Now the good news is the way it actually you know, through a thermal cooling mechanism is actually getting rid of the heat where the insulin is. And so it's saying, you know, keeping it at room temperature. And why this is important also is because a lot of other things out there will make insulin really cold or accidentally freeze it or just make a cold. And really once it's out, and once it's open, it should say every temperature and so this really ensures that it will happen.   Stacey Simms  12:52 That's interesting. So the V cap doesn't necessarily keep it cold. It keeps it like it doesn't keep it refrigerated.   Diana Isaacs  12:59 Right, it's keeping it at room temperature. So it's really meant for the pen that you're using you're actively using. You can throw this cap on you can put it on your long acting and your mealtime insulin, and you can go on a trip, you can go wherever do whatever and it will stay at room temperature.   Stacey Simms  13:17 Here's a dumb question. We don't use pens very often. So I'm curious, do all pins have the same caps would this fit on pretty much any insulin pen   RIGHT BACK TO DIANA in just a moment but first Diabetes Connections is brought to you by Gvoke Hypopen and when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. That's why most of us carry fast acting sugar and in the case of very low blood sugar why we carry emergency glucagon? There's a new option called Gvoke Hypopen. The first auto injector to treat very low blood sugar. Gvoke Hypopen  is pre mixed and ready to go with no visible needle in usability studies. 99% of people were able to give Gvoke correctly find out more go to Diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma visit Gvoke glucagon comm slash risk. Now back to Diana answering my question about what type of insulin pen fits in the VIVI cap?   Diana Isaacs  14:25 No, that's a really good question. So they actually make different ones for different types of pens. So for example, if you're using like the novalogic products like novolog, and for siba are similar. There's a V cap for those. If you're using like human log products, they have a different Vivi cap. And so yeah, depending on the type of insulin that you're using, you would just go ahead and get the vivie cap that goes corresponding to the one that you need.   Stacey Simms  14:49 It's amazing that until now, I mean we're seeing a few more products address this, but it seems like you know insulin has been around for a long time and you know until recently cuz I've seen a few products like this until recently, the freo is the only thing I can think of that was really out there affordable, you know, easy to use, do you think people are just kind of catching on to the fact that this is really important?   Diana Isaacs  15:11 Well, I think this is just like a really neglected area. Like I spend a lot of my time like analyzing glucose levels, looking at CGM, and in blood sugars and all that kind of stuff. You know, often you're trying to figure out the puzzle. Why are the blood sugars out of range this day? Why was it in range this day? And why? What's the difference? And this is really one of those pieces to the puzzle. And I think we spend so much of our time worried about other pieces like food that sometimes this really goes neglected. And as it's summer, you know, summer is approaching is really a good opportunity to remind everyone that this is a really important for insulin. I mean, this is so so important and will affect it, if it's not stored properly.   Stacey Simms  15:52 It just sounds like common sense. But I'm curious, have there been studies of this? Do we have any idea how many people are having issues with insulin that's not stored properly, or using insulin that has, you know, been out of the fridge for too long? Is there any information on that?   Diana Isaacs  16:08 Well, I don't know, if we have, you know, we certainly don't have like randomized control trial data on that. I mean, how would you do it? Right? I can tell you anecdotally, I think it's just difficult to capture. Because you could ask people I mean, oh, with any person will say that they've had their insulin at high temperatures at some point. I mean, if you, you know, are a human being that goes outside, you know, it's likely that your, you know, your insulin was exposed to higher than room temperature. It's just a matter of how long and I think in the summer, it's really easy for it to, you know, when you meant for it to just be a couple of minutes, that ends up being hours. And then before you know it, you just don't know. And I think also it's difficult to classify, because there's so many reasons that blood sugars can go higher. And so in the moment, it might be hard for someone to be like, Oh, wait, oh, yeah, I was, you know, I left my insulin in the car for three hours. That's why my blood sugar is so high versus they might be thinking, Oh, was it the food I ate? Or am I under stress? So I think sometimes it's just difficult for people to make that connection that it really was the insulin that made their sugars higher,   Stacey Simms  17:11 because I'm kind of picturing people listening to this episode of had diabetes for a long time going, I don't need that. It's been fine. Right? And I'm kind of one of those people that I'm like, Oh, it's fine. I can't imagine this really happening all the time. But you're exactly right. How would we know?   Diana Isaacs  17:26 Yeah, I would just encourage people to reflect on it. I mean, it likely has happened. If you had diabetes long enough, it's probably happened at some point in your life where your insulin hasn't been stored perfectly, right. I am a really big fan of patient choice, and people knowing what's out there. So if you've come up with a perfect solution, or your insulin is always at home, and you never go out great. You don't need something like the Vivi cat. But you know, if you're out you're traveling or going on a trip, I think it's good to know what options exist out there.   Stacey Simms  17:54 I'm curious too. And this is kind of separate from vicap. My son is using insulin pumps since he was two years old. And he we live in the south, as I've mentioned, and it's always hot, the summer is ridiculous. But he has the insulin next to his body. His body is pretty warm all the time. Is there any Are there any issues with that three days in the pump? Do you see people having more issues in the summertime? And do you ever recommend, you know, changing the insulin at more often because of temperature?   Diana Isaacs  18:20 I do. Yeah. A lot of people have issues is especially in the summer. I'm like I've seen people with like Omni pod. And it's just like boiling in the sun. And it goes bad very quickly. So yeah, I am a fan of encouraging people to change more often, like every two days instead of every three days if they notice that it's wearing off sooner. So I think like a lot of people should consider that in the summer if they noticed that third day there. boluses are just not having the same effects on their blood sugar's.   Stacey Simms  18:46 We've also found that winter to summer, we always have to change basil rates. And that's probably because of activity, but it's also because of heat. And I know that that affects people differently. How do you advise your patients to look at the weather and how it affects their bodies?   Diana Isaacs  19:01 That's a good question. I mean, everyone is affected a little bit differently. I really like Adam brown from diatribe. And he talks about 42 factors that affect glucose levels. And actually a sunburn is one of the things that could affect levels, it could increase glucose. So I think, you know, weather can affect it any kind of stressor on the body can absolutely affect glucose levels, but it is very individualized. For many people, the weather won't be a huge deal. But for some they may be more sensitive. And I think the best thing is to really reflect on it to review data with a diabetes educator or diabetes care and education specialist and really try to determine what are the patterns and who knows, yeah, it could be whether it does create a pattern for someone that if you know that it's helpful, because then you can kind of preemptively prepare for it and give yourself more or less insulin as needed.   Stacey Simms  19:52 Can we talk about sunburn for a minute, because every year in the parenting groups, somebody comes in and says it's their first time can the sunburn I raise my kids blood sugar, and everybody kind of says yes, yes. Why is that? Is it just trauma to the body? Is it like being ill?   Diana Isaacs  20:07 Yeah, I think it's like anytime there's a stressor on the body that can affect it. So yeah, if it's causing stress, you know, sunburns can be pretty painful. And we know pain can increase glucose, so it's likely related to those factors.   Stacey Simms  20:21 I don't wanna change the subject too much, but I'm reading your bio. You know, in researching for this episode, he talks about how you run a CGM shared medical appointment program. Can you tell us what that is?   Diana Isaacs  20:33 Yeah, so I am a big advocate of CGM of continuous glucose monitoring. And in our program, we often introduce people to CGM for the first time. And so with our shared medical appointments, we have usually four to six people with diabetes, and we have a meeting. And then we also have a dietician, and it's a two part shared appointment. And the first part, we get everyone together we place the CGM, and we have a discussion about what are the glucose targets and what kind of things affect glucose levels. We also review how to treat high and low glucose levels. And then everyone comes back after seven days and we download the devices and we we actually show everybody's data on a big screen and we go through it together. It's really interesting because a lot of people there, you know, there's similar things like the overtreating Alo or learning you know how oatmeal affects your blood sugar's you know, like, there's a lot of similarities that kind of it's nice to have that group environment. Yeah, that's   Stacey Simms  21:30 I've so many questions, but my first one would be, you'll have to, you'll have to come back on and just talk CGM with us. I'm curious, how do you manage or handle when people are looking at everybody's CGM numbers? And some must feel like, Oh, that's bad? Or I didn't do that very well. You know, do you talk about that part as well, and kind of managing the data mentally.   Diana Isaacs  21:51 So my rule is data numbers are data, and they cannot be good or bad. So it's simply being in target or out of target. But it's not a judgment, there's no such thing as good or bad numbers. And I'm really careful about this. I mean, even you know, when someone is 100%, in range, and has an agency of 6%, I try really hard not to say, Oh, that's so good. Like, you know, do jumping jacks, because, you know, I don't want someone then to have a higher agency and to be less than range and then not want to come back for their appointment because they think I'm only be happy when it's, you know, in range. So it's really an important point to not be judgmental with with data.   Stacey Simms  22:27 Oh, all right. You're gonna have to come back on and talk to us more about that. I think that's,   Unknown Speaker  22:31 I'd love to Alright, good. Good. Good.   Stacey Simms  22:32 All right, back to the summer, though. So since you work with a lot of people with with CGM, do you find that there are ways for people to keep their gear better on in the summer? Do you have any advice for that? Because diabetes technology can be kind of slippy in the summer?   Diana Isaacs  22:45 Yeah, no, it can be. So I'm a big fan of skin tack and of overlay patches, like sin patch, and stuff for keeping on CGM sensors and sites for the pump. I think technique with everything is really important. Making sure the skin is clean and dry. You know, placing it right after a person has recently showered or bathed just to have the most success with it digging and staying on. But I think absolutely using products like skin tack mass assault, for people that sweat, it's just it's like kind of a must to have those extra, those things can really help.   Stacey Simms  23:17 Yeah, we found or at least just anecdotally, everybody's skin is so different that you know, overlays vary brand to brand. So unfortunately, you kind of have to keep trying until you see what works for you. And one of the nice things we did locally when we could meet up and we're going to start meeting up again, which I'm very excited about is I always tell people, like let's bring samples, right? Because you get like a 20 pack of sim patch, and I get a 20 pack of stay put medical patches and you know, people just bring different brands, and then we can kind of trade because I used four or five different brands on my son before we found what worked. So if you're listening and you have a local group, and you're meeting up again, that's just something you can try cuz it's so frustrating.   Diana Isaacs  23:55 Yeah. And sometimes like, right, you put something on over it, and then you know, it starts peeling off after a couple of days, you have to put another thing over it. So yeah, I agree trial and error. You know, we   Stacey Simms  24:05 spoke a lot about the temperature extremes with insulin on the warm end, we touched on freezing, but let's talk about that again. What's the danger of insulin freezing? I mean, we know it doesn't work well. But is there anything to say about that in terms of why? Or you know, is it just that you mean, obviously, if it's frozen, you can't put it in a syringe, but it does completely lose its potency? Right?   Diana Isaacs  24:26 Well, I don't know if it completely loses its potency, but it very much does. But also, I mean, particles may form to which could make it definitely more difficult injecting and then I mean, I guess it could cause pain with injection as well. So I mean, it's just another reminder to like anything, you should really always visually inspect the insulin as well. And most insolence should be clear. So checking for that is really important as well.   Stacey Simms  24:54 Yeah, that's the the hotel refrigerator syndrome. So many times the fridge In the hotel is not set to the correct temperature. So you put your vial of insulin and it freezes. I've heard that so many times. It's just terrible.   Diana Isaacs  25:07 Yeah, I mean, it's really, it's really a problem. And so yeah, I mean, that's a really good point, when you're traveling, it's often really hard to rely on the hotel refrigerator, which is often is not set correctly for temperature is the right temperature,   Stacey Simms  25:21 what we usually do is, if we're staying for more than one night, is we'll put something you know, water, we'll put whatever in that fridge and kind of see how it does in a couple of hours, to see if we trust the insulin. But that's only helpful if you're going to be there for a couple of days, and you have a way to keep your extra insulin, you know, at a cool temperature, because so much of what we're talking about is not even so much for the the insulin you're using at that moment, although you want to keep it at room temperature, exactly. But you know, we don't have to keep it refrigerated. But when you're traveling with extra insulin, that's really a problem.   Diana Isaacs  25:52 I just would encourage people to think about it and just be just plan. I mean, just have a plan for the summer, whatever that plan is. And just be aware that I think some of the traditional methods that people use, like using like a lunch bag and putting an ice pack in it can, you know, you don't really know that temperature that's going to be in there. So there is an option available that you can be assured it's going to stay at room temperature. And it's just it's really simple. And it doesn't take up all this extra space and everything. I think that's the key. It's just it's a super simple thing. And so I would just encourage people to kind of check it out and go to the website and learn more about it.   Stacey Simms  26:34 It's interesting too, because insulins not alone, I mean, so many medications are temperature sensitive, as newer insulins come out, do you think that the temperature sensitivity will ever be factored out of insulin? Or it's just it's just part of the component?   Diana Isaacs  26:51 It's a really good question. Because I I'm sure you know, there's research in this area to see can insulin be more stable, or it's not? I think the problem is, it's just it's a large peptide. And, like due to its nature, it's just really hard to get it to be stable for a long period of time. I mean, it's one of the reasons why we don't have oral insulin, at least not yet. Like we don't have it in pill form. It's just really, really unstable. I think it's going to be challenging. Maybe one day we'll have that. But it's definitely going to be a challenge to   Stacey Simms  27:19 have that. You mentioned the newer insolence, like the longer acting like to CBOE and toujeo. Is that considered an advancement? Or is it just different, it's not going to apply to the shorter acting?   Diana Isaacs  27:30 Well, I think it is an advancement, in that we have an insulin that they were able to alter to work longer in the body, which I think ultimately really helped to stabilize blood sugars. And when you think about like, where we progressed, we started off with NPH, which you know, only works like half a day. And then we got longer act insulins like lantis and lab Amir, and then now we have these, like ultra long ones, like TJ Oh, and receba. And there's actually a weekly insulin that's in development that hopefully will, you know, see in the near future. So I think we're definitely making advancements and insulin, which is really exciting. Although the other area where we need to make advancements, which is a whole other episode is the affordability of insulin as well. But there are definitely advancements that are are being made. So yes, maybe with the storage, those will be things that will get better. But I don't see it completely resolving, you know, anytime soon.   Stacey Simms  28:23 How do pharmacies Sue with this? I mean, as far as I know, we've never had a problem getting our insulin from the pharmacy at the right temperature, of course, then I have to bring it home. And we do a lot with mail order as well and knock on wood. It's always been delivered, I think at the right temperature. Is there a problem from that perspective as well, like in the supply chain,   Diana Isaacs  28:43 know, the supply chain is heavily regulated? So I mean, they are monitoring refrigerators constantly. And they have certain standards, there's inspection so you can feel really good about the supply chain. It's really once it gets to the person that it's not regulated. But yeah, in the pharmacy, it is very, very maintained to a tee to those temperature and they're like specialized refrigerators is not just your it's definitely not your hotel refrigerator that for storing Insulet   Stacey Simms  29:12 Yeah, it's good. That's good. That is good. Before I let you go, I'm just curious. I we have been lucky enough to see my son's endocrinologist in person for the last couple of visits when we did a lot of telehealth. Are you seeing people back in the office? I mean, how are you all doing through all this?   Diana Isaacs  29:29 I never stopped seeing people in the office. So I've been here through the whole pandemic, I've actually come to work every day. Now. A lot of our visits have been virtual out of convenience for people but we are open and people could come here you know, whenever they want. And some For some it's preferred because as much as we've made advances in technology, we you know, we've got some patients who really have challenges downloading their data at home and stuff and it's, it's good to have them in the clinic. So yeah, our doors are open and but I will Say telehealth has flourished. And for a lot of people, it just makes so much more sense. Like today this morning, you know, we trained a person on their new pump. And rather than like me having to have her come in next week, I can just do a virtual and just look at her data that way and make adjustments. That's kind of where we're at with it.   Stacey Simms  30:15 I would imagine your patients have been very happy to walk in and see you during this past year. Like it's very be very reassuring. I was surprised how when we were able to see my son's endocrinologist again. I'm kind of happy we were.   Diana Isaacs  30:29 Yeah, I think it's nice. And I mean, I feel especially now with like the vaccine now that we've all been vaccinated, I feel very, you know, I feel great. It was definitely a little stressful. Like, I'll tell you back in December, we were doing our CGM shared medical appointment. And I had a class of four people and I, you know, you see people starting to like, move their masks down, and you're like, Oh, my gosh, is this safe, like at this stage, because we're doing a class and that was right, when the numbers were really increasing? So we did, we did pause them for a few months till the numbers came down. But But yeah, I think overall, you know, it's good. It has been reassuring. And you know, it's care doesn't stop, like some people are getting new insulin pumps. And yes, while you can get, you could do virtual training. And for many people, we do like some people really want that hands on time, when that was their first time starting upon, they want to come in and see it.   Stacey Simms  31:17 I can't imagine the people who were diagnosed this past year or had children diagnosed and were more isolated than normal. It's isolating enough to have diabetes. And I just can't imagine. So thanks for doing that. And, you know, keeping in touch with everybody, I mean, I'm not your patient. You don't really know me, but I want to say thank you.   Diana Isaacs  31:34 Oh, you're welcome. I mean, I love doing it. I love working with people with diabetes. It's so rewarding. And it's like, I just, yeah, I just feel like I feel very optimistic. With all the new technology and the advances being made. I just feel like, yeah, there's so much opportunity to help people.   Stacey Simms  31:50 Well, thank you so much for spending so much time with me. And we'll have you back on to talk more about CGM and the shared medical stuff. I think that sounds great. Thank you so much.   Unknown Speaker  31:57 Oh, you're very welcome. Yeah, thanks for the opportunity.   Unknown Speaker  32:05 You're listening to Diabetes Connections with Stacey Simms   Stacey Simms  32:11 I’ve  got more information about the temperature at which insulin is supposed to stay. We touched on that. But if you'd like to learn more, and there's some more studies that really delve into this, I'll put that at Diabetes connections.com. Every episode has its own homepage there. If you're listening on an app for podcasts, there are always show notes, but some of them don't show these things very well, you can always come back to the main page, and I'll put it there with a transcript as well. And the promo code for VIVI Cap is DIACON21, like Diabetes Connections, di a co n di a con 21, which gets you 10% off the product. Alright, tell me something good. Coming up help prom photos provided some unexpected inspiration. But first Diabetes Connections is brought to you by Dexcom. So I was watching a movie with my husband the other night, and I got a Dexcom alert and he was upstairs in his room. And you know, for some reason, that took me back to the days when we basically had blood sugar checks on a timer, we would check doing a finger stick the same time every day at home and at school and you know, whatever extra we needed to. But it's amazing to think about how much our diabetes management has changed with share and follow. I didn't have to stop the movie to get up and check him. I knew what was going on, I could decide whether to just text him or go upstairs and help him out. Using the share and follow apps have really helped us talk less about diabetes, which I never thought would happen with a teenager. Trust me, he loves that part too. That's what's so great about the Dexcom system. I think for the caregiver or the spouse or the friend, you can help the person with diabetes manage in the way that works for your individual situation. Internet connectivity is required to access Dexcom follow separate follow up required, go to Diabetes connections.com and click on the Dexcom logo.   Tell me something good this week, I don't know about you. I'm in a lot of moms groups. And I have seen a bajillion prom photos over the last month and it's really nice. But one of the things that happened that I didn't expect is that it provided diabetes inspiration to families, especially families with younger kids, I don't have permission to share her name. So I'm just gonna tell you the story here. But this woman posted that she was looking at all the pictures of the beautiful girls and their dresses and their Dexcom and their pumps and their Omni pods showing. And you know, she was excited to see that. But her little girl who's totally into the princess phase right now she's six or seven years old, loved seeing the photos of all these grown up girls with diabetes. And it really provided an easier way to get her little girl to feel better about the gear that she is wearing. And I just thought that after all these years was still kind of unexpected. Now let's be honest, not everybody wants to show their gear all the time. And that's okay too. And honestly, I highly doubt that these girls are going to the prom thinking. I'm gonna have my mom posted. On Instagram or Facebook and that's going to inspire somebody else. Right? But man did it ever. So thanks to all of you who did that, who posted the photos? What a cool thing I have to wish a happy wedding anniversary to Janice and Bill Grigsby they celebrated 50 years married in April. And Janice was cute. I was asking for good news in the Diabetes Connections group and she wrote that may not be what you were looking for, since it doesn't have to do with diabetes. But you know, Janice, we're all together because of diabetes. Janice and Bill's daughter marked 20 years with type one late last year, so I think that counts so congratulations on that amazing milestone. It doesn't all have to be diversities. 50 years married. That is fantastic. And a big congrats to Alison nim Lowe's, who had a baby last week, little Stellan joins Big Brother Henrik is still in it was a little impatient came into the world a little bit early. So he'll be staying at the hospital for a while. And they helped to bring him home by the end of May. But everybody's doing well. Alison is somebody I've known for years. She's been on the show before I will link up that episode. She's on social media as the diabetic therapist Of course, we talked about therapy and mental health in that episode, but congratulations all around really exciting stuff. If you have something good to share, please let me know Stacy at Diabetes, Connections comm or pop into our Facebook group and share when I asked on a regular basis. Just tell me something good. Before I let you go, quick reminder that on Wednesdays in May, I am doing in the news, a live diabetes newscast every Wednesday at 4:30pm. Eastern time. I hope you can join me for that. I'm also turning it around to then putting it out on different social platforms. And on this podcast. That episode right usually has been coming up Thursdays or Fridays. And it looks like we may continue this because people are really liking it. I definitely need to know how you feel about it though. So you can email me comment on the post itself. It's a little bit of different work than the podcast to be honest with you. Not necessarily more work, but I do have to brush my hair and put some lipstick on to go live on Facebook. That's just how I am if I continue this, maybe you'll see me eventually in the ponytail and opaque but I'm having a lot of fun doing it. And I think it's a need. We don't really have a diabetes newscast anywhere. So I may continue. I will be deciding probably between this weekend next week's episode, and I'll definitely let you know. Thanks as always to my editor John Bukenas from audio editing solutions and thank you so much for listening. I'm Stacey Simms. I'll see you back here in just a couple of days. Until then be kind to yourself.   Benny  37:42 Diabetes Connections is a production of Stacey Simms Media. All rights reserved. All wrongs avenged

Insulin pumps and continuous glucose monitors (CGM) have changed the standard of care for managing Type 1 Diabetes. A closed-loop system (also described as an artificial pancreas or automated insulin delivery system) consists of a CGM, an insulin pump, and a control algorithm that automatically calculates basal insulin delivery based on real-time glucose levels. Closed-loop insulin pumps may offer an opportunity to improve glycemic management while reducing some of the associated stress. However, there are limited data evaluating the safety and efficacy of this technology in children less than 14 years old. Guest Authors:  Mary K Culp, PharmD and Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES Music by Good Talk

What are EAP's and how can we use them in today's environment?

Access affordability resources at DiabetesEducator.org/AffordabilityTo access the insulin cost-savings resource: https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/insulin-cost-saving-resources-3-4-19.pdf?sfvrsn=2To access the non-insulin medications cost-savings resource: https://www.diabeteseducator.org/docs/default-source/practice/educator-tools/non-insulin-agents-cost-saving-resource-7-29-19.pdf?sfvrsn=2

Resources mentioned in the episode: DANA – www.DANAtech.org, DANA is a benefit of AADE membership. Login with your AADE member ID The Diabetes Educator Role in Continuous Glucose Monitoring Paper – https://www.danatech.org/resources/the-diabetes-educator-role-in-continuous-glucose-monitoring/ AADE's Project Vision – https://www.diabeteseducator.org/about-aade/project-vision CGM Connecting the Dots course – https://www.danatech.org/education-course?prd_key=26999a89-7eb7-45ba-9dff-cf4e5febb7f6&type=Course CGM Data in Clinical Practice course – https://www.danatech.org/education-course?prd_key=6889ce34-81fa-4bf3-93c5-51bfd36cd313&type=Course The Ins and Outs of Starting a CGM Program Webinar – https://www.danatech.org/education-course?prd_key=123489c0-0d37-4ebc-919d-ca942816484e&type=Course CGM Reference Guide from The Diabetes Educator – https://journals.sagepub.com/doi/full/10.1177/0145721718818066