Podcasts about dm2

Recomendações da ADA 2025 sobre a abordagem de pacientes com DM2 e IC

Recomendações da ADA 2025 prevenção do DM2

Join the Behind the Knife Bariatric Surgery Team as they kick off 2025 with a crucial discussion on pediatric and adolescent bariatric surgery. Drs. Matt Martin, Adrian Dan and Katherine Cironi delve into the latest ASMBS guidelines, comparing long-term outcomes of gastric bypass and sleeve gastrectomy in adolescents versus adults. They explore key comorbidities, including type 2 diabetes, hypertension, and orthopedic issues, and emphasize the importance of early intervention. This episode also tackles the complex ethical considerations surrounding surgery in this vulnerable population, including consent, multidisciplinary care, and the evolving role of medical therapies like GLP-1 agonists. Show Hosts: - Matthew Martin - Adrian Dan - Katherine Cironi Learning Objectives:  ·  Identify the current ASMBS guidelines for pediatric and adolescent bariatric surgery, including BMI thresholds and associated comorbidities.  ·  Describe common comorbidities seen in the pediatric population eligible for bariatric surgery, such as type 2 diabetes, hypertension, and orthopedic issues.  ·  Compare and contrast long-term outcomes of bariatric surgery (gastric bypass and sleeve gastrectomy) in adolescents and adults, including remission rates of comorbidities and reoperation rates.  ·  Discuss the importance of a multidisciplinary approach, including psychological and ethical considerations, when evaluating adolescent patients for bariatric surgery.  ·  Explain the ethical framework used in evaluating adolescents for bariatric surgery, including consent/assent, parental involvement, and addressing potential coercion.  ·  Recognize the evolving role of medical management (e.g., GLP-1 agonists) in conjunction with or as an alternative to bariatric surgery in adolescents. Article #1: Inge 2019 – Five-year outcomes of gastric bypass in adolescents as compared with adults https://pubmed.ncbi.nlm.nih.gov/31461610/ - The cumulative effect of sustained severe obesity (BMI >35) from adolescence into adulthood increases the likelihood of diabetes, hypertension, respiratory conditions, kidney dysfunction, walking limitations, and venous edema in legs/feet (when compared to adults that did not report severe obesity in adolescence) - American Society for Metabolic and Bariatric Surgery (ASMBS) guidelines for adolescents who should be considered for bariatric surgery: BMI is ≥35 with a co-morbidity or if they have a BMI ≥40 (class 3 obesity, 140% of the 95th percentile) - This article utilizes the Teen-Longitudinal Assessment of Bariatric Surgery (TEENS LAB) and LABS (adults) databases to evaluate the outcomes of adolescents vs. adults who underwent bariatric surgery Roux-en-Y gastric bypass (2006-2009) - 161 adolescents (13-19 at the time of surgery) with severe obesity (BMI>35) vs 396 adults (25-50 years old at the time of surgery) who have remained obese (BMI>30) since adolescence  - Both groups had the gastric bypass procedure as their primary bariatric operation  - Both groups had unadjusted similar demographics, however, BMI was higher in adolescence (54) when compared to adults (51)  - Results were analyzed using linear mixed and Poisson mixed models to analyze weight and coexisting conditions - After surgery, adolescents were significantly more likely than adults to have remission of type 2 diabetes and hypertension - Increased likelihood of remission of diabetes due to the shorter duration of diabetes, lower baseline glycated Hgb, less use of medications, and increased baseline C-peptide levels  - Increased vascular stiffness in adults along with a longer duration of hypertension make the cessation of hypertension less responsive with surgery in adults  - No significant difference in percent weight changes between adolescents and adults 5 years after surgery  - Both adults and adolescent groups had decreased rates of hypertriglyceridemia and low HDL levels, albeit not significantly different when comparing the two groups  - Of note, the rate of abdominal reoperations was significantly higher among adolescents (20%) than among adults (16%) with cholecystectomy representing nearly half the procedures in both groups - Limitations - At baseline, adults had a high prevalence of both diabetes and hypertension - only 14% of adolescents had diabetes vs 31% of adults  - Only 30% of adolescents had hypertension vs 61% of adults  Article #2: Ryder 2024 – Ten-year outcomes after bariatric surgery in adolescents  https://pubmed.ncbi.nlm.nih.gov/39476348/ - The goal is to discuss the long-term durability of weight loss and remission of coexisting conditions in adolescents after bariatric surgery  - This article utilizes the Teen-Longitudinal Assessment of Bariatric Surgery (TEENS LABS) database to evaluate the 10-year outcomes in adolescents who underwent gastric bypass or sleeve gastrectomy  - 260 adolescents with an average age of 17 years old at the time of surgery (ages ranged from 13-19 years old) - 161 adolescents underwent gastric bypass, 99 adolescents underwent sleeve gastrectomy  - Results were analyzed using propensity score-adjusted linear and generalized mixed models  - At 10 years, the average BMI had decreased significantly with both groups experiencing about a 20% change in BMI on average - To assess comorbidities, both groups were analyzed together -  55% of patients who had DM2 at baseline, were in remission at 10 years - 57% of patients who had HTN at baseline, were in remission at 10 years -  54% of patients who had dyslipidemia at baseline, were in remission at 10 years - Limitations  - Neither of these studies compare surgery to medical management. GLP-1s have shown promise for weight loss management but we need more data in terms of long-term outcomes in co-morbidities like diabetes, hypertension, dyslipidemia  - Highlighted Outcomes  - Metabolic bariatric surgery is quite effective in the adolescent population  - Adolescents tend to have weight loss that is similar to that of adults and improved resolution of comorbid conditions (DM2, HTN, dyslipidemia) Article #3: Moore 2020 – Development and application of an ethical framework for pediatric metabolic and bariatric surgery evaluation https://pubmed.ncbi.nlm.nih.gov/33191162/ - The purpose of this paper is to describe the ethical framework that supports the use of metabolic & bariatric surgery (MBS) on the principle of justice, and how providers can conduct a thorough evaluation of patients presenting for these surgeries - Highlights adolescents with intellectual and developmental disabilities (IDD) and preadolescent children who pose more ethical questions before considering surgery  - This article utilizes the bariatric surgery center at one children's hospital and the institution's ethics consult service to develop an ethical framework to evaluate pediatric patients seeking bariatric surgery – using the national ASMBS guidelines  - This ethical framework utilized 4 central ethical questions 1.     Should any patients be automatically excluded from evaluation for MBS? 2.     How should it be determined that the benefits of MBS outweigh the risks? 3.     How do we ensure the patient fully understands and is capable of cooperating with the surgery and follow-up care? 4.     How do we make sure the decision to have surgery is truly voluntary, and not coerced by family or others? - Results: this ethical framework was discussed in depth in two case studies  - Overview of framework: an ethical question would arise from the bariatric team they would review & apply the ethical framework. The question is either resolved by the bariatric team OR ethics consult, continue pre-operative workup vs no surgery - Case 1: 17M (BMI 42) with a history of autism spectrum disorder, pre-DM, depression with behavior challenges, HTN, dyslipidemia. Testing at school demonstrates intellectual functioning at a fourth-grade level. Pt lives with mom and 11-year-old sister. Mom endorses food insecurity (on supplemental nutrition assistance benefits) and struggles with her son's large intake of food.  1.     Co-morbidities should not be exclusionary, but pt should undergo a comprehensive psychosocial evaluation with attention to family dynamics and support and the patient's decision-making capacity  2.     Discuss benefits vs risks. Benefits – decreased progression of DM2, HTN, hyperlipidemia, cardiometabolic dx. Risks – gastric leak, infection, bleeding, dumping syndrome, etc.  3.     Can assess decision-making capacity with the surgical team or if need be other teams. In this case, the pt had limited decision-making capacity  - His level of understanding remained stable during the pre-op visits, and he gave assent to surgery - The mom identified a second source of support (extended family) - The team talked to both the patient and mother alone and then, together, found that the patient developed an independent desire for surgery, and thus moved forward.  - Case 2: 8F (BMI 50) with a history of mod OSA, L slipped capital femoral epiphysis s/p surgical stabilization (6 mos prior). The patient is neurotypical & excels in school, and lives with mom & dad. Referred by mom & dad (mom with a recent history of sleeve gastrectomy).  1.     An 8-year-old should not be discriminated against based solely on age, but the patient should be offered more conservative/less invasive options before OR.  a.     In this case, the family had not yet been offered these nonsurgical approaches (structured weight management program, physical support, dietician) 2.     Discuss benefits vs risks. Benefits – preventing progression of hip disease, improvement of OSA, decreased risk of cardiometabolic dx. Risks – anatomic/infectious/nutrition risks  3.     Decision-making capacity was assessed. Found that the parents were more advocating for the surgery saying she has a poor quality of life physically and socially. When the patient was separated from her parents, she said she could lose weight if she had healthier foods at home and someone to exercise with. The patient had decision-making capacity & did not assent to surgery.  4.     When the ethics team interviewed the patient and parents, the parents had a strong preference toward surgery vs patient was scared of surgery and wanted to try other approaches first  a.      Decided that the child's dissent outweighed the medical necessity for surgery and that there were conservative treatment options still available to try  - Highlighted Outcomes  - ASMBS guidelines give us good direction on who qualifies for surgery and emphasize an interdisciplinary approach to decision-making. The decision to pursue surgery should always weigh the benefits and risks and should be made collaboratively with the patient, family, and care team ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Quais são nossas metas gerais ao abordar um paciente com DM2?

Qual classe de antidiabéticos é obrigatória para pacientes com DM2 e doença renal do diabetes?

Wat zijn de belangrijkste wijzigingen in de herziene NHG-Standaard Diabetes mellitus type 2 (DM2)? Werkgroepleden Bas Houweling en Bertien Hart praten je in 40 minuten bij over onder meer een vernieuwd medicatieplan en DM2 in remissie. 

Discutiremos neste episódio a extensão do SURMOUNT-1, avaliando a eficácia da tirzepatida na prevenção do surgimento do DM2.

Classificando o risco cardiovascular do paciente com DM2

Qual é o antidiabético de primeira escolha para pacientes com DM2 e insuficiência cardíaca?

Manejo dos fatores de risco cardiovascular no DM2 – caso clínico

Como rastrear a insuficiência cardíaca em pacientes com DM2?

Quais fatores aumentam o risco de um paciente com DM2 apresentar insuficiência cardíaca?

Diretriz brasileira sobre o tratamento do DM2 em pacientes com insuficiência cardíaca

Quais opções de tratamento do DM2 aumentam as chances de remissão?

Congresso ADA 2024: prevenindo o DM2

It's only been a year and Maddie's addicted to mobile games. Has it been a while? It's been a long time. 53yo M w PMH of HTN, HLD, DM2 p/w NSTEMI w CP. Check out Binging with Bbirchtats on YouTube: https://www.youtube.com/watch?v=i6djKQIviwk Ride on the magic council! I went to the school to get the D. Dimothy? Doug Dimmidome? Drubder? YOU DON'T HAVE PARENTS! This anime is trash and I'm Oscar THE FUCKING GROUCH. This dying thing is sick... Triggering all chemists. Say hello to GUMBO, THE DESTROYER OF WORLDS. Has Jim been uploading to YouTube for us?? We know our FBI guy is at least named ..... Eddd.... Wurddd? He knows at least 3 of the 5 guys! The milkman, the paper boy, THE EVENING TV. Gariel and Angelo, the cats who love you.   If you'd like to request us to cover YOUR favorite anime on My Favorite Anime, then donate on Ko-fi or Patreon https://ko-fi.com/myfavoriteanime https://www.patreon.com/mfanime Merch is back up (with some exclusive patreon merch soon): https://animate-station.creator-spring.com/listing/tanks-are-for-girls-my-favor Links to the podcast: https://open.spotify.com/show/0AV1raD6J16xjX5sVTuqNR?si=s1174woBQMSAlEAdZZqKgQ https://pca.st/BA5s https://podcasts.apple.com/us/podcast/my-favorite-anime/id1448147787

Tratamento do DM2 no SUS: recomendações da SBD --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

The Basic Crawl 00:00:21 - Intro 00:11:07 - Some words from the show's editor Rich Tom and Jason's Top 5 Favorite Modules / Adventures 00:12:14 - Banter about the top 5 favorite modules / adventures 00:13:33 - Number 5 00:17:38 - Number 4 00:21:07 - Number 3 00:25:19 - Number 2 00:28:46 - Honorable Mentions 00:32:29 - Number 1 Jason and Tom answer Listener Questions 00:40:02 - Question 01 from Ivan 00:44:32 - Question 02, also from Ivan 00:48:26 - Question 03 from Jasper 00:52:30 - Question 04 from McWarmaker 00:59:38 - Question 05, also from McWarmaker 01:02:35 - Question 06 from Dr. DM2 01:09:19 - Question 07 from Jeppe 01:12:26 - Question 08 from Andy 01:15:18 - Question 09 from Necro-grantik 01:17:21 - Question 10 from intobats Join our Discord!

No último final de semana, o mundo da cardiologia foi bombardeado de novidades com o Congresso da ESC 2023. Após uma ampla cobertura no instagram e newsletter, chegou a vez de trazermos as novidades resumidas para você em um podcast, com comentários sobre as principais e diretrizes do evento. Pontos que abordaremos nesse episódio: Diretrizes: SCA, IC, endocardite, manejo cardiovascular do DM2 e cardiomiopatias; Artigos de IC: STEP-HFEpF; HEART-FID, QUEST, BUDAPEST CRT, CASTLE-HTX Artigos de arritmia: NOAH-AFNET, COP-AF Artigos de coronária: FIRE, STOPDAPT-3, MULTISTARS AMI, OPT-BIRISK

Você sabia que nem todo diabetes é igual? Além dos tipos 1 e 2, que são mais conhecidos, existem também o diabetes LADA e MODY. Neste episódio, vamos explicar as diferenças e semelhanças entre eles. Será que tem como prevenir?  E ainda: Quais os critérios de diagnóstico? DM2 tem cura? DM1 ocorre só em crianças? LADA e MODY são irreversíveis? O que todos os tipos de diabetes têm em comum? Estamos no Instagram: Dr. Souto - Sari Fontana  Área de membros do blog Ciência Low-Carb: Clique Aqui! Para ser avisado sobre cada novo episódio e receber os links das matérias mencionadas e as referências bibliográficas por e-mail, cadastre-se gratuitamente em https://drsouto.com.br/podcast Para aprender sobre rótulos e como fazer melhores escolhas, acesse https://sarifontana.substack.com/ e cadastre seu e-mail. Você passa a receber conteúdo gratuito, e se quiser apoiar este trabalho, receber conteúdo exclusivo e enviar rótulos para a Sari analisar, faça upgrade para os planos pagos. Conheça também o Podcurso Low-Carb da Teoria à Prática em https://drsouto.com.br/podcurso/

Hoy hablamos sobre cómo mejorar el control de la diabetes (y prevenirla) con Enol Sierra, graduado en Ciencias de la Actividad Física y el Deporte y experto en diabetes. Antes de empezar te recuerdo que si quieres aprender más sobre pérdida de peso, puedes hacerlo apuntándote a mi newsletter⁠masendocrino.com/listavip⁠. Cada domingo recibirás una pequeña historia con moraleja saludable sobre pérdida de peso y además, al suscribirte te llevas un ebook de regalo. Parece mentira que una enfermedad completamente prevenible y tratable, siga siendo la principal causa a nivel mundial de ceguera, de insuficiencia renal con diálisis y de amputaciones de miembros. Como te imaginarás estoy hablando de la temida diabetes, una verdadera epidemia que no ha parado de crecer en los últimos 50 años conforme crecía la otra gran epidemia del primer mundo, la obesidad. Pero ojo, por qué tipos de diabetes hay varias, lo mismo que tipos de tratamientos, que riesgos a largo plazo e incluso que gurús que van a intentar venderte la moto de que tienen la cura milagrosa de la diabetes. Para arrojar un poco de luz sobre un asunto tan complejo he charlado un ratito con Enol Sierra, graduado en ciencias de la actividad física y del deporte, experto en diabetes y conocido divulgador en redes. Hemos hablado de los diferentes tipos de diabetes, de qué es lo que estamos haciendo mal para que el problema siga creciendo y de algunas estrategias tanto nutricionales como ejercicio que podemos aplicar como pacientes para controlar la glucemia La verdad es que he disfrutado como un niño hablando con él, es un profesional de esos que sabe simplificar los conceptos para que lo entienda cualquiera y me dado una visión complementaria a la que tengo como endocrino que me ha sorprendido. En el programa de hoy hablamos de... Diferencias entre tipos de diabetes (DM1 y DM2) Principales riesgos de la diabetes Qué falla en el abordaje actual de la diabetes. ¿nos olvidamos de las causas y nos vamos solo a las consecuencias? ¿Nos olvidamos de prevenir y solo vamos a "curar"? Cuales son las recomendaciones básicas para alguien con DM2. Recomendaciones atípicas que no suelen dar los médicos pero que sí funcionan. Papel del ejercicio en el tratamiento de la diabetes Ejercicio básicos y sencillos para empezar Enfoque dietético para tratar la diabetes. Vídeos recomendados en el programa: Ejercicio de principiantes si tienes diabetes: https://youtu.be/6oE7hFRmPNE El mejor ejercicio para diabetes: https://youtu.be/DrcAI7fqcyk Más sobre Enol SIerra aquí: Club STOP diabetes Instagram Youtube Libro: La mentira de la Diabetes Un abrazo y ¡seguimos aprendiendo! ℹ️ ENLACES DE INTERÉS

Podcast Endocrinopapers: Nova diretriz SBD sobre tratamento do DM2 no Idoso --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

Suzanne Bakker, kaderhuisarts diabetes en collega's vroegen praktijkondersteuners en diabetesverpleegkundigen uit de huisartsenpraktijk naar hun eerste ervaringen met bijwerkingen van SGLT2-remmers bij mensen met DM2. In deze podcast praten zij en Marco Krukerink u helemaal bij over de ervaringen met SGLT2-remmers. GerelateerdH&W | Ervaringen met SGLT2-remmers

On this episode, we go over a pharmacotherapy plan for a patient with sickle cell disease, HFrEF, DM2, dyslipidemia, hypertension, POAG, dry eye disease, constipation, GERD, and OSA. Episode 227 Patient Case Information 57-year-old male with sickle cell disease, HFrEF, DM2, dyslipidemia, hypertension, POAG, dry eye disease, constipation, GERD, and OSA comes to your clinic to establish care. His primary concern is the number of sickle cell crisis he has been experiencing (3 ER visits in the last 5 months). He is having significant constipation daily due to his maintenance opioid regimen.  He also reports difficulty controlling his blood glucose. He has experienced 6 hypoglycemic events (BG range between 65 and as low as 42) and is confused as to what he is doing wrong with managing his diabetes. He is also concerned because he is having vivid nightmares almost every night. He also asks about the best artificial tears to get OTC because his Refresh Optive (carboxymethylcellulose) doesn't seem to be working anymore. Medication List: Losartan 100 mg daily, atenolol 50 mg daily, torsemide 20mg – 4 tabs daily, metolazone 2.5 mg 2 times per week, amlodipine 5 mg daily, simvastatin 40 mg daily, fenofibrate 160 mg daily, lantus 40 units twice daily, humalog 5 units with meals if his pre-meal BG is > 150 mg/dL, metformin ER 500 mg twice daily, hydroxyurea 500 mg – two capsules daily (admits to limited adherence), latanoprost 0.005% nightly, esomeprazole 40 mg twice daily, famotidine 40 mg daily, MiraLax 17 grams daily, and bisacodyl 5 mg daily He has a CPAP at home but admits to using it very infrequently. BMP BP – 165/89 HR – 82 Na – 137 K – 3.6 Cl – 102 CO2 – 26 Glucose – 253 eGFR – 95 mL/min Ca – 8.9 Mg – 1.9 Lipid Profile Chol – 162 LDL-C – 99 HDL-C – 49 Triglycerides  - 242 Echo with EF – 32% B-Type Natriuretic Peptide – 56.2 Vitamin B12 – 367 Hemoglobin – 7.2 Hematocrit – 20.8 MCV – 98.6 Ferritin – 1491.6 (received blood transfusion 2 weeks ago) Thanks for listening! If you want to support the podcast, check out our Patreon account. Subscribers will have access to all previous and new pharmacotherapy lectures as well as downloadable PowerPoint slides for each lecture. You can find our account at the website below:  www.patreon.com/corconsultrx If you have any questions for Cole or me, reach out to us on any of the following: Text - 415-943-6116 Mike - mcorvino@corconsultrx.com Cole - cswanson@corconsultrx.com Instagram and other social media platforms - @corconsultrx                  

Welcome back to Intellicast! In today's episode, Brian Lamar and Producer Brian cover the latest market research news and give a recap/teaser of some conferences! The episode kicks off with a chat about the upcoming IIeX conference at the end of May. Producer Brian will be speaking as he was named to the Greenbook Futures List. We're all familiar with Producer Brian and his awesome work behind the scenes so we're excited to see him on the main stage for a change! Brian Lamar shares some insight from his experience at IIeX and Producer Brian gives a little taste of his upcoming session. In the second segment, Brian and Brian discuss the latest market research news including the announcement that Big Village has sold its Insights and Agency Business to Blue Mountain Media for $20M and the latest Bellwether report by the Institute of Practitioners in Advertising which found that UK market research spending fell by a net 3.2% in Q1 of 2023. The Brians discuss what that might mean for us here in the US. The episode closes with an overview of what Brian Lamar says is now his favorite conference he's ever been to, the Insights Association Annual Conference, in Hilton Head. Find out more about Brian's session with Chuck Miller of DM2, the IA NCC being named Chapter of the Year, what made this conference the best ever, why he had to rent a bike, and more! It's really the best recap of a conference you can get. Thanks for listening! EMI's annual report on the sample industry, The Sample Landscape: 2023 Edition, is now available! Get your copy here: https://emi-rs.com/the-sample-landscape/ Register for our webinar with BrandTrust: http://ow.ly/K2qq50NYHWO Want to catch up on our blogs? Click here. Missed one of our webinars or want to get some of our whitepapers and reports? You can find it all on our Resources page on our website here. Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back to Intellicast! On today's episode, Brian Lamar and Producer Brian cover the latest news from the market research industry. The guys will take some time to cover current events, conferences, and more. Brian Lamar has had a busy travel schedule for Q1, so he kicks off the episode by sharing his experience with a few different industry conferences including Quirks, the Pharmaceutical Conference, the upcoming IA Annual Conference, and more! The overview of the IA Annual Conference is a great way to get warmed up for the event if you're attending. Brian even shares a preview of our speaking session with Chuck Miller of DM2. In the second segment, Brian and Brian discuss the 5th edition of The Sample Landscape report which launched April 11th. The report has an entirely new look and feel—listeners will get a sneak peek into how the sausage gets made in terms of laying out the research and its evolution. The report is truly a labor of love for everyone at EMI and we're always looking to make it better, so let us know what you think of it! The guys then touch on a few different news stories including Escalent's acquisition of Hall & Partners and C Space from Omnicom. The new combined organization will offer access to a proprietary platform that helps manage brand knowledge with almost 2,000 employees in 20 countries. They also touch on Xperiti's launch of Vepp which says it will mitigate fraudulent responses in B2B research. Sidenote: should the podcast start a “Market Research Name Quiz?” If we did, could you pass? Come on the podcast and find out! Thanks for listening! EMI's annual report on the sample industry, The Sample Landscape: 2023 Edition, is now available! Get your copy here: https://emi-rs.com/the-sample-landscape/ Want to catch up on our blogs? Click here. Missed one of our webinars or want to get some of our whitepapers and reports? You can find it all on our Resources page on our website here. Learn more about your ad choices. Visit megaphone.fm/adchoices

Quando é hora de iniciar uma insulina rápida para o paciente com DM2? --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

Como iniciar um esquema de insulinização nos pacientes com DM2? --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

Este pódcast está destinado exclusivamente a profesionales de la salud. El uso de finerenona ha mostrado eficacia y seguridad, volviéndose una nueva opción de tratamiento para pacientes con diabetes y enfermedad renal crónica e insuficiencia cardiaca. Nuestro invitado: El Dr. Carlos Alberto Garza García es médico internista y nefrólogo, actualmente ejerce en Monterrey, Nuevo León, México. Notas: https://espanol.medscape.com/verarticulo/5910670 Time stamps Presentación de nuestro invitado ... 01:13  Recomendaciones de la semana … 02:12 Finerenona … 05:06 Diferencia con otros fármacos … 07:08 Efectos clínicos … 09:30 Estudios clínicos representativos … 15:43 Inquietudes … 26:22 Puntos para llevar a casa … 33:41

Devo iniciar um inibidor de SGLT2 para um paciente com DM2, mesmo que ele esteja com HbA1c no alvo? --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

In deze aflevering is diëtist en diabetesverpleegkundige Harriet Verkoelen aan het woord. Vol passie vertelt ze over haar ervaring met de reguliere behandeling van diabetes type 2, en ook type 1, en hoe dat volgens haar niet klopt. Koolhydraatbeperking is volgens Harriet dé manier om medicatie en complicaties bij diabetes type 2 te verminderen.Ook legt ze uit wat de waarde is om naast het meten van glucose ook insuline te meten. Sinds kort bieden Harriet en ik met een klein team de gecombineerd OGTT (Orale Glucose Tolerantie Test) en IRT (Insuline Respons Test) aan. Ze legt uit waarom deze test zo belangrijk is en welke inzichten het biedt.Meer informatie over de insulinemetingen vind je op de website van Harriet Verkoelen. Lees hier haar wetenschappelijke publicatie over de resultaten van koolhydraatarm bij DM2. Zoek je begeleiding van een professional bij koolhydraatbeperking? Je vindt ze zowel op de website van Harriet als bij Ketogeen Instituut Nederland.Veel luisterplezier!Disclaimer: De informatie in deze podcast is informatief bedoeld en kan geenszins beschouwd worden als medisch advies.

On the latest Curtis News Network, the Howard Beach attack in depth. Plus, Kamala Harris is slammed for going to DM2 instead of Texas. Also, today mark's the 5 year anniversary of Hugh Hefner's death. And finally, today is Gwenyth Paltrow's 50th birthday. Learn more about your ad choices. Visit megaphone.fm/adchoices

Quando pensar em DM2 diante de um adulto jovem com diabetes? --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

September 15th is International Myotonic Dystrophy Awareness Day. To learn more about helping educate and advocate for Myotonic Dystrophy visit the Muscular Dystrophy Association or Myotonic Dystrophy Foundation. The purpose of this Awareness Day is to garner the attention of the wider general public, policy makers, regulators, biopharmaceutical representatives, researchers, health care professionals, and anyone with an interest in changing the future of myotonic dystrophy. Raising awareness of myotonic dystrophy will help improve service provision, basic research, drug development, and policymaking related to the disease. Increased funding for myotonic dystrophy research will improve health outcomes, reduce disability, and increase life expectancy for individuals living with the disease, and holds great promise for helping individuals with diseases with similar genetic bases, such as Fragile X syndrome and Huntington's disease. To learn about the different types of myotonic dystrophy, visit this NORD webpage. In addition to this podcast host/producer who lives with Myotonic Dystrophy Type 1, the following podcast episodes have featured guests living with DM1, DM2, or caregivers in a DM family: Food = Medicine Passion and Motivation to Move through the Hard Stuff Working with Wounded Warriors Music Gives Me a Peace Bubble Salute to Caregivers Stories of Healing with Essential Oils

Episode 98: Apretude and code blue. Apretude is a new injectable medication for HIV pre-exposure prophylaxis (PrEP), Dr. Yomi presents how to use it. Then, Mandeep, Jon, and.  Introduction: Apretude, a new injectable for HIV PrEP.  By Timiiye Yomi, MD. Moderated by Jennifer Thoene, MD.   What is HIV PrEP? Pre-exposure prophylaxis (or PrEP) consists of taking medication when a patient has a high risk of contracting HIV to lower their chances of getting infected.  Who can take HIV PrEP? Individuals who may benefit from PrEP include but are not limited to: Male who have sex with male (MSM), people with multiple sexual partners with no consistent use of condoms, or people who have been diagnosed with an STD in the past 6 months, IV drug users who share needles, syringes, or other injection equipment. History of HIV PrEP: In 2012, the first medication for HIV PrEP was approved—Truvada® (tenofovir-emtricitabine). Truvada is a once-daily oral prescription drug. Seven years later, in 2019, the next medication for HIV PrEP was approved— Descovy® (tenofovir alafenamide and emtricitabine). It is also a daily PO medication. But today we want to introduce you to the newest medication for HIV PrEP—Apretude® (cabotegravir). On Dec 20, 2021, FDA approved Apretude (cabotegravir), an extended-release injectable for HIV-1 pre-exposure prophylaxis for at-risk adolescents and adults who weigh at least 35 kg (77 lbs). Mechanism of action: Apretude is a long-acting integrase inhibitor that works by binding to the HIV integrase active site and blocking the strand transfer step of retroviral DNA integration. How is it given? Comes as a 600-mg (3-mL) injection. Patients receive 2 initiation injections administered 1 month apart, thereafter every 2 months. Patients can start medication immediately or first take the oral formulation for 4 weeks to assess how well they tolerate the medication before beginning the injection. Trials: The safety and efficacy of Apretude in reducing the risk of contracting HIV-1 were evaluated in two randomized double-blind trials comparing Apretude and Truvada (once-daily oral medication).Trial 1: Participants who took Apretude had a 69% less risk of contracting HIV compared to Truvada.Trial 2: Participants who took Apretude had a 90% less risk of contracting HIV compared to Truvada. Common side effects: Fever, malaise, fatigue, sleep problems, myalgias and arthralgias, headache, rash, red and swollen eyes, edema of face, lips, mouth, tongue; GI discomfort, hepatotoxicity, and depression. Note: Some drug-resistant HIV variants have been identified in people with undiagnosed HIV prior to beginning Apretude. People who test positive for HIV while on Apretude must transition to a complete HIV treatment regimen as Apretude is not approved for HIV treatment.  Requirements to receive Apretude: -Patient must be HIV-1 negative-Patient must remain negative to continue receiving Apretude-Patient must not miss any injections as this increases their risk of contracting the virus Apretude does not protect against other sexually transmitted infections. Patients must be sexually responsible and use other forms of protection such as condoms during sexual intercourse. This is the Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California. Our program is affiliated with UCLA, and it's sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________A code blue in clinic.  By Manpreet Singh, MS3; Jon-Ade Holter, MS3; and Sheinnera Gerongay, MS3. Ross University School of Medicine. What is a code blue?Arreaza: Today we will present to you a case to remind you about some principles of cardiopulmonary resuscitation (CPR). The term “code blue” in the United States refers to a situation where a patient is in cardiac arrest, respiratory arrest, unresponsive, or experiencing another medical emergency that requires immediate attention. “Code blue” is commonly used in hospitals and clinics to call a rapid response team to arrive immediately to evaluate the patient. We hope you can benefit from this brief review and feel ready for your next code blue. Of course, you will need more than we provide during these few minutes, but we hope it triggers your curiosity to keep learning or practicing. By the way, “code blue” is not standard for medical emergency in the whole world. For example, in the United Kingdom, they call it “code red”. Case presentation: Mr. DD 56-year-old man with a past medical history of coronary artery disease, recent MI, DM2, and CHF presents today to our clinic for hospital follow. He had an MI 2 weeks ago. He reports that when he was at home working in the yard, he suddenly had 8/10 retrosternal chest pain, pressure-like, accompanied by shortness of breath and diaphoresis. The pain radiated to the left side of his neck/jaw and down his left shoulder and arm. Jon: Nitroglycerin was taken by Mr. DD 3 times without resolution of symptoms. The patient was taken by EMS to Kern Medical ER. In the hospital, there was a 4mm ST elevation on ECG on leads II, III, and aVF. Q waves were also seen in anterior leads V4-V6. Patient was taken to cath lab and stent was placed in the RCA. ECHO showed decreased left ventricle wall motion and dilated left ventricle with an ejection fraction of 28%. Mr. DD was discharged after 5 days in the hospital.M: He is currently on lisinopril, carvedilol, atorvastatin, aspirin, clopidogrel, metformin, and digoxin. He states he is not compliant with all the medications because he forgets to get refills at times. He has a 35-pack year history of smoking and drinks 3-4 4oz drinks every day after work. He states he has used methamphetamine and cocaine intermittently within the last 6 months.J: Today, he lets the MA know that he is having some chest pain at night, shortness of breath with minimal activity for the last week, and at times he feels his heart is beating too fast. He has a follow-up appointment with cardiology in 2 weeks. The MA tells you that the patient vitals today are BP:195/105, HR: 108, RR: 28, and O2% 89% on room air. M: You are reviewing the patient's chart when you hear a loud thud coming from the room, you rush into the room and find the patient on the ground. The patient is unresponsive and is not moving. What is your next action? A. Try to lift the patient off the ground and back onto the chair or bed B. Give the patient nitroglycerin sublingually C. Call and wait for the EMS before proceeding D. Obtain IV accessE. See if the patient is arousable and check pulse and breathing E is the correct answer to this question because before initiating any type of treatment, first, you must assess the patient for alert response and their basic vitals such as their pulse and breathing.J: We do this because we need to know if the cardiopulmonary systems are intact. When they are not intact, regardless of the level of medical training, we must start CPR protocol. M: This patient most likely suffered a tachyarrhythmia, a very common post-MI-complication that causes the highest mortality rates. The most common cause of death are ventricular fibrillation and ventricular tachycardia. J: These are the steps we must take in order to start resuscitation of the cardiopulmonary system in any environment before the patient can be taken to a higher level of care. In this situation, Doctor Holter and Doctor Singh will perform 2-patient CPR. This is only an introduction of basic life support and advanced cardiac life support. You will need additional training to get the BLS and ACLS certificates. M: First, assure your environment is safe before preceding to render care. You want to be able to give the best uninterrupted care to your patient without becoming a patient yourself. Jon: Doctor Holter. Mandeep: Doctor Singh.J - Doctor Holter: I will reach down and check the patient. “Sir, Sir, are you okay” – I am assessing for reactions from visual or verbal cues given by me. When the patient is unresponsive to verbal and visual cues, I will give a painful stimulus to the patient such as a nail bed pinch or sternal rub. Next, it is necessary to assess the pulse and breathing of the patient. Narrator: The reason we check if the patient is alert is to assess the neurologic activity. The lack of response to painful stimuli indicates there is no self-protect response. To assess the carotid pulse, you must palpate the carotid artery by placing the index and middle fingers near the upper neck between the sternomastoid and trachea roughly at the level of the cricoid cartilage. Assess breathing by checking the rise and fall of the chest. Lack of responsiveness, pulse, and breathing indicates that immediate Cardiopulmonary Resuscitation (CPR) needs to be initiated. J - Doctor Holter: Please call 911 and get an AED.M - Doctor Singh: I will call 911 and get an AED.J- Doctor Holter: I will place the person on their back and start single-person CPR until Doctor Singh comes back. Narrator: CPR is performed by placing the patient flat on their back on an even surface. Place the heel of your hand on the center of the person's chest (on the mid sternum) then place the palm of your other hand on top. Press down 5-6 cm (2-2.5 inches) at a rate of 100-120 beats per minute. Compressions should not be interrupted because they serve as an artificial way of contracting the heart and circulating the blood to maintain blood perfusion. For 1 or 2 person CPR on an adult: Give 5 cycles of 30 compressions to 2 breaths.For 1 person CPR on a child: Give 5 cycles of 30 compressions to 2 breaths.For 2 person CPR on a child: Give 5 cycles of 15 compressions to 2 breaths.M - Doctor Singh : Doctor Holter, continue the compressions and I will give rescue breaths and start to place the AED pads on the patient. Let me know if you are tired and we can switch to give high-quality CPR with adequate depth and rate. Narrator: The AED comes with a diagram made on the pads to instruct where to place the pads. Once an AED is positioned correctly on the patient's chest, let it detect if a shockable rhythm is present. Shockable rhythms include ventricular fibrillation and ventricular tachycardia. If there is not a shockable rhythm detected, then continue with CPR until a higher level of care is reached. If a shockable rhythm is detected, the AED will advise the users to step back and verbalize “clear” in order to ensure that everyone is clear of the patient. It will then administer a shock to the patient in the range of 120-200 Joules, based on the device manufacturer's recommendation.M - Doctor Singh: Doctor Holter, stay clear of the patient. The AED advises shocking the patient. I will press the button to administer the shock now.Narrator: After administration of the first shock, ACLS guidelines recommend continuing CPR for 2 minutes without checking for a pulse, as effective cardiac contractility lags behind the restoration of an organized electrical rhythm. After the next 2-minute cycle of CPR, the AED will reanalyze the patient's rhythm to determine if the rhythm is once again shockable. J - Doctor Holter: Doctor Singh , continue high-quality CPR while I initiate ACLS protocol. I will get an IV and start epinephrine. M- Doctor Singh: I will continue CPR in the meantime. Narrator: ACLS starts with again CPR, AED rhythm reading, and shock administration but with a higher level of care (ACLS). You must obtain IV or IO access. Epinephrine is administered every 3-5 minutes during the cycle in doses of 1 mg at a time. After each dose of epinephrine and CPR for 2 minutes the AED should reassess if the rhythm is shockable, and then continue CPR for another 2 minutes. At this time, it is recommended to use amiodarone or lidocaine. CPR will continue but at this time patient will likely be in the ambulance on the way to the hospital, and EMS will be managing the cycles. The cycles will continue until return of spontaneous circulation is obtained.J: Myocardial infarction is the most common cause of shock-refractory ventricular fibrillation, along with coronary artery disease. If CPR does not resume spontaneous circulation within 40-50 minutes, there is a decreased chance of recovery. Spontaneous circulation may be achieved in patients with refractory Vfib with coronary revascularization. Therefore, in addition to traditional CPR, venoarterial ECMO (extracorporeal membrane oxygenation) can be used as an adjunct and can result in much better systemic perfusion. Essentially, this is a technique in which blood is drained from the body and circulated outside through an oxygen and heat exchanger and is then reintroduced into the body. This technique can be used if preparing for coronary revascularization. M: Vfib is a great risk in the acute phase after MI, up to 72 hours after revascularization, due to the recent ischemia and reperfusion. After the first 72 hours and up to a month following, Vfib remains a risk due to the continued remodeling of the heart. This newly remodeled tissue can cause interruptions in the normal electrical signaling of the heart leading to dissociated contractions and subsequent lack of perfusion through the body, which can quickly lead to death within minutes if not recognized and managed immediately with CPR and defibrillation as described.J: Clinicians should be aware of their patients who would be more susceptible to serious events such as this and be on top of their training about management. This may not be a common occurrence in clinics, but it is a very serious event and requires a prompt and appropriate response. Conclusion: Now we conclude our episode number 98 “Apretude and code blue.” Dr. Yomi concisely explained how to use the new injectable medication for HIV Pre-Exposure Prophylaxis (PrEP). Then, Manpreet, Jon, and Sheinnera presented a case that can actually happen in clinic and anywhere. CPR is a life-saving skill that needs to be learned and practiced over and over so we are not taken by surprise. Remember that heart disease continues to be the number 1 killer in the United States. So, make sure you know where your AED is and be ready to use it when needed. Even without trying, every night you go to bed being a little wiser.This week we thank Hector Arreaza, Timiiye Yomi, Jennifer Thoene, Manpreet Singh, Jon-Ade Holter, and Sheinnera Gerongay.Thanks for listening to Rio Bravo qWeek Podcast. If you have any feedback, contact us by email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. Audio edition: Suraj Amrutia. See you next week!_____________________References:American Heart Association 2022 CPR cheat sheet. American Heart CPR Class, BLS, ACLS Ft. Myers all Lee County. (n.d.). Retrieved June 2, 2022, from https://www.cprblspros.com/cpr-cheat-sheet-2022. Algorithms. CPR & First Aid, Emergency Cardiovascular Care, American Heart Association, cpr.heart.org. Retrieved June 2, 2022, from https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms. Bhar-Amato J, Davies W, Agarwal S. Ventricular Arrhythmia after Acute Myocardial Infarction: 'The Perfect Storm'. Arrhythm Electrophysiol Rev. 2017 Aug;6(3):134-139. doi: 10.15420/aer.2017.24.1. PMID: 29018522; PMCID: PMC5610731. Farkas, J. (2021, November 29). Post-mi complications. EMCrit Project. Retrieved June 2, 2022, from https://emcrit.org/ibcc/post-mi-complications/#ventricular_tachycardia. 

O que dizem os guidelines sobre terapia baseada em insulina nos pacientes com DM2? --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

O que o novo guideline da ADA recomenda para pacientes com DM2 e DRC? --- Send in a voice message: https://podcasters.spotify.com/pod/show/endocrinopapers/message

Happy Holidays! Brian and Brian are taking some time off, but never fear! We're back with another year of “Best of” episodes for you. You know the drill: in each episode, Brian and Brian will revisit some of our favorite interviews from the past year. So, let's get started! In Part 1 of our Best of Intellicast Season 4 episodes, we'll be revisiting interviews with Colson Steber of Communications for Research and Ag Access, Dan Fletcher of Research Defender, and Chuck Miller of DM2. [3:22-23:31] Colson's interview kicks off with a trip down memory lane to the last time he was on the podcast in April of 2020, the height of the pandemic. This sets the tone for the rest of his interview where he discusses the hurdles he faced leading his company through COVID, the launch of Ag Access, completely moving their call center to remote work and turnover challenges that ultimately lead to the lowest turnover rate the organization has ever seen! [23:32-55:00] In Dan and Chuck's interview, they discuss data quality trends in the industry covering everything from supply shifts to fraudulent behavior. They also share their best practices for data quality in survey design, noteworthy types of fraud, the transition away from cookies and third-party data, an increase in industry collaboration against fraud, and more! Thanks for listening to Part 1 of our Best of Season 4 series! Stay tuned for Part 2 next week! We have been nominated for the Market Research Podcast of the Year. Click here to vote for Intellicast! Want to catch up on our blogs? Click here. Missed one of our webinars or want to get some of our whitepapers and reports? You can find it all on our Resources page on our website here. Got a suggestion or feedback? Reach out to us at Intellicast@emi-rs.com, or on Twitter at @Intellicast1, or leave us a voicemail on our call-in line at 513-401-5463. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode, Dr. Christopher Tookey and Dr. Rose Wolbrink discuss metformin, one of the most common medications used for type 2 diabetes.  A disclaimer, we're providing general guidance but everyone is different and you should always discuss with your health care professional management of any disease and therapy before trying anything you discover from a source on the internet (including this podcast) 

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

Our final interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

Our final interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

This week, we continue our four-part interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

This week, we continue our four-part interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

This week, we continue our four-part interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

This week, we continue our four-part interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

This month, join us for a four-part interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

This month, join us for a four-part interview with the founder and President of DM2 (Disciple-Makers Multiplied), Bret Nazworth, as he discusses a new aspect of DM2's ministry entitled 3DTC (3D Training Center). 3DTC is a gap-year training program for young adults (18-25) that is designed to facilitate their growth into future disciple-makers.

Los inhibidores del cotrasportador de sodio y glucosa tipo 2 (SGLT2) son una “nueva” clase de fármacos para la diabetes mellitus tipo 2 (DM2) con un mecanismo de acción completamente distinto: con efectos en diabetes, corazón y riñón.

Show Notes Jeff: Welcome back to EMplify the podcast corollary to EB Medicine's Emergency Medicine Practice. I'm Jeff Nusbaum and I'm back with Nachi Gupta for the 30th episode of EMplify and the first Post-Ponte Vedra Episode of 2019. I hope everybody enjoyed a fantastic conference. This month, we are sticking in the abdomen for another round of evidence-based medicine, focusing on Emergency Department Management of Patients With Complications of Bariatric Surgery. Nachi: As the obesity epidemic continues to worsen in America, bariatric procedures are becoming more and more common, and this population is one that you will need to be comfortable seeing. Jeff: Thankfully, this month's author, Dr. Ogunniyi, associate residency director at Harbor-UCLA, is here to help with this month's evidence-based article. Nachi: And don't forget Dr. Li of NYU and Dr. Luber of McGovern Medical School, who both played a roll by peer reviewing this article. So let's dive in, starting with some background. Starting off with some real basics, obesity is defined as a BMI of greater than 30. Jeff: Oh man, already starting with the personal assaults, I see how this is gonna go… Show More v Nachi: Nah! Just some definitions, nothing personal! Jeff: Whatever, back to the article… Obesity is associated with an increased risk of hypertension, hyperlipidemia, and diabetes. Rising levels of obesity and associated co-morbidities also lead to an increase in bariatric procedures, and thereby ED visits! Nachi: One study found a 30-day ED utilization rate of 11% for those undergoing bariatric surgery with an admission rate of 5%. Another study found a 1-year post Roux-en-y ED visit rate of 31% and yet another found that 25% of these patients will require admission within 2 years of surgery. Jeff: Well that's kind worrisome. Nachi: It sure is, but maybe even more worrisome is the rising prevalence of obesity. While it was < 15% in 1990, by 2016 it reached 40%. That's almost half of the population. Additionally, back in 2010, it was estimated that 6.6% of the US population had a BMI> 40 – approximately 15.5 million adults!! Jeff: Admittedly, the US numbers look awful, and honestly are awful, but this is a global problem. From the 80's to 2008, the worldwide prevalence of obesity nearly doubled! Nachi: Luckily, bariatric surgical procedures were invented and honed to the point that they have really shown measurable achievements in sustained weight loss. Along with treating obesity, these procedures have also resulted in an improvement in associated comorbidities like hypertension, diabetes, NAFLD, and dyslipidemia. Jeff: A 2014 study even showed an up to 80% reduction in the likelihood of developing DM2 postoperatively at the 7-year mark. Nachi: Taken all together, the rising rates of obesity and the rising success and availability of bariatric procedures has led to an increased number of bariatric procedures, with 228,000 performed in the US in 2017. Jeff: And while it's not exactly core EM, we're going to briefly discuss indications for bariatric surgery, as this is something we don't often review even in academic training programs. Nachi: According to joint guidelines from the American Society for Metabolic and Bariatric Surgery, the American Association of Clinical Endocrinologists, and The Obesity Society, there are three groups that meet indications for bariatric surgery. The first is patients with a BMI greater than or equal to 40 without coexisting medical problems. The second is patients with a BMI greater than or equal to 35 with at least one obesity related comorbidity such as hypertension, hyperlipidemia, or obstructive sleep apnea. And finally, the third is patient with a BMI of 30-35 with DM or metabolic syndrome though current evidence is limited for this group. Jeff: Based on the obesity numbers, we just cited – it seems like a TON of people should be eligible for these procedures.