Podcasts about scientific sessions

Dean's Chat hosts, Drs. Jeffrey Jensen and Johanna Richey welcome Dr. David Armstrong to the podcast.  This discussion wasn't about the "Diabetic Foot" as much as it was getting to know what makes the world leader in "Diabetic Foot" click.  His background and fascination with technology, intro to podiatry (he considered law) to transforming clinical opportunities at Kern Hospital and UT- San Antonio.   Dr. Armstrong is Distinguished Professor of Surgery and Neurological Surgery with Tenure at the University of Southern California. Dr. Armstrong holds a Master of Science in Tissue Repair and Wound Healing from the University of Wales College of Medicine and a PhD from the University of Manchester College of Medicine, where he was appointed Visiting Professor of Medicine. He is founder and co-Director of the Southwestern Academic Limb Salvage Alliance (SALSA).  Dr. Armstrong has produced more than 720 peer-reviewed research papers in dozens of scholarly medical journals as well as over 120 books or book chapters. He is founding co- Editor of the American Diabetes Association's (ADA) Clinical Care of the Diabetic Foot, now in its fourth edition.  Armstrong is Director of USC's National Science Foundation (NSF) funded Center to Stream Healthcare in Place (C2SHiP) which places him at the nexus of the merger of consumer electronics, wearables, and medical devices in an effort to maximize hospital-free and activity-rich days. Dr. Armstrong was selected as one of the first six International Wound Care Ambassadors and is the recipient of numerous awards and degrees by universities and international medical organizations including the inaugural Georgetown Distinguished Award for Diabetic Limb Salvage. In 2008, he was the 25th and youngest-ever member elected to the Podiatric Medicine Hall of Fame. He was the first surgeon to be appointed University Distinguished Outreach Professor at the University of Arizona. He was also the first podiatric surgeon to be selected as President of Faculty at Keck School of Medicine of USC. Furthermore, he was the first podiatric surgeon to become a member of the Society of Vascular Surgery, and the first US podiatric surgeon named fellow of the Royal College of Surgeons, Glasgow. He is the 2010 and youngest ever recipient of both the ADA's Roger Pecoraro Award and 2023 recipient of the ISDF's Karel Bakker Award, the highest awards given in the field. Dr. Armstrong is past Chair of Scientific Sessions for the ADA's Foot Care Council, and a past member of the National Board of Directors of the American Diabetes Association. He sits on the Infectious Disease Society of America's (IDSA) Diabetic Foot Infection Advisory Committee and is the US appointed delegate to the International Working Group on the Diabetic Foot (IWGDF). Dr. Armstrong is the founder and co-chair of the International Diabetic Foot Conference (DF-Con), the largest annual international symposium on the diabetic foot in the world. He is also the Founding President of the American Limb Preservation Society (ALPS), a medical and surgical society dedicated to building interdisciplinary teams to eliminate preventable amputation in the USA and worldwide. https://limbpreservationsociety.org/ https://bakodx.com/ https://bmef.org/ www.explorepodmed.org https://podiatrist2be.com/  

Cardiologist Amit Khera, MD, chair of the American Heart Association's recent flagship meeting, discusses some of the most important clinical studies presented at the conference with JAMA Medical News Director Jennifer Abbasi. They touch on antiobesity drugs, new compounds to reduce lipoprotein(a), AI tools, and more. Related Content: Lp(a) Reduction, GLP-1s for Heart Failure, and More—Highlights From the AHA Scientific Sessions

The following question refers to Sections 7.3.3 and 7.3.6 of the 2022 ACC/AHA/HFSA Guideline for the Management of Heart Failure.The question is asked by Palisades Medical Center medicine resident & CardioNerds Academy Fellow Dr. Maryam Barkhordarian, answered first by UTSW AHFT Cardiologist & CardioNerds FIT Ambassador Dr. Natalie Tapaskar, and then by expert faculty Dr. Robert Mentz.Dr. Mentz is associate professor of medicine and section chief for Heart Failure at Duke University, a clinical researcher at the Duke Clinical Research Institute, and editor-in-chief of the Journal of Cardiac Failure. Dr. Mentz has been a mentor for the CardioNerds Clinical Trials Network as lead principal investigator for PARAGLIDE-HF and is a series mentor for this very Decipher the Guidelines Series. For these reasons and many more, he was awarded the Master CardioNerd Award during ACC22.The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance.Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. American Heart Association's Scientific Sessions 2024As heard in this episode, the American Heart Association's Scientific Sessions 2024 is coming up November 16-18 in Chicago, Illinois at McCormick Place Convention Center. Come a day early for Pre-Sessions Symposia, Early Career content, QCOR programming and the International Symposium on November 15. It's a special year you won't want to miss for the premier event for advancements in cardiovascular science and medicine as AHA celebrates its 100th birthday. Registration is now open, secure your spot here!When registering, use code NERDS and if you're among the first 20 to sign up, you'll receive a free 1-year AHA Professional Membership! Question #39 Ms. Kay Lotsa is a 48-year-old woman with a history of CKD stage 2 (baseline creatinine ~1.2 mg/dL) & type 2 diabetes mellitus. She has recently noticed progressively reduced exercise tolerance, leg swelling, and trouble lying flat. This prompted a hospital admission with a new diagnosis of decompensated heart failure. A transthoracic echocardiogram reveals LVEF of 35%. Ms. Lotsa is diuresed to euvolemia, and she is started on carvedilol 25mg BID, sacubitril/valsartan 49-51mg BID, and empagliflozin 10mg daily, which she tolerates well. Her eGFR is at her baseline of 55 mL/min/1.73 m2 and serum potassium concentration is 3.9 mEq/L. Your team is anticipating she will be discharged home in the next one to two days and wants to start spironolactone. Which of the following is most important regarding her treatment with mineralocorticoid antagonists?ASpironolactone is contraindicated based on her level of renal impairment and should not be startedBSerum potassium levels and kidney function should be assessed within 1-2 weeks of starting spironolactoneCEplerenone confers a higher risk of gynecomastia than does spironolactoneDThe patient will likely not benefit from initiation of spironolactone if her cardiomyopathy is ischemic in origin Answer #39 ExplanationThe correct answer is B – after starting a mineralocorticoid receptor antagonist (MRA), it is important to closely monitor renal function and serum potassium levels.MRA (also known as aldosterone antagonists or anti-mineralocorticoids) show consistent improvements in all-cause mortality, HF hospitalizations, and SCD across a wide range of patients with HFrEF.

The following question refers to Sections 7.4 and 7.5 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.The question is asked by the Director of the CardioNerds Internship Dr. Akiva Rosenzveig, answered first by Vanderbilt AHFT cardiology fellow Dr. Jenna Skowronski, and then by expert faculty Dr. Randall Starling.Dr. Starling is Professor of Medicine and an advanced heart failure and transplant cardiologist at the Cleveland Clinic where he was formerly the Section Head of Heart Failure, Vice Chairman of Cardiovascular Medicine, and member of the Cleveland Clinic Board of Governors. Dr. Starling is also Past President of the Heart Failure Society of America in 2018-2019. Dr. Staring was among the earliest CardioNerds faculty guests and has since been a valuable source of mentorship and inspiration. Dr. Starling's sponsorship and support was instrumental in the origins of the CardioNerds Clinical Trials Program.The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance.Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. American Heart Association's Scientific Sessions 2024As heard in this episode, the American Heart Association's Scientific Sessions 2024 is coming up November 16-18 in Chicago, Illinois at McCormick Place Convention Center. Come a day early for Pre-Sessions Symposia, Early Career content, QCOR programming and the International Symposium on November 15. It's a special year you won't want to miss for the premier event for advancements in cardiovascular science and medicine as AHA celebrates its 100th birthday. Registration is now open, secure your spot here!When registering, use code NERDS and if you're among the first 20 to sign up, you'll receive a free 1-year AHA Professional Membership! Question #38 Mrs. M is a 65-year-old woman with non-ischemic dilated cardiomyopathy (LVEF 40%) and moderate to severe mitral regurgitation (MR) presenting for outpatient follow-up. Despite improvement overall, she continues to experience dyspnea on exertion with two flights of stairs and occasional PND. She reports adherence with her medication regimen of sacubitril-valsartan 97-103mg twice daily, metoprolol succinate 200mg daily, spironolactone 25mg daily, empagliflozin 10mg daily, and furosemide 80mg daily. A transthoracic echocardiogram today shows an LVEF of 35%, an LVESD of 60 mm, severe MR with a regurgitant fraction of 60%, and an estimated right ventricular systolic pressure of 40 mmHg. Her EKG shows normal sinus rhythm at 65 bpm and a QRS complex width of 100 ms. What is the most appropriate recommendation for management of her heart failure?AContinue maximally tolerated GDMT; no other changesBRefer for cardiac resynchronization therapy (CRT)CRefer for transcatheter mitral valve intervention Answer #38 ExplanationChoice C is correct. The 2020 ACC/AHA Guidelines for the management of patients with valvular heart disease outline specific recommendations.In patients with chronic severe secondary MR related to LV systolic dysfunction (LVEF

The following question refers to Section 7.4 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.The question is asked by the Director of the CardioNerds Internship Dr. Akiva Rosenzveig, answered first by Vanderbilt AHFT cardiology fellow Dr. Jenna Skowronski, and then by expert faculty Dr. Clyde Yancy.Dr. Yancy is Professor of Medicine and Medical Social Sciences, Chief of Cardiology, and Vice Dean for Diversity and Inclusion at Northwestern University, and a member of the ACC/AHA Joint Committee on Clinical Practice Guidelines.The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance.Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. American Heart Association's Scientific Sessions 2024As heard in this episode, the American Heart Association's Scientific Sessions 2024 is coming up November 16-18 in Chicago, Illinois at McCormick Place Convention Center. Come a day early for Pre-Sessions Symposia, Early Career content, QCOR programming and the International Symposium on November 15. It's a special year you won't want to miss for the premier event for advancements in cardiovascular science and medicine as AHA celebrates its 100th birthday. Registration is now open, secure your spot here!When registering, use code NERDS and if you're among the first 20 to sign up, you'll receive a free 1-year AHA Professional Membership! Question #37 Mr. S is an 80-year-old man with a history of hypertension, type II diabetes mellitus, and hypothyroidism who had an anterior myocardial infarction (MI) treated with a drug-eluting stent to the left anterior descending artery (LAD) 45 days ago. His course was complicated by a new LVEF reduction to 30%, and left bundle branch block (LBBB) with QRS duration of 152 ms in normal sinus rhythm. He reports he is feeling well and is able to enjoy gardening without symptoms, though he experiences dyspnea while walking to his bedroom on the second floor of his house. Repeat TTE shows persistent LVEF of 30% despite initiation of goal-directed medical therapy (GDMT). What is the best next step in his management?AMonitor for LVEF improvement for a total of 60 days prior to further interventionBImplantation of a dual-chamber ICDCImplantation of a CRT-DDContinue current management as device implantation is contraindicated given his advanced age Answer #37 Explanation Choice C is correct. Implantation of a CRT-D is the best next step. In patients with nonischemic DCM or ischemic heart disease at least 40 days post-MI with LVEF ≤35% and NYHA class II or III symptoms on chronic GDMT, who have reasonable expectation of meaningful survival for >1 year,ICD therapy is recommended for primary prevention of SCD to reduce total mortality (Class 1, LOE A). A transvenous ICD provides high economic value in this setting, particularly when a patient's risk of death from ventricular arrhythmia is deemed high and the risk of nonarrhythmic death is deemed low. In addition, for patients who have LVEF ≤35%, sinus rhythm, left bundle branch block (LBBB) with a QRS duration ≥150 ms, and NYHA class II, III, orambulatory IV symptoms on GDMT, cardiac resynchronization therapy (CRT) is indicated to reduce total mortality, reduce hospitalizations, and improve symptoms and QOL. Cardiac resynchronization provides high economic value in this setting. Mr.

The following question refers to Sections 2.1 and 4.2 of the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure.The question is asked by CardioNerds Academy Intern Dr. Adriana Mares, answered first by CardioNerds FIT Trialist Dr. Christabel Nyange, and then by expert faculty Dr. Shelley Zieroth. Dr. Zieroth is an advanced heart failure and transplant cardiologist, Head of the Medical Heart Failure Program, the Winnipeg Regional Health Authority Cardiac Sciences Program, and an Associate Professor in the Section of Cardiology at the University of Manitoba. Dr. Zieroth is a past president of the Canadian Heart Failure Society. She has been a PI Mentor for the CardioNerds Clinical Trials Program. The Decipher the Guidelines: 2022 AHA / ACC / HFSA Guideline for The Management of Heart Failure series was developed by the CardioNerds and created in collaboration with the American Heart Association and the Heart Failure Society of America. It was created by 30 trainees spanning college through advanced fellowship under the leadership of CardioNerds Cofounders Dr. Amit Goyal and Dr. Dan Ambinder, with mentorship from Dr. Anu Lala, Dr. Robert Mentz, and Dr. Nancy Sweitzer. We thank Dr. Judy Bezanson and Dr. Elliott Antman for tremendous guidance. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. American Heart Association's Scientific Sessions 2024As heard in this episode, the American Heart Association's Scientific Sessions 2024 is coming up November 16-18 in Chicago, Illinois at McCormick Place Convention Center. Come a day early for Pre-Sessions Symposia, Early Career content, QCOR programming and the International Symposium on November 15. It's a special year you won't want to miss for the premier event for advancements in cardiovascular science and medicine as AHA celebrates its 100th birthday. Registration is now open, secure your spot here!When registering, use code NERDS and if you're among the first 20 to sign up, you'll receive a free 1-year AHA Professional Membership! Question #36 A 50-year-old woman presents to establish care. Her medical history includes COPD, prediabetes, and hypertension. She is being treated with chlorthalidone, amlodipine, lisinopril, and a tiotropium inhaler. She denies chest pain, dyspnea on exertion, or lower extremity edema. On physical exam, blood pressure is 154/88 mmHg, heart rate is 90 beats/min, and respiration rate is 22 breaths/min with an oxygen saturation of 94% breathing ambient room air. BMI is 36 kg/m2. Jugular venous pulsations are difficult to assess due to her body habitus. Breath sounds are distant, with occasional end-expiratory wheezing. Heart sounds are distant, and extra sounds or murmurs are not detected. Extremities are warm and without peripheral edema. B-type natriuretic peptide level is 28 pg/mL (28 ng/L). A chest radiograph shows increased radiolucency of the lungs, flattened diaphragms, and a narrow heart shadow consistent with COPD. An electrocardiogram shows evidence of left ventricular hypertrophy. The echocardiogram showed normal LV and RV function with no significant valvular abnormalities. In which stage of HF would this patient be classified?AStage A: At Risk for HFBStage B: Pre-HFCStage C: Symptomatic HFDStage D: Advanced HF  Answer #36 Explanation The correct answer is A – Stage A or at risk for HF. This asymptomatic patient with no evidence of structural heart disease or positive cardiac biomarkers for stretch or injury would be classified as Stage A or “at risk” for HF. The ACC/AHA stages of HF emphasize the development and progression of disease with specific therapeutic interventions at each stage. Advanced stages and disease progression are associated with reduced survival. The stages were revised in this edition of guidelines to emphasize new terminologies of “at risk” for Stage A and “pre...

In this special episode recorded live at the American Diabetes Association's 2024 Scientific Session the hosts of all of ADA's podcasts – that is Diabetes Care ‘On Air', DiabetesBio, Diabetes Core Update and Diabetes Day by Day - discuss making podcasts and discuss some of the presentations that they found compelling at the Scientific Sessions.  This special episode is supported by an independent educational grant from Bayer.   The group discusses high-impact research presented at the meeting, implications for future research, and clinical considerations and take-aways --- across the “bench-to-beside” spectrum of biomedical research, clinical research, and treatment advances. More information about ADA's portfolio of podcasts can be found at:      https://diabetesjournals.org/journals/pages/podcasts. The participants in the live recording include: Alice Cheng, MD, chair of ADA's 2024 Scientific Sessions Planning Committee and co-host of Diabetes Care ‘On Air' Kirk Habegger, PhD, cohost of DiabetesBio Michael Rickels, MD, MS, cohost of Diabetes Care ‘On Air' Darleen Sandoval, PhD, cohost of DiabetesBio Neil Skolnik, MD, cohost of Diabetes Core Update and Diabetes Day by Day Kevin Williams, PhD, cohost of DiabetesBio

Endocrinologist Robert Gabbay, MD, PhD, the ADA's chief scientific and medical officer, speaks with JAMA Medical News about clinical research highlights from the annual meeting, including some of the latest data on blockbuster weight loss medications, “game-changing” diabetes technologies, and a new use for a familiar drug. Related Content: New Data on GLP-1s, Diabetic Retinopathy, and CGMs—Highlights From the ADA's Scientific Sessions

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

I list off the tech I'm most excited about from the ADA's Scientific Sessions. I cover cgms like the Libre 3 Plus that now works with pumps and the latest Dexcom G7 upgrades. I get into pumps from the Omnipod iPhone app, the CeQur insulin patch, and the Luna overnight AID insulin pump. And I get into updates from the Vertex stem cell therapy findings that could lead to a cure for type 1 diabetes.    Find a Doctor on ZocDoc (today's sponsor)   Fill out T1D Exchange Registry  (US residents only)   Join Patreon for Exclusive Content | Join Diabetech Community Discord   Follow my other pages: Instagram | Tik Tok | YouTube | Facebook   More Videos from ADA: Interview with Dexcom: https://youtu.be/FTjeMorMY30 Twiist Demo: https://youtu.be/FXaK77aFcV8   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, Rob provides an update on various Diabetics Doing Things projects, including the Diabetes Legends basketball clinic, upcoming speaking engagements, the "Doing Well with Diabetes" series, and a new podcast series with the International Diabetes Federation. He also plans to highlight Olympic and national team athletes who have previously appeared on the podcast. While the podcast schedule may be slightly less consistent over the next few weeks due to Rob's busy schedule, he promises to continue delivering high-quality content, including sharing the top 5 things he learned from the ADA 2024 Scientific Sessions. Main Topics Discussed: * Diabetes Doing Things Update (00:02:30) - Rob provides updates on the Diabetes Legends basketball clinic in Dallas, upcoming speaking engagements, and the "Doing Well with Diabetes" series in partnership with CenterWell and the North Texas Food Bank. * International Diabetes Federation Podcast (00:13:01) - Rob shares that he and Erica have been asked by the International Diabetes Federation to host a podcast series featuring athletes with diabetes, which will be a great opportunity to showcase their work. * Olympic Athlete Highlights (00:14:41) - Rob plans to re-air episodes featuring Olympic and national team athletes, such as Mark White, Mary Markworth, and Lauren Cox, to celebrate the upcoming Olympic games. * Summer Podcast Schedule (00:16:27) - Rob acknowledges that the podcast may not be as consistent over the next few weeks due to the various projects and events he is involved in, but he promises to continue providing high-quality content. * Top 5 Learnings from ADA 2024 (00:18:30) - Rob shares the top 5 things he learned from the ADA 2024 Scientific Sessions, focusing on insights from the poster sessions. * How emerging adults with type 1 diabetes seek self-care information (00:18:30) * The higher prevalence of psychotherapeutic drug use among adults with diabetes (00:22:36)  * The association between environmental mastery and reduced diabetes distress (00:24:35) * The impact of a digital health coaching program on food insecure rural populations with type 2 diabetes (00:28:55) * The differing glucose responses to moderate vs. high intensity exercise (00:30:57) Key References: International Diabetes Federation (IDF) virtual event "The Power of Movement To Tackle Diabetes"  Breakthrough T1D event in Dallas, TX Diabetes Legends Basketball Camp in Denver "Doing Well with Diabetes" series with CenterWell primary care

It's In the News! A look at the top diabetes stories and headlines happening now. Top stories this week: The Eversense CGM could soon be approved for one year of continuous use, the first generic GLP-1 medication is launched, a new company tauts and all-in-one sensor and pump infusion set, a new diabetes accessory in the Roblox game, and more! Find out more about Moms' Night Out  Please visit our Sponsors & Partners - they help make the show possible! Learn more about Gvoke Glucagon Gvoke HypoPen® (glucagon injection): Glucagon Injection For Very Low Blood Sugar (gvokeglucagon.com) Omnipod - Simplify Life Learn about Dexcom  Edgepark Medical Supplies Check out VIVI Cap to protect your insulin from extreme temperatures Learn more about AG1 from Athletic Greens  Drive research that matters through the T1D Exchange The best way to keep up with Stacey and the show is by signing up for our weekly newsletter: Sign up for our newsletter here Here's where to find us: Facebook (Group) Facebook (Page) Instagram Twitter Check out Stacey's books! Learn more about everything at our home page www.diabetes-connections.com  Reach out with questions or comments: info@diabetes-connections.com Episode transcription with links: Hello and welcome to Diabetes Connections In the News! I'm Stacey Simms and every other Friday I bring you a short episode with the top diabetes stories and headlines happening now. XX In the news is brought to you by Edgepark simplify your diabetes journey with Edgepark XX The first ever generic GLP-1 medication will soon be available in the US. It's a generic of Victoza, originally approved by the FDA in 2010 for diabetes, is part of the same class of drugs that includes Ozempic and Mounjaro. Liraglutide is Glucagon-like peptide-1 receptor agonists (otherwise known as GLP-1s or GLP-1 RAs) are a class of incretin drugs that mimic the body's natural hormones to help treat diabetes and obesity. However, the popularity of the drugs has spiraled out of control at times, leading to shortages and supply chain issues in the US and abroad.  The arrival of a GLP-1 generic drug provides reasons to be hopeful for doctors and patients alike, but there are also caveats. Couple of caveats - liraglutide is injected once daily (vs. weekly) and many doctors say it doesn't work as well for as many people as semaglutide and terzepatide. No confirmation on the price Two other generic options are being developed and could launch in December 2024. Patents for newer GLP-1 medications like Ozempic and Wegovy won't expire until several years down the road https://www.healthline.com/health-news/victoza-generic-glp1-drug-available XX Senseonics plans to launch a 365-day sensor in the U.S. in the fourth quarter of this year. A one-year Eversense CGM could be a game changer for the company.   In 2024, Senseonics expects to more than double U.S. new patient starts and increase the global installed base by around 50%. The growth is built on the current 180-day version of Senseonics' implantable Eversense CGM. Eversense's 180-day sensor can need calibrating twice a day, something Senseonics CEO Tim Goodnow said “has been a competitive disadvantage.” Users calibrate the 365-day sensor once a week. Senseonics is in talks with insulin pump manufacturers about integrating its Eversense CGM with their devices but has yet to commit to a timeline for finalizing an agreement. https://www.medtechdive.com/news/senseonics-365-day-cgm-2025-sales/719717/ XX People who take Ozempic or Wegovy may have a higher risk of developing a rare form of blindness, a new study suggests. Still, doctors say it shouldn't deter patients from using the medicines to treat diabetes or obesity.   Last summer, doctors at Mass Eye and Ear noticed an unusually high number of patients with non-arteritic anterior ischemic optic neuropathy, or NAION, a type of eye stroke that causes sudden, painless vision loss in one eye.   The condition is relatively rare — up to 10 out of 100,000 people in the general population may experience it — but the doctors noted three cases in one week, and each of those patients was taking semaglutide medications. The risk was found to be greatest within the first year of receiving a prescription for semaglutide.   The study, published Wednesday in the medical journal JAMA Ophthalmology, cannot prove that semaglutide medications cause NAION. And the small number of patients — an average of about 100 cases were identified each year — from one specialized medical center may not apply to a broader population. The ways that semaglutides interact with the eyes are not entirely understood. And the exact cause of NAION is not known either. The condition causes damage to the optic nerve, but there is often no warning before vision loss.   For now, patients who are taking semaglutide or considering treatment should discuss the risks and benefits with their doctors, especially those who have other known optic nerve problems such as glaucoma or preexisting visual loss, experts say https://www.reuters.com/business/healthcare-pharmaceuticals/wegovy-ozempic-linked-with-sight-threatening-eye-disorder-study-2024-07-03/ XX We got some updates at ADA about the over the counter CGMS Dexcom Stelo and Abbot's Libre. Dexom plans a late august launch of stelo, which you'll order from their website – it won't be physically in stores. Abbott also plans to sell its wellness-oriented Lingo device this summer through an e-commerce website. That's a sensor that's been available in other coutnires for a while, but was recently okayed in the US. It's not meant for people with diabetes. The Libre Rio is designed or adulst with type 2 who don't use insulin. No timing yet on that product's launch. Neither Abbott nor Dexcom have disclosed pricing for the upcoming products. https://www.medtechdive.com/news/abbott-dexcom-over-the-counter-cgm-launch/719928/ XX Insulet is looking to expand the label for its Omnipod 5 insulin pump for people with Type 2 diabetes. The company said Friday it recently filed with the Food and Drug Administration. Insulet presented study results at the American Diabetes Association's 84th Scientific Sessions that evaluated Omnipod 5 in people with Type 2 diabetes who were taking basal insulin or multiple daily injections. The results showed “substantial improvements in blood glucose outcomes and overall quality of life,” said study chair Francisco Pasquel, an associate professor of endocrinology at Emory School of Medicine. Omnipod 5 is currently cleared in the U.S. for people with Type 1 diabetes. Insulet hopes to expand the pump to people with Type 2 diabetes, with an expected launch in early 2025. The FDA has not yet cleared any automated insulin delivery systems for people with Type 2 diabetes, Insulet said. The company has a basal-only insulin pump, called Omnipod Go, that was cleared for people with Type 2 diabetes last year, but it does not connect to other devices. Even though Omnipod 5 is not currently indicated for Type 2 diabetes, doctors prescribe it for their patients with full reimbursement since the pharmacy channel doesn't distinguish between Type 1 or Type 2 patients, J.P. Morgan analyst Robbie Marcus wrote in a research note on Sunday. https://www.medtechdive.com/news/insulet-omnipod-5-type-2-diabetes-study/719644/ XX In the keynote address at the American Diabetes Association annual conference, FDA Commissioner Dr. Robert Califf expressed concerns about the rising rates of diabetes in the U.S. Though revolutionary medications and technologies for diabetes and weight loss continue to emerge, these treatments are vastly underused. The silver lining lies with type 1 diabetes therapies, which are showing great promise in clinical trials. “For the larger epidemic of type 2 diabetes, we're failing right now,” Califf said. “I don't say that lightly.” A huge problem, Califf said, is access. While most health insurance plans cover medical devices and medications for diabetes, without insurance, costs add up quickly. Ozempic, for example, costs nearly $1,000 per month without insurance. Studies have found that regardless of insurance status, roughly 26% of Americans skipped or delayed treatment due to cost. https://diatribe.org/diabetes-management/fda-commissioner-says-were-failing-people-type-2-diabetes XX Embecta presented two abstracts at the American Diabetes Association Scientific Sessions last weekend making the case for its insulin patch pump for Type 2 diabetes. The company submitted the device for Food and Drug Administration clearance in late 2023. The diabetes device company developed a patch pump with a larger insulin reservoir that can hold up to 300 units. Embecta, which is better known for making equipment such as pen needles and insulin syringes, has been developing its first patch pump. The company found that a device with a larger insulin reservoir could provide longer wear times and fewer disposable patches. https://www.medtechdive.com/news/embecta-insulin-patch-pump-volume-american-diabetes-association/719779/ XX   Pump/CGM sensor in one The niaa signature patch pump, shown with a watch displaying current blood sugar level The niaa signature patch pump has a manual bolus button and is part of an in-development AID system. Swiss technology maker Pharmasens demonstrated a new semi-reusable tubeless patch pump and glucose sensor in the same compact device, called the niia signature, which the company says can be worn for five days.   The top of the device, which includes Bluetooth connectivity and the electronic and mechanical parts to control the pump, separates from the disposable 300-unit reservoir along with the adhesive used to attach the device to the body via a steel cannula. A small button on the device allows manual bolusing. The company says an AID system will manage the device, controlled by smartphone.   PharmaSens' simpler basal-bolus patch pump, the niia essential, was submitted for FDA approval in late December. Availability of the niia signature AID system has yet to be announced. https://diatribe.org/diabetes-technology/diabetes-technology-display-ada-2024 XX Edgepark Commercial XX New international consensus statement offers guidance on the care and monitoring of people who are at high risk for type 1 diabetes (T1D). This is all about screening and testing for islet autoantibodies. These individuals are classified as: At risk or Stage 0 (single autoantibody or transient single autoantibody), Stage 1 (two or more autoantibodies with normoglycemia), and Stage 2 (two or more autoantibodies with dysglycemia but without symptoms and not yet meeting diagnostic criteria for Stage 3 clinical T1D). The document was presented on June 24, 2024 in a 90-minute symposium at the American Diabetes Association's annual Scientific Sessions and published simultaneously in both Diabetes Care and Diabetologia. "This is not guidance around who to screen or when to screen. This is guidance for the hundreds of thousands of people around the world who have participated in screening, mostly through research programs, and have been identified with positive autoantibodies and need care in the clinical setting," panel co-chair Anastasia Albanese-O'Neill, PhD, APRN, CDCES, of Breakthrough T1D, told Medscape Medical News.   The recommendations also include when to start insulin, and how to provide education and psychosocial support to individuals and family members of those given the early-stage T1D diagnosis. https://www.medscape.com/viewarticle/experts-advise-early-risk-monitoring-type-1-diabetes-2024a1000bpo XX Roblox has added a diabetic option, complete with insuli pen and Dexcom You can find it in the marketplace JDRF – now breakthrough t1d – started a world in roblox a couple of years ago as well Roblox is a super popular online game that a lot of kids play. https://www.roblox.com/games/5823990610/Breakthrough-T1D-World XX FFL next week! Join us again soon!

This episode of StartUp Health NOW dives deep into the world of diabetes research and innovation. Host Logan Plaster takes you inside the American Diabetes Association's annual conference in Orlando, Florida. Insights from industry leaders: Logan interviews StartUp Health's Impact Board members Chuck Henderson, CEO of the ADA, and Sean Sullivan, Program Officer at the Helmsley Charitable Trust. Get the latest updates: Hear directly from these leaders on the cutting edge of diabetes research, as they talk about the future of diabetes care and the role of startups in the broader ecosystem. Metabolic Moonshot on the horizon: Explore the upcoming launch of StartUp Health's Metabolic Moonshot, designed to build a community of founders and researchers tackling metabolic diseases. Tune in for a compelling look at the fight against diabetes and the innovative solutions emerging from the research community. Innovating in Alzheimer's disease? Learn how you can join our new Alzheimer's Moonshot. Want more content like this? Sign up for StartUp Health Insider™ to get funding insights, news, and special updates delivered to your inbox. Innovators: Health Transformer University fuels your health moonshot Funders: Become a Health Moonshot Champion

Send us a Text Message.Novo Nordisk expansion in the US:https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=168528Generic liraglutidehttps://www.onthepen.com/post/teva-launches-first-ever-generic-glp-1-a-game-changer-for-diabetes-and-weight-managementNew Wegovy Coupon:https://www.wegovy.com/coverage-and-savings/save-on-wegovy.htmlNew Mounjaro Card (tiktok video)https://mounjaro.lilly.com/savings-resourcesTirzepatide (tiktok video):https://www.reuters.com/business/healthcare-pharmaceuticals/weight-loss-drug-zepbound-resolves-sleep-apnea-up-52-patients-lilly-says-2024-06-21/Petrelintidehttps://www.onthepen.com/post/introducing-petrelintide-discover-the-promise-of-amalyn-agonist-medications-for-weight-lossGut bacteria:Interesting research that shows that type-2 diabetics have more microbiome in their gut that suppresses incretin hormones like GLP-1. This is more evidence that #glp1 medications fix what is biologically brokenhttps://www.onthepen.com/post/glp-1-slow-responders-gut-bacteria-may-hold-the-keyDACRA:https://ir.vikingtherapeutics.com/2024-06-24-Viking-Therapeutics-Presents-Preclinical-Data-on-Novel-Dual-Amylin-and-Calcitonin-Receptor-Agonists-at-84th-Scientific-Sessions-of-the-American-Diabetes-AssociationSupport the Show.MY WORK RELIES ON YOUR GENEROSITY, WAYS TO SUPPORT:Venmo: OnThePenCa$h App: ManOnMounjaroBECOME A MEMBER:https://www.youtube.com/channel/UCDocQ-4IhVS3ihy_dW7nSKw/joinSOCIAL LINKShttps://www.tiktok.com/@manonthemounjarohttps://twitter.com/ManOnMounjarohttps://instagram.com/manonthemounjarohttps://facebook.com/manonthemounjaro

In this excerpt from last July, Stephen Harrison shares results of the FASCINATE-2 study as part of SurfingMASH's larger coverage of exciting drug trials presented at The EASL Congress. The original writeup reads:This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This is the second session focusing on drug development, and specifically, on several presentations for exciting drugs in development. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers plenty of compelling clinical trial data.Jörn preludes this discussion by noting just how much important drug development research was released at this year's EASL Congress. Stephen proceeds from here to detail positive Phase 2b FASCINATE-2 clinical trial interim data for fatty acid synthase (FASN) inhibitor, denifanstat, as presented at EASL Congress by Rohit Loomba. In the process, Stephen elucidates why the idea of a FASN inhibitor is so exciting. It blocks de novo lipogenesis, which means it can have effects on inflammation and possibly direct fibrosis inhibition. Previously in Season 4, Episode 32, it was discussed why inflammation, which is tied to liver volume, might be a critical component to better understand for therapuetic development and the wider scope of liver health. From here, Stephen goes on to describe the trial, starting with basic design and sharing the MRI-PDFF and biomarker data that was presented at the EASL Congress. He finishes with safety and efficacy data and a general comment that the trial demonstrated, 'the drug is doing what it's intended.'

CME credits: 0.75 Valid until: 20-06-2025 Claim your CME credit at https://reachmd.com/programs/cme/plozasiran-aro-apoc3-decreases-apoc3-and-triglycerides-tg-in-patients-with-mixed-hyperlipidemia-muir-final-results/24409/ This program brings you select scientific abstracts and late-breaking results from the recent American College of Cardiology 2024 Scientific Sessions. From clinical trials like PIONEER-AF and VOYAGER PAD to updates on the new guidelines, faculty experts are here to break down ways to advance cardiovascular care for all.

CME credits: 0.50 Valid until: 30-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/acc-2024-shasta-2-final-study-results/24408/ This program brings you select scientific abstracts and late-breaking results from the recent American College of Cardiology 2024 Scientific Sessions. From clinical trials like PIONEER-AF and VOYAGER PAD to updates on the new guidelines, faculty experts are here to break down ways to advance cardiovascular care for all.

CME credits: 0.50 Valid until: 30-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/acc-2024-voyager-pad-part-2/24407/ This program brings you select scientific abstracts and late-breaking results from the recent American College of Cardiology 2024 Scientific Sessions. From clinical trials like PIONEER-AF and VOYAGER PAD to updates on the new guidelines, faculty experts are here to break down ways to advance cardiovascular care for all.

CME credits: 0.50 Valid until: 30-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/acc-2024-voyager-pad-part-1/24406/ This program brings you select scientific abstracts and late-breaking results from the recent American College of Cardiology 2024 Scientific Sessions. From clinical trials like PIONEER-AF and VOYAGER PAD to updates on the new guidelines, faculty experts are here to break down ways to advance cardiovascular care for all.

CME credits: 0.50 Valid until: 30-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/acc-2024-whats-really-new-in-electrophysiology-that-will-change-my-practice/24405/ This program brings you select scientific abstracts and late-breaking results from the recent American College of Cardiology 2024 Scientific Sessions. From clinical trials like PIONEER-AF and VOYAGER PAD to updates on the new guidelines, faculty experts are here to break down ways to advance cardiovascular care for all.

CME credits: 0.50 Valid until: 30-04-2025 Claim your CME credit at https://reachmd.com/programs/cme/acc-2024-the-pioneer-af-pci-trial/24404/ This program brings you select scientific abstracts and late-breaking results from the recent American College of Cardiology 2024 Scientific Sessions. From clinical trials like PIONEER-AF and VOYAGER PAD to updates on the new guidelines, faculty experts are here to break down ways to advance cardiovascular care for all.

It's Monday, November 13th, A.D. 2023. This is The Worldview in 5 Minutes heard at www.TheWorldview.com. I'm Adam McManus. (Adam@TheWorldview.com) By Adam McManus Why Nigeria tops list of 2023 Worst Persecutors Appearing on Washington Watch, the Family Research Council radio show, Jeff King, president of International Christian Concern, explained that Nigeria, Africa now tops the list of the 2023 Worst Persecutors of countries worldwide, edging out North Korea. KING: “Well, North Korea can always be number one or two on the list. We wanted to move Nigeria to the top. “If you look at the last 20 years, imagine up to 100,000 Christians killed, 3.5 million farmers pushed off their lands their land stolen. And this is all from radical Islamists. The mindbender in all this is that, year after year, they come to Washington and they say, ‘Oh, my gosh, this is such a hard problem to tackle. We're doing our best. Maybe if you sent more money or arms, we could do a better job.' “To scale these numbers up to the United States, imagine if in the last 20 years, 400,000 Christians had been murdered, and 18 million people kicked out of their homes and the government never does anything. The reason is because the Islamists are embedded in the government and they control the security organs of the state -- that's Intel, that's police, army, etc. So, Washington, I think, is slowly waking up to this and saying this is actually a religious conflict. They didn't actually even see that before.” The 88-page report documenting the world's most oppressive countries for Christians. Between 200 and 300 million Christians live under persecution – attacks, arrests, forced conversions, denial of rights and more – fueled by radical Islam, communist regimes, discrimination, and plain evil.  Pro-Hamas mob shuts down NYC's Grand Central Station Christian talk show host Todd Starnes reports that New York City's Grand Central Terminal was shut down on Saturday after thousands of pro-Hamas demonstrators, wearing headscarves, stormed the historic building. PROTESTORS: (yelling) “Shut it down. Shut it down.” NEW YORK POLICE: “This is the New York City Police Department. You are unlawfully obstructing pedestrian traffic. You are ordered to disperse now to allow the safe flow of pedestrian traffic. If you do so voluntarily, no charges will be placed against you. If you refuse to disperse, you will be placed under arrest and charged with disorderly conduct.” Viral News NYC tweeted, “Pro-Hamas and pro-Palestinians rioters break windows, spit, and kick cops.” Elsewhere in New York City, violent demonstrators clashed with Jews in Times Square and Columbus Circle outside Central Park. An Israeli flag was set on fire and fake blood was thrown on the front doors of The New York Times. The Netherlands: Abortions up almost 15% in 2022 According to the Dutch Healthcare and Youth Inspectorate, the number of abortions in the Netherlands increased by almost 15% last year, reports Evangelical Focus. The rise in mothers between 25 and 35 years of age who kill their unborn babies was up by 23%. And 13% more teenage mothers chose to abort their children. Proverbs 24:11 says, “Rescue those who are being taken away to death; hold back those who are stumbling to the slaughter.” DeSantis remains number one challenger to Trump According to a RealClearPolitics.com average of polls of Republican presidential contenders between October 17th and November 5th, Donald Trump polled at 58.5% among likely GOP voters.  Florida Governor Ron DeSantis came in at 14.4%, former U.N. Ambassador Nikki Haley at 9%, and entrepreneur Vivek Ramaswamy at 4.7%. Last Wednesday in Miami, NBC hosted the third Republican presidential debate which Trump chose not to attend.  DeSantis, who has been endorsed by Iowa Governor Kim Reynolds, spoke decisively on key issues like Bidenomics. DeSANTIS: “I'm going to take all the executive orders, the regulations, everything involving Bidenomics, and I'm going to rip it up and I'm going to throw it in the trashcan on Day One where it belongs.” The Florida governor spoke to our southern border. DeSANTIS: “I'm sending the U.S. military to the border. I'm going to stop the invasion cold. If someone in the drug cartels is sneaking fentanyl across the border when I'm president, that's going to be the last thing they do. We're going to shoot them stone cold dead.” DeSantis addressed Hamas-supporting students here in America on a student visa. DeSANTIS: “If you are here on a student visa, as a foreign national, and you're making common cause with Hamas, I'm canceling your visa and I'm sending you home.” And he appealed directly to the voter. DeSANTIS: “I will take the arrows. I will take the barbs because it's not about me. It's about you. It's not about the past. It's about your future. I will always put service above self as President. And, as your president, I will not let you down.” Sen. Joe Manchin not to seek re-election, possible presidential run Democrat Senator Joe Manchin of West Virginia, age 76, announced Thursday that he will not seek re-election to the Senate in 2024, reports TheHill.com. MANCHIN: “After months of deliberation and long conversation with my family, I believe in my heart of hearts that I have accomplished what I set out to do for West Virginia. I have made one of the toughest decisions of my life and decided that I will not be running for re-election to the United States Senate.” He was staring down the toughest electoral challenge of his Senatorial career, as West Virginia Republican Governor Jim Justice has increasingly become the favorite to win next year. However, Manchin has long flirted with a 2024 presidential bid with an upstart centrist party, called No Labels, that has shown interest in fielding a bipartisan presidential ticket. Good cardiovascular health can knock six years off your biological age And finally, good cardiovascular health can knock six years off your biological age, reports Good News Network. A team from Columbia University Medical Center in New York City tested the American Heart Association's Essential 8 checklist and the effects of sticking to it. To take care of the heart and blood vessels, which are linked to many diseases, adopt the Essential 8 habits: healthy sleep, not smoking, regular physical activity, healthy diet, healthy body weight, and healthy blood glucose, cholesterol and blood pressure. The study, presented at the American Heart Association's Scientific Sessions 2023 in Philadelphia, examined 6,500 adults from varying backgrounds and found that when people abided by the Essential 8 they tested six years younger biologically than their actual age. In 1 Corinthians 6:19-20, Paul asks, “Do you not know that your bodies are temples of the Holy Spirit, Who is in you, Whom you have received from God? You are not your own; you were bought at a price. Therefore, honor God with your bodies.” Close And that's The Worldview in 5 Minutes on this Monday, November 13th in the year of our Lord 2023. Subscribe by iTunes or email to our unique Christian newscast at www.TheWorldview.com. Or get the Generations app through Google Play or The App Store. I'm Adam McManus. (Adam@TheWorldview.com).  Seize the day for Jesus Christ.

Join us for an insightful journey into the world of diabetes management technology on this very special episode of Real-Time, Real Talk. Recorded live from the American Diabetes Association's 83rd Scientific Sessions in San Diego, host Nancy Hanna is joined by Dexcom's Cher Pastore in our very first simulcast. To explore how Dexcom and Omnipod are influencing the dynamics of diabetes technology and reshaping patient outcomes for the better, they're joined by Dr. Viral Shah - an endocrinologist whose research into these innovative therapies has touched and improved countless lives. Across the episode, you'll discover how technological advancements are changing the game and reducing daily management burdens for people with diabetes. Hear invaluable insights from Dr. Shah on the importance of early adoption of tools and how they can prove pivotal in managing diabetes and improving glycemic control. Dr Shah examines the different barriers to technology adoption, and how fostering a pro-active conversation can help overcome them. All this, plus a sneak peek into the future of diabetes tech. Real-time real talk is intended for healthcare professionals in the US. Disclaimer: This podcast is not approved for CME credit. Every diabetes treatment plan is different, individual results may vary – nothing you hear on this podcast should be considered medical advice. All claims are supported by clinical evidence referenced in the show notes. For clinical study results, please refer to the Dexcom G6 User Guide (chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://dexcompdf.s3.us-west-2.amazonaws.com/en-us/G6-CGM-Users-Guide-new.pdf). For product-related questions, please refer to the instructions for use. For complete safety information, go to dexcom.com/safety-information. Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings. Smart devices are sold separately. For a list of compatible smart devices, visit: dexcom.com/compatibility. The Dexcom G6 Continuous Glucose Monitoring System (Dexcom G6 System) is a real time, continuous glucose monitoring device indicated for the management of diabetes in persons aged 2 years and older. Dexcom's partners are working to integrate insulin pumps, insulin pens, and digital health apps with Dexcom G7. Data from collaborator devices and products must be verified by those collaborator devices and products. Users should confirm data and connections with their collaborator devices and products. A separate Follow app and internet connection are required to follow CGM users' glucose readings and trends. CGM users should always confirm glucose readings on the Dexcom G6 app or receiver before making treatment decisions. Dr. Viral Shah MD, is a paid spokesperson for Dexcom. About Hello Dexcom (https://provider.dexcom.com/prescribe-sample#block-contactus) Dexcom Provider website (https://provider.dexcom.com/) Warning: Do not use the Dexcom G7 CGM System or the Dexcom G6 System if you are on dialysis. The performance of these CGM systems has not been evaluated in this population and sensor readings may be inaccurate. Brief Safety Statement BRIEF SAFETY STATEMENT: Failure to use the Dexcom G6 Continuous Glucose Monitoring System (G6) and its components according to the instructions for use provided with your device and available at https://www.dexcom.com/safety-information and to properly consider all indications, contraindications, warnings, precautions, and cautions in those instructions for use may result in you missing a severe hypoglycemia (low blood glucose) or hyperglycemia (high blood glucose) occurrence and/or making a treatment decision that may result in injury. If your glucose alerts and readings from the G6 do not match symptoms, use a blood glucose meter to make diabetes treatment decisions. Seek medical advice and attention when appropriate, including for any medical emergency. Dexcom Clarity Safety Information The web-based Dexcom Clarity software is intended for use by both home users and healthcare professionals to assist people with diabetes and their healthcare professionals in the review, analysis, and evaluation of historical CGM data to support effective diabetes management. It is intended for use as an accessory to Dexcom CGM devices with data interface capabilities. Caution: The software does not provide any medical advice and should not be used for that purpose. Home users must consult a healthcare professional before making any medical interpretation and therapy adjustments from the information in the software. Caution: Healthcare professionals should use information in the software in conjunction with other clinical information available to them. Caution: Federal (US) law restricts this device to sale by or on the order of a licensed healthcare professional. Dexcom, Dexcom Follow, Dexcom Clarity, and Dexcom Share are registered trademarks of Dexcom, Inc. in the U.S., and may be registered in other countries. References: 1. Sue A. Brown, et al, Omnipod 5 Research Group; Multicenter Trial of a Tubeless, On-Body Automated Insulin Delivery System With Customizable Glycemic Targets in Pediatric and Adult Participants With Type 1 Diabetes. Diabetes Care 1 July 2021; 44 (7): 1630–1640. https://doi.org/10.2337/dc21-0172 2. Champakanath A, Akturk HK, Alonso GT, Snell-Bergeon JK, Shah VN. Continuous Glucose Monitoring Initiation Within First Year of Type 1 Diabetes Diagnosis Is Associated With Improved Glycemic Outcomes: 7-Year Follow-Up Study. Diabetes Care. 2022 Mar 1;45(3):750-753. doi: 10.2337/dc21-2004. 3. Mulinacci G, Alonso GT, Snell-Bergeon JK, Shah VN. Glycemic Outcomes with Early Initiation of Continuous Glucose Monitoring System in Recently Diagnosed Patients with Type 1 Diabetes. Diabetes Technol Ther. 2019 Jan;21(1):6-10. doi: 10.1089/dia.2018.0257. 4. https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52464&ver=49&contractorName=all&sortBy=updated&bc=13 5. Davis GM, Peters AL, Bode BW, Carlson AL, Dumais B, Vienneau TE, Huyett LM, Ly TT. Safety and Efficacy of the Omnipod 5 Automated Insulin Delivery System in Adults With Type 2 Diabetes: From Injections to Hybrid Closed-Loop Therapy. Diabetes Care. 2023 Apr 1;46(4):742-750. doi: 10.2337/dc22-1915. 6. Davis GM, et al. Automated Insulin Delivery with Remote Real-Time Continuous Glucose Monitoring for Hospitalized Patients with Diabetes: A Multi-Center, Single-arm, Feasibility Trial. Diabetes Technol Ther. 2023 Aug 14. doi: 10.1089/dia.2023.0304.

Join us for an insightful journey into the world of diabetes management technology on this very special episode of Beyond The Bolus. Recorded live from the American Diabetes Association's 83rd Scientific Sessions in San Diego, host Nancy Hanna is joined by Dexcom's Cher Pastore in our very first simulcast. To explore how Omnipod and Dexcom are influencing the dynamics of diabetes technology and reshaping patient outcomes for the better, they're joined by Dr. Viral Shah - an endocrinologist whose research into these innovative therapies has touched and improved countless lives. Across the episode, you'll discover how technological advancements are changing the game and reducing daily management burdens for people with diabetes. Hear invaluable insights from Dr. Shah on the importance of early adoption of tools such as CGM and the Omnipod Five, and how they can prove pivotal in managing diabetes and improving glycemic control. Dr Shah examines the different barriers to technology adoption, and how fostering a pro-active conversation can help overcome them. All this, plus a sneak peek into the future of diabetes tech. 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.

What We Learned at the ADA Scientific Sessions TAKING CONTROL OF YOUR DIABETES® - THE PODCAST! ...With Expert Endocrinologists Living with T1D, Drs. Steven V. Edelman & Jeremy PettusWe're talking highlights from the ADA Scientific Sessions! As one of the biggest medical diabetes conferences of the year, this event brings together thousands of experts, clinicians, and researchers to talk about the most exciting data and developments happening in diabetes right now.  And we're breaking down what you need to know. Tune in to hear about the latest cutting-edge research in diabetes treatments and how they could affect your management.Questions We'll Cover in This Episode: What is new with GLP-1 drugs? Can you prevent type 1 diabetes?  What is going on with once-weekly basal insulin?  How should you set a target for LDL cholesterol? How have the targets changed over the years? How do doctors measure and monitor kidney disease? What is happening with non-insulin therapies for type 1 diabetes?  ONE 2023 - https://events.blackthorn.io/en/36jDRT6/g/TCOYDCal/one-2023-in-person-august-18-20th-4a3cEY1N4n/overviewDiatribe - https://diatribe.org/JEREMY PETTUS, MDAssociate Professor, University of California, San Diego Health Systems; Director, Type 1 Track & CME, TCOYD; Co-Creator of We Are One DiabetesEUGENE WRIGHT, MDMedical Director, Performance Improvement; Charlotte Area Health Education Center (AHEC)JOHN B. BUSE, MD, PhDVerne S. Caviness Distinguished Professor; Director, Diabetes Center; Director, NC Translational and Clinical Sciences Institute; Senior Associate Dean, Clinical Research; University of North Carolina School of MedicineATHENA PHILIS-TSIMIKAS, MDCorporate VP, Scripps Whittier Diabetes Institute; Director of Community Engagement, Clinical Translational Science Award, Scripps Research Translational Institute; Co-Leader, Scripps Ambulatory Health Equity Council; Associate Clinical Professor of Medicine (voluntary), UCSDJUAN PABLO FRIAS, MDMedical Director and Principal Investigator, Velocity Clinical Research, Los Angeles; Assistant Clinical Professor of Medicine, UCSD**Tune in for 2 new episodes each month! Like what you hear and want to help us grow? Please rate and review this podcast so we can reach more people living with diabetes!** ★ Support this podcast ★

This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space.This episode starts with a welcome (and happy birthday) to Roger as he belatedly joins the discussion. From here Mazen discusses some of the implications of the anticipated upcoming approval for resmetirom and what that will mean for treatment, drug development and noninvasive tests. Stephen nexts dives into the phase 2b pemvidutide trial in greater detail. In response, Jörn notes that the weight loss is not what you might have expected from a GLP-1 and asks whether this has to be a function of GLP-1 to glucagon ratio. Stephen notes that there is a relatively high level of glucagon to GLP-1 in pemvidutide that might translate not only into greater antifibrotic activity, but also possibly a lower level of side effects relative to a combination agent with a lower level of glucagon compared to GLP-1.  Each conversation covers a lot of ground on drug development, analysis of trial results, and the upcoming increases in importance of omics and artificial intelligence. If you have questions or comments around the EASL Congress or ADA meetings, or the themes and data discussed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On

This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space.This final conversation covers a range of topics. Jörn starts off with comments around the importance of safety as well as some thoughts about dosing strategy relative to safety and initial tolerability. Stephen picks up on this issue before moving on to consider whether the drugs discussed have an impact on cravings for alcohol and might be successful in a broader set of patients. He then goes on to identify two concerns for the agent class: suicidal ideation and possible amounts of lean muscle loss, both of which need to be for further. Jörn notes that lean muscle loss might be particularly critical in the study of patients with cirrhosis who are frail to begin with. Stephen continues by discussing a review of the frequency of lean muscle loss for GLP-1s, suggesting a 20 to 50% loss in many cases. Finally, Louise comments on the possible psychological effects of this weight loss. All this leads to Roger's final question which asks what have we learned in the last month that might affect research or conceptual thinking going forward? The topics each panelists chooses vary largely, but the concepts and all the thoughts around them are stimulating and worth a listen. Each conversation covers a lot of ground on drug development, analysis of trial results, and the upcoming increases in importance of omics and artificial intelligence. If you have questions or comments around the EASL Congress or ADA meetings, or the themes and data discussed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On

This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This is the second session focusing on drug development, and specifically, on several presentations for exciting drugs in development. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers plenty of compelling clinical trial data. Jörn preludes this discussion by noting just how much important drug development research was released at this year's EASL Congress. Stephen proceeds from here to detail positive Phase 2b FASCINATE-2 clinical trial interim data for fatty acid synthase (FASN) inhibitor, denifanstat, as presented at EASL Congress by Rohit Loomba. In the process, Stephen elucidates why the idea of a FASN inhibitor is so exciting. It blocks de novo lipogenesis, which means it can have effects on inflammation and possibly direct fibrosis inhibition. Previously in Season 4, Episode 32, it was discussed why inflammation, which is tied to liver volume, might be a critical component to better understand for therapuetic development and the wider scope of liver health. From here, Stephen goes on to describe the trial, starting with basic design and sharing the MRI-PDFF and biomarker data that was presented at the EASL Congress. He finishes with safety and efficacy data and a general comment that the trial demonstrated, 'the drug is doing what it's intended.' The following excerpt is from the Sagiment Biosciences press release on this topic:The Phase 2b FASCINATE-2 study is a 52-week randomized, double-blind, placebo-controlled trial evaluating the safety and histological impact of a 50mg daily oral dose of denifanstat compared to placebo in 168 biopsy-confirmed NASH patients with moderate-to-severe fibrosis (stage F2 or F3). The primary efficacy endpoint is histological (liver biopsy) improvement at week 52 in nonalcoholic fatty liver disease (NAFLD) activity score (NAS) without worsening of fibrosis or resolution of steatohepatitis without worsening of fibrosis. Secondary endpoints include biomarkers of inflammation, fibrosis and liver injury.Denifanstat was well-tolerated and met primary endpoint in planned interim readout with 67% of treated patients achieving ≥30% reductions in liver fat at week 26 compared to 18% placebo (p

This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space. Jörn and Mazen begin by prompting Stephen with questions around the FASCINATE-2 study outlined in the previous conversation. Stephen confirms that the data presented was based on a planned interim analysis of a prespecified subset of patients at week 26 of a 52-week trial. Mazen next asks questions designed to challenge Stephen to reveal how excited he truly is about the drug (denifanstat) and surrounding data. Specifically, Mazen asks whether denifanstat feels like an add-on agent when compared to more 'mainstream' FGF-21 agents. Stephen responds by referring to a need for what he characterizes as a plethora of agents before commenting on possible and practical differences between orals and injectables. He suggests that injectables seem to produce faster drops in liver fat reduction and ALT improvements than orals, although orals may 'catch up' over time in a sort of 'tortoise and the hare' phenomenon. From here Stephen describes the ways which he might use injectables first in more severe patients before introducing orals after achieving the desired effect. He also talks about simply starting with orals in less severe patients. The group digs deeper into these ideas by introducing ACC inhibitors and pan-PPAR agonist, lanifibranor, to the conversation. Finally, concluding comments return to the theme that injectables might produce stronger efficacy results, although there are several agents yet to be clearly differentiated among orals. Each conversation covers a lot of ground on drug development, analysis of trial results, and the upcoming increases in importance of omics and artificial intelligence. If you have questions or comments around the EASL Congress or ADA meetings, or the themes and data discussed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On

This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. In doing so, the Big Band of Surfers (Stephen Harrison, Jörn Schattenberg, Louise Campbell and Roger Green) are joined by Mazen Noureddin for a fascinating conversation which covers compelling data and ideas emerging from the drug development space.Mazen starts this conversation by stressing the importance of omics, particularly metabolomics and proteomics, in creating a single blood-based measure that can offer standardization around evaluation or, otherwise, a small set of standard tests. He goes on to describe breakthrough obesity presentations at the ADA meeting and returns to the question that he raised in Episode 31: do we need NASH drugs given how powerful the upcoming weight-loss pharmacotherapies will be? He simply says, yes we do, and describes why. Stephen returns to the topic of omics, stating his preference for additional omics works, albeit with some skepticism about proteomics. That said, he questions whether omics will get a far enough and expresses hope that epigenetics might get even further. The rest of this conversation entails Mazen, Stephen and Jörn discussing biomarkers and omics issues. Stephen wraps up the session by noting that we will have plenty to talk about in this arena for years to come. Finally, he mentions AI as another key area for future growth. Each conversation covers a lot of ground on drug development, analysis of trial results, and the upcoming increases in importance of omics and artificial intelligence. If you have questions or comments around the EASL Congress or ADA meetings, or the themes and data discussed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On

This month, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from June's two major conferences: the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This is the second session focusing on drug development, and specifically, on several presentations for exciting drugs in development.This session kicks off with a twist as co-host Jörn Schattenberg introduces the episode and its panelists because Roger Green is late (he will join later with a bit of birthday banter). Joining this in-depth discussion around the latest drug development stories to emerge from the EASL and ADA meetings is Stephen Harrison, Mazen Noureddin and Louise Campbell.Stephen starts the episode by discussing findings from the Phase 2b FASCINATE trial of the FASN inhibitor denifanstat, as presented at the EASL Congress by Rohit Loomba. After describing key efficacy and safety findings, Stephen notes that denifanstat does pretty much what observers expected it to do. Mazen follows up with a series of questions noting that denifanstat's efficacy does not appear equal to the FGF-21s efruxifermin and pegozafermin, and asks whether it will become a "front-line" or "add-on" agent. In response, Stephen suggests we will need a plethora of modes of action, that orals and injectables will each have a place depending on the type of patient, and that this will compete for front-line use in less severe patients and maintenance use in more severe patients with the other oral agent classes. From here, the conversation moves on to discuss the increasing importance of omics and epigenetics, and the role these may play in the future. This is the point at which Roger joins the discussion. Because Mazen has to leave, Roger asks him a broad question about markers for the future; Mazen bases his answer on the anticipated future approval of resmetirom. After he leaves, Stephen presents results from the Phase 2b study for the dual GLP-1/glucagon agonist pemvidutide, which wanders into the importance of the actual GLP-1-to-glucagon impact ratio, potentially significant safety signals that remain to be fully studied, and the subject of how much lean muscle mass these agents produce. This leads Louise Campbell into a brief but fascinating comment on the psychological impacts of lean muscle mass on different patients.In the final question, Roger asks the group what we have learned in the previous month that might affect research design or disease strategy thinking going forward. The answers vary widely, and each has value. If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress and the American Diabetes Association's 83rd Scientific Sessions. For this feature, Sven Francque (University of Antwerp) and Ian Rowe (University of Leeds) join Jörn Schattenberg and Roger Green to discuss a range of fascinating topics to emerge at the EASL Congress meeting held in Vienna.This final conversation begins with Sven's choice to discuss another paper by Vincent Wong that correlated liver stiffness with risk of decompensation and HCC. It is noted that the study relied on repetitive MRE readings over time and could not be performed in many different countries. This leads to comments around the plausibility of shifting from biopsy to NITs and insights around the cost effectiveness and the frequency of testing. On the flip side, Ian next underscores a study that investigates identification of a gene signature that will accurately predict the risk of decompensation and, ultimately, determine how to make better use of the biopsy tissue received in research. Finally, the session winds down with a closing question around what to expect in next year's meeting. If you have questions or comments around the EASL Congress meeting, new nomenclature, discussed papers or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress and the American Diabetes Association's 83rd Scientific Sessions. For this feature, Sven Francque (University of Antwerp) and Ian Rowe (University of Leeds) join Jörn Schattenberg and Roger Green to discuss a range of fascinating topics to emerge at the EASL Congress meeting held in Vienna.This conversation begins with Roger's note of a population study from South Korea looking to identify patients with steatotic liver disease, but not cirrhosis, that will progress to HCC over a ten year period. After sharing the study details, both Ian and Jörn express common concern around the relatively small size of the identified patient group. Jörn shares his hope that with new disease classification which combines metabolic and alcoholic components we will be able to study these issues more broadly in populations that might be more finely tuned for the study aims. Next, Jörn highlights a paper that leads the group to unpack how little is known about the mechanisms of fibrosis resolution beyond the idea that there are clear differences between the progression and regression processes. If you have questions or comments around the EASL Congress meeting, new nomenclature, discussed papers or any other topics addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress and the American Diabetes Association's 83rd Scientific Sessions. For this feature, Sven Francque (University of Antwerp) and Ian Rowe (University of Leeds) join Jörn Schattenberg and Roger Green to discuss posters and presentations that they find critical and/or compelling.Ian starts this conversation by pointing to unmet needs in the primary care setting for disease identification. He refers to a related presentation of interest from Vincent Wong titled A clinical care pathway to detect advanced liver disease in patients with type 2 diabetes through automated fibrosis score calculation and electronic reminder messages: a randomised controlled trial. Ian suggests that this study proves both the value of working to identify more patients and the considerable amount of work remaining in this area. The group goes on to discuss what the implications of this study are for treatment in primary care both now and into the future of patient care. In particular, Jörn elucidates the value of FIB-4 not only as a screening tool for liver-related outcomes, but also as a predictor of cardiovascular risk and all-cause mortality. Secondly, Jörn notes that when a NASH therapy becomes available, "the granularity of picking up those patients will be higher" and physicians will be more motivated to take action provided that they have both a screening tool and available treatment to prescribe. This leads to discussion around the differences between hepatology and private medicine practices and management of a population-level disease. Ian raises the question around how frequent should testing be performed in the primary care setting for different pathways.  If you have questions or comments around the EASL Congress meeting, new nomenclature, discussed papers or any other topics addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress and the American Diabetes Association's 83rd Scientific Sessions. For this feature, Sven Francque (University of Antwerp) and Ian Rowe (University of Leeds) join Jörn Schattenberg and Roger Green to discuss a range of fascinating topics to emerge at the EASL Congress meeting held in Vienna.This conversation focuses on the outcome of the nomenclature process, a three-stage Delphi process that produced new names and classification for what had previously been known as fatty liver disease and henceforth will be known as the steatotic liver disease (SLD). Sven, who was actively involved in the entire exercise, gives a concise summary of the process by which the new classifications were developed and how the new terminology will work. The rest of the conversation focuses on three issues. First, excitement that we will now have the opportunity to study patients whose disease has both metabolic and alcohol-based components. Second, the processes by which the three clinicians, Sven, Ian and Jörn are starting to share the new structure with their patients with varying degrees of success. One interesting observation emerges here from Sven: the English language terms do not translate equally into Dutch, so there is a patient advocate-led effort to create a new set of terms in Dutch. Third, Roger raises concerns about implementation planning for the new nomenclature. One concern is around the possible impact on drug or diagnostic development and the other about the kinds of communication issues covered earlier episodes. Sven, who again worked more closely on the process, states with confidence that the change will not have impact on drug or diagnostic trials. Read more about the switch to steatotic liver disease (SLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) here.If you have questions or comments around the EASL Congress meeting, new nomenclature, discussed papers or any other topics addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress and the American Diabetes Association's 83rd Scientific Sessions. For this feature, Sven Francque (University of Antwerp) and Ian Rowe (University of Leeds) join Jörn Schattenberg and Roger Green to discuss a range of fascinating topics to emerge at the EASL Congress meeting held in Vienna.The episode begins on the subject of new NAFLD/NASH nomenclature. Sven provides a cogent summary of the background, processes and decisions related to the name changes. The other panelists respond with varying perspectives and expand on the  following ideas that emerge:the changes reflect an opportunity to study metabolically at-risk populations that consume more than little-to-no alcoholthe adoption of more neutral scientific terms  - steatotic rather than fatty -destigmatizes the conditionIn general, improved clarity around definition of disease is a positive step forward in putting a major dent in the pandemic The conversation shifts to practical considerations around how to implement the changes in different settings and with patients. Read more about the switch to steatotic liver disease (SLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) here. The group refocuses on posters and presentations that they find critical and/or compelling. Ian points to a presentation from Vincent Wong titled A clinical care pathway to detect advanced liver disease in patients with type 2 diabetes through automated fibrosis score calculation and electronic reminder messages: a randomised controlled trial. Ian suggests that this study proves both the value of working to identify more patients and the considerable amount of work remaining in this area. Roger next mentions a population study from South Korea looking to identify patients with steatotic liver disease, but not cirrhosis, that will progress to HCC over a ten year period. After the group comments on this study, Jörn highlights a paper which unpacks how little is known about the mechanisms of fibrosis resolution beyond the idea that there are clear differences between the progression and regression processes. Sven then chooses to discuss another paper by Vincent Wong that correlated liver stiffness with risk of decompensation and HCC. This leads to comments around the plausibility of shifting from biopsy to NITs and insights around the cost effectiveness and the frequency of testing. On the flip side, Ian underscores a study that investigates identification of a gene signature that will accurately predict the risk of decompensation and, ultimately, determine how to make better use of the biopsy tissue received in research. Finally, the session winds down with a closing question around what to expect in next year's meeting.  If you have questions or comments around the EASL Congress meeting, new nomenclature, discussed papers or any other ideas addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On! 

You've probably heard of a sweet tooth, the term for people who love sugary foods and desserts. But you might be less familiar with a salt tooth. In other words a  preference for salty foods, such as crisps, olives, cheese and other salty things.  According to a study presented at the American Heart Association's Scientific Sessions meeting in 2016, there is a genetic basis for your salt cravings. Some people carry a variation of a gene that may give them more of a taste for salt. This gene also affects how people perceive bitterness, which may explain why people with a salt tooth tend to avoid foods such as broccoli and dark leafy greens. What causes a salt tooth, and is it bad for your health ? How can you satisfy your salt tooth without harming your health ? In under 3 minutes, we answer your questions ! To listen to the last episodes, you can click here : What is brain tapping, the viral technique for improving sleep quality? What is the half and half drinking method? How can heatwaves impact our mental health? A podcast written and realised by Amber Minogue. In partnership with upday UK. Learn more about your ad choices. Visit megaphone.fm/adchoices

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. To reflect on the insight-laden occasion, Stephen Harrison and Jörn Schattenberg join Roger Green to explore emerging drug development stories in detail.This conversation starts with a discussion about the importance of treating early stage cirrhosis patients. Jörn suggests that with new agents in place we may soon be looking to treat other patient populations such as, for example, those with HCC. In such instances NASH drugs will become adjuvant therapy to improve treatment against the primary disease target. Stephen agrees, noting that we will need a better test to diagnose HCC and, once available, there will be fewer presentations of advanced HCC because we will have treated more of them earlier with better agents and adjuvant therapies. Again, all this will await the approval of NASH and ideally cirrhosis drugs in the future. Roger asks how to identify the 20 to 30% of HCC patients who develop cancer before NASH. Stephen suggests it depends largely on NIT development. From there the panelists each share final thoughts around what the session has yet to cover that is important. Stephen comes up with a new idiom and Jörn speculates a new concept. Listen to the session to find out what they are.If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. To reflect on the insight-laden occasion, Stephen Harrison and Jörn Schattenberg join Roger Green to explore emerging drug development stories in detail.This conversation focuses largely on therapeutic candidate, resmetirom, and a series of MAESTRO-NASH trials that will hopefully lead to a first drug approval and treatment for NASH. Stephen, lead Principal Investigator of the MAESTRO program, begins by outlining the resmetirom clinical trial package in its entirety. Before Stephen shares numbers from the trial, Jörn opens a discussion around efficacy endpoints. He notes the structure of reading biopsy and suggests that reporting improvement in fibrosis and NASH resolution might not accurately reflect the extent of efficacy once the MAESTRO outcomes trial completes several years from now and patients are treated in practice. Stephen goes on to share the efficacy outcomes of the MAESTRO-NASH trial and offers notes from several different perspectives around dosing, placebo, metrics and other elements of the study population. Finally, Stephen suggests where in the liver he believes the drug works and why the drug might have more robust effects than can currently be measured using the testing tools available.If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. To reflect on the insight-laden occasion, Stephen Harrison and Jörn Schattenberg join Roger Green to explore emerging drug development stories in detail.This conversation continues on data presented by Stephen on the MAESTRO series of trials for resmetirom. It starts with a few clarifications on data presented in regards to liver volume. This discussion point evolves to consider how liver volume is not well understood and the three speculate what sort of useful insights can be derived from bridging that gap in knowledge. Stephen steers discussion back to the specific data by discussing the resmetirom safety profile. First, he shares the practical implications of safety for these drugs in everyday use. Next he provides an encouraging safety profile for the trial. As he does so, he shares thoughts about how to and how not to interpret a diahrea metric. Jörn responds by stating that the safety and liver volume profile suggest a reduction in liver pain and associated improvements to quality of life. He suggests the latter might be important with European regulators. As the conversation winds down, Stephen expresses his hope that the rolling submission with possible priority review and this profile will produce extremely positive news within the next 6 to 8 months. If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. To reflect on the insight-laden occasion, Stephen Harrison and Jörn Schattenberg join Roger Green to explore emerging drug development stories in detail.In this session, conversation shifts from resmetirom to Mazen Noureddin's "NASH Monopoly" game and focus on the value of FGF-21s and glucagon agents. Stephen posits two comments about GLP-1s. First, there is now adequate data suggesting that GLP-1s will not melt away all liver fat and as a result lead to dramatic fibrosis regression. Second, we know from a small sub-cohort of patients in Akero's SYMMETRY trial that patients already on fairly low doses of GLP-1s saw what Stephen describes as an 'incredible' and incremental benefit for the FGF-21 agent, efruxifermin. The group notes that while glucagon dual and treble agents are likely to produce dramatically more robust results in weight loss and liver defatting than GLP-1s alone, they still seem unlikely to 'usurp the need for other types of agents.' From here discussion considers the FGF-21 class. Stephen notes that two drugs, efruxifermin and pegozafermin, have demonstrated significant efficacy against fibrosis. As the conversation concludes, the panelists agree that earlier, more aggressive screening to arrest cirrhosis will become pivotal and will not occur until the right drug becomes available. If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy past month at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. For this feature, Stephen Harrison and Jörn Schattenberg discuss at depth drug development insights emerging from the meetings with host Roger Green.As lead Principle Investigator, Stephen expounds on Phase 3 MAESTRO-NASH data on resmetirom that he presented during the opening general session. He begins with a cogent backdrop of the study parameters, including endpoint criteria, before detailing results and implications. In his analysis, Stephen notes the challenges of teasing how well a drug performs in comparison to placebo. He then expands on the power of AI in digital pathology and its ability to enhance assessment of biopsy beyond ordinal scoring systems. Jörn adds that these extension studies are fascinating for their ability to hone in on patient benefits experienced beyond liver histology alone. From here, the group discusses at length deepening the field's understanding of liver volume reduction.Moving on, Roger revisits a metaphor from Mazen Noureddin in last week's episode which likened the two most valuable properties in "NASH Monopoly" to GLP-1s and FGF-21s. Stephen suggests a takeaway to be that "GLP's are coming to the forefront as a very active player in the fields of obesity, diabetes and ultimately CV risk reduction." The group next agrees that, in Jörn's paraphrased words, while a defatting effect on the liver can be beneficial, treating obesity by itself does not outright resolve fibrogenic burden and there remains the need for more liver-directed drugs. Stephen expands on his recurring phrase of "not all FGF-21s are created equal" while transitioning the group's focus to consider the fact that an increasing number of patients are progressing to cirrhosis. The remainder of the conversation posits fascinating and far-reaching speculations on the future study of disease including revolutionizing the way we diagnose HCC. In final comments, each panelist touches on one additional element in the drug development landscape to emerge out of an exciting month of June. If you have questions or comments around the EASL Congress or ADA meetings, the discussed therapeutics, new nomenclature, or any other topic addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Data on a new crop of hormone analogues for weight loss—including an oral version of semaglutide and the triple agent retatrutide—were recently presented at the American Diabetes Association's annual Scientific Sessions. Robert Gabbay, MD, PhD, the ADA's chief scientific and medical officer, speaks with JAMA's Jennifer Abbasi about this and other clinical data presented at the meeting. Related Content: New Weight Loss Drugs Make Headlines at Diabetes Meeting

Omnipod's new iPhone app, Dexcom's direct-to-Apple Watch, extended infusion sets, and Beta Bionics dual-hormone pump. Gary Scheiner and I discuss the biggest tech announcements at this year's Scientific Sessions.   Listen to the episode Origins of DIY Loop to hear about the incredible story behind Loop and the smart group of people who built one of the first closed loop insulin delivery systems.     Subscribe to this podcast for new episodes every Monday.     Gary's Book: Think Like a Pancreas    Follow for more: Instagram | Tik Tok | YouTube | Facebook   Watch Video Podcast on Youtube    This podcast should NOT be considered medical advice. Always consult with your doctor before making changes to health care treatment.

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This final conversation between Roger and Jörn begins by moving beyond the subject of drugs to the importance behind noninvasive testing and the myriad ways by which the term artificial intelligence is being claimed. Jörn talks about a poster he shared at EASL around an AI-assisted mode called qVessel which investigates the ability of researchers to quantitate changes in blood vessels and liver architecture as fibrosis progresses. This example provides contrast between how we develop diagnostic scientific insight versus drug approval process versus clinical applications and patient treatment. The conversation continues on to highlight some of what Jörn and Roger consider to be some of the most exciting drug development pieces to emerge from the EASL and ADA meetings. This leads to comments around how the nature of the questions being asking in 2023 versus 2019 demonstrates how much the field has learned about liver disease over the last few years. Our entire key opinion leader and advocate team has been struck forcibly by how many studies in the last month provided significant advances in knowledge and how some of these advances may change an underlying appreciation of drugs, diagnostics, artificial intelligence, machine learning and how we think about Fatty Liver disease overall.Both conversations with Mazen and Jörn explore different perspectives around the complexities associated with drug development and the wider field's understanding of Steatotic Liver Disease (SLD). Stay tuned for more in the subsequent conversations to be released. If you have any questions or comments around these meetings, the discussed therapeutics or the new nomenclature, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This first conversation with Jörn starts with discussion around the idea that even dramatic improvements in obesity medications will not resolve all issues related to fibrosis in MASLD patients. After speculation around the therapeutic landscape for NASH, conversation turns toward the new nomenclature consensus and what this will mean for the liver community and beyond. Both conversations with Mazen and Jörn explore different perspectives around the complexities associated with drug development and the wider field's understanding of Steatotic Liver Disease (SLD). Stay tuned for more in the subsequent conversations to be released. If you have any questions or comments around these meetings, the discussed therapeutics or the new nomenclature, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This second and final conversation with Mazen continues to explore what we do or do not know about the different mechanisms of action in NASH drugs and the commercial implications. Later, the Monopoly metaphor around NASH therapeutic development as described in the preceding conversation is expanded. Roger shares his interesting idea on how Big Pharma is similar to the role of Hollywood in movie production and distribution opportunities. Finally, the two discuss why it is critical to move beyond ordinal histopathology reads in the drug approval process before sharing final thoughts around what factors are contributing to an exciting future for combating liver disease. Both conversations with Mazen and Jörn explore different perspectives around the complexities associated with drug development and the wider field's understanding of Steatotic Liver Disease (SLD). Stay tuned for more in the subsequent conversations to be released. If you have any questions or comments around these meetings, the discussed therapeutics or the new nomenclature, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Throughout the month of July, Surfing NASH embarks on a series of episodes dedicated to takeaways emerging from a busy last few weeks at both the 2023 EASL Congress in Vienna and the American Diabetes Association's 83rd Scientific Sessions meeting in San Diego. This first installment comprises two distinct 1:1 interviews with Tsunami co-host Roger Green, one with key opinion leader Mazen Noureddin and the other with co-host Jörn Schattenberg.This first conversation with Mazen begins with comments on the many excellent drug development studies emerging from both EASL Congress and the ADA's Scientific Sessions meeting. While the two share exceptional results, they also explore potential downsides in terms of tolerability and longterm antibody inflammation. An illustrative new metaphor is coined by Mazen in which the NASH therapeutic landscape is likened to the game Monopoly. In "NASH Monopoly," each street or monopoly presents a mechanisms of action. The two most expensive streets to GLP-1s and FGF-21s. He goes on to commend and describe the promise of GLP-1s and the double and triple agents in development as leading to such significant weight loss that some question the need for bariatric procedures altogether. Both conversations with Mazen and Jörn explore different perspectives around the complexities associated with drug development and the wider field's understanding of Steatotic Liver Disease (SLD). Stay tuned for more in the subsequent conversations to be released. If you have any questions or comments around these meetings, the discussed therapeutics or the new nomenclature, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.Stay Safe and Surf On!

Episode 142: Tirzepatide IIFuture Dr. Beuca explains that tirzepatide has shown benefits in patients with obesity that go beyond its weight-reducing effects and includes reduction of blood pressure, among others. Dr. Arreaza explains that Wegovy (semaglutide approved for weight loss) is also very beneficial for weight loss and explains.  Written by Maria Beuca, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Maria: Hello everyone, today is June 2, 2023, and we want to re-visit our discussion about the drug Tirzepatide from our May 19th, 2022. A little re-cap for those of you who don't know, tirzepatide, also known by the brand name Mounjaro, is a drug that was approved by the FDA a year ago for the treatment of type 2 Diabetes. It is similar to the drug Semaglutide, also known by the brand name Ozempic which many of you may be more familiar with, thanks to the Kardashians and other celebrities making it popular as a “weight loss” drug. Arreaza: The brand name for weight semaglutide is Wegovy.Maria: Both of these drugs are injected once a week and mimic the effect of the incretin hormone GLP-1 by binding to its receptor. Incretin hormones are a group of hormones that cause insulin to be released from the pancreas after eating to help lower blood sugar levels.  These incretin hormones also help suppress the appetite, causing you to eat less and lose weight. Tirzepatide is different because it is the first drug to mimic the action of two hormones, both GLP-1 and GIP. In our last episode, we also discussed the SURPASS-2 study that showed tirzepatide to be superior to semaglutide because of this dual incretin action, with greater weight loss, lower HA1c levels, and lower triglyceride and VLDL levels. At that time, we also mentioned the SURMOUNT-1 Phase 3 clinical trial that was ongoing at the time. Well, it is now complete, and the results are in. There were 2,539 obese or overweight participants without diabetes in the study who lost between 16-22.5% of their starting weight on Tirzepatide. On 15 mg dose, participants lost about 52 lbs (24 kg), on 10 mg 49 lbs (22 kg) and on 5 mg about 35 lbs (16 kg), but those on the placebo lost only 2.4% or about 5 lbs (2 kg). As you can see there is very little difference in weight loss between the 10 mg dose and the 15 mg dose, although a big difference is seen compared to the 5 mg dose. It's important to note that they took Tirzepatide for 72 weeks or a year and a half. Arreaza: That's very significant weight loss. It is important to emphasize that these patients did NOT have diabetes. Maria: These weight loss results have proven to be comparable to bariatric surgery. The study also showed improvement in cardiovascular and metabolic risk factors such as lower blood pressure, fasting insulin, lipid levels and even aspartate aminotransferase levels in comparison to the placebo. By the end of the study, more than 95% of the participants who had pre-diabetes had converted to normal glucose levels. This study was so impressive that it was presented at the 82nd Scientific Sessions of the American Diabetes Association and was also published in The New England Journal of Medicine. Arreaza: It seems like tirzepatide is ahead of the game for weight loss.Maria: Although it is approved as a drug for diabetes, the next step is to approve it for weight loss and to begin treating obesity as a chronic disease that needs to be treated. Maria: And this makes sense. Currently, more than 4 in 10 American adults have obesity, and obesity is the cause of many other conditions. Just yesterday, I was seeing patients in the orthopedic clinic and I had several patients being seen for knee pain due to obesity, and they are postponing surgery because they have been losing weight on tirzepatide and are already feeling better. I think avoiding knee surgery alone is a pretty good reason to approve these drugs for weight loss, but there are many other conditions that are improved by weight loss. Arreaza: My anecdotes are related to semaglutide, but I can imagine that this may also apply to tirzepatide. I had a patient who was able to stop all antihypertensive medications because of 40-lb weight loss. Maria: Dr. Caroline Apovian, director of the Center for Weight Management and Wellness at Brigham Women's Hospital, states that “If everybody who had obesity in this country lost 20% of their body weight, we would be taking patients off all these medications for reflux, for diabetes, for hypertension. We would not be sending patients for stent replacement.”Maria: Last month, officials from Eli Lilly, the company that makes tirzepatide, stated that they are hoping to have a fast-track approval to sell it for chronic weight management by sometime this year. The problem is that many of these patients who were prescribed Tirzepatide have not been able to get it because it has been out of stock for the last few months in all the local pharmacies. They get the prescription, start taking Tirzepatide and begin to lose weight or improve their blood sugar levels and then it is out of stock and now you have people with Diabetes who have gotten off insulin because Tirzepatide worked so well and suddenly they can't get it and are at risk for getting pretty sick without it. Arreaza: The manufacturer of Wegovy announced this, “we will only be able to supply limited quantities of 0.25 mg, 0.5 mg, and 1 mg dose strengths to wholesalers for distribution to retail pharmacies which will not meet anticipated patient demand. We anticipate that many patients will have difficulty filling Wegovy® prescriptions at these doses through September 2023. We do not currently anticipate supply interruptions of the 1.7 mg and 2.4 mg dose strengths of Wegovy®”. Why is this happening? Maria: The problem is that this drug was not meant for the masses, for all these young girls wanting to lose a few pounds for aesthetic reasons. It was meant for people with a BMI 30 or with a BMI 27 plus another comorbidity such as hypertension. Celebrities have brought attention to these drugs for weight loss, for example Ozempic has over 433 million views on TikTok. It has gotten so bad that people are turning to questionable sources online to purchase these drugs, where it is given cute names like “skinny shots.” And if your insurance does not cover Tirzepatide, it is still expensive, starting at around $1000 per month. Some of the insurers who used to cover the cost stopped covering it or placed new restrictions on who qualifies. Another downside is that tirzepatide and other drugs of this class have not been on the market that long, so the long-term effects are still not known. So far, early evidence shows that most people gain the weight back as soon as they stop taking it, so are the weight loss benefits sustainable at this high cost? Maria: We talked about the adverse effects in the last episode, but it's important to go over them again. Patients can have diarrhea, nausea, vomiting, constipation, and abdominal pain that can often bring these patients into the clinic or even the Emergency room thinking they are ill, when in fact it is an adverse effect of their medication, especially the first few days of starting or increasing the dose. So, educating patients is very important before they start this new drug. There is also a small risk of pancreatitis or gallbladder problems, so it is important to have blood work done to check the pancreas and gallbladder prior to starting tirzepatide. There is also a warning to avoid using it if you have a family or personal history of thyroid cancer. Arreaza: Reminder, MEN type 1. I would like to mention the so-called “Ozempic face”. It is the face you get with rapid weight loss, making you look a little older due to fat loss on the face. As a summary, tirzepatide is a very effective medication for weight loss, pending FDA approval. It is not free of side effects, so we still need to follow the recommendations from FDA and other reputable sources to prescribe it responsibly. There is room for further research on these medications. Currently, there are no clear guidelines regarding labs before starting treatment (lipase?) or labs for monitoring after treatment. The evidence regarding these medications continues to evolve and we should stay up to date with the changes. _______________________Conclusion: Now we conclude episode number 142 “Tirzepatide II.” Future Dr. Beuca came back almost one year later to shed more light on the use of tirzepatide in the treatment of obesity. Dr. Arreaza provided some insight into the management of side effects and the potential harm of this novel medication. Overall, tirzepatide is effective and safe and may be the answer to many of our patients with diabetes and obesity. This week we thank Hector Arreaza and Maria Beuca. Audio editing by Adrianne Silva.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Brownie, Grace. “The Problematic Arrival of Anti-Obesity Drugs.” Wired, 25 January 2023. https://www.wired.com/story/anti-obesity-drugs/Dockrill, Peter. “Experimental Drug Breaks Record for Weight Loss in Latest Clinical Trial Results.”ScienceAlert, 9 May 2022, https://www.sciencealert.com/experimental-drug-breaks-record-for-weight-loss-in-latest-clinical-trial-results.Frías, Juan P., et al. “Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes.”New England Journal of Medicine, 5 August 2021, https://www.nejm.org/doi/full/10.1056/NEJMoa2107519.Jastreboff, Ania  M., et al. “Tirzepatide Once Weekly for the Treatment of Obesity.” New England Journal of Medicine, 21 July 2022, www.nejm.org/doi/full/10.1056/NEJMoa2206038.“Label as Approved by FDA. - Pi.lilly.com.”Mounjaro Prescribing Information, Lilly USA, LLC, May 2022, https://pi.lilly.com/us/mounjaro-uspi.pdf.Mounjaro. Prescribing Information. Lilly USA, LLC.  May 2022. https://pi.lilly.com/us/mounjaro-uspi.pdf?s=pi“Surmount-1 Study Finds Individuals with Obesity Lost up to 22.5% of their Body Weight when Taking Tirzepatide.” 4 June 2022. https://diabetes.org/newsroom/press-releases/2022/surmount-1-study-finds-individuals-%20with-obesity-lost-up-to-22.5-percent-body-weight-taking-tirzepatide.Royalty-free music used for this episode: "Happy-Go-Lucky." Downloaded on October 13, 2022, from https://www.videvo.net/ 

This week's episode is dedicated to one of the biggest cardiovascular meetings, AHA's Scientific Sessions. Dr Ankur Kalra's guest is Dr Manesh Patel, chair of the AHA Committee on Scientific Sessions and Chief of the Division of Cardiology and Co-Director of the Heart Center at Duke University. Year on year, the organisers of the Scientific Sessions aim to give platform to cardiovascular science at its best: innovative, impactful, and collaborative. In this information-packed episode, Dr Patel takes us behind the scenes and talks about the work that goes into the curation of the programme and the considerations that shape the event. Dr Kalra asks Dr Patel about his highlights over the years and the movement and changes that he observed as vice chair and chair of the event. Dr Patel elaborates on the key late-breaking science trials in 2022. Dr Kalra and Dr Patel discuss the grading system of the award applications and share some useful information with our listeners. What does Dr Patel think about the function of the Scientific Sessions? What happens after you submit your application to an award? How do the organisers concert a balance between the scientific and the social need of a global community? Questions and comments can be sent to “podcast@radcliffe-group.com” and may be answered by Ankur in the next episode. Guest: @manesh_patelMD, host: @AnkurKalraMD and produced by: @RadcliffeCARDIO.