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Doctors Lisa and Sara talk to Consultant Nephrologist Dr Darren Green about patients with Type 2 Diabetes who also have Chronic Kidney Disease and Heart Failure. We go through a hypothetical case to illustrate some of the finer points of management that can commonly get missed or might not be appreciated. A really detailed talk full of useful practice enhancing tips for this complex group of patients. Disclaimer: This episode was supported by Greater Manchester NHS who received support from Boehringer. You can use these podcasts as part of your CPD - we don't do certificates but they still count :) Resources: Dr Kevin Fernando counselling diabetic patients starting an SGLT2 Inhibitors like Dapagliflozin or Empagliflozin: https://www.youtube.com/watch?v=pc99SdtlsyU Diabetes UK counselling sheets on SGLT2 inhibitors: https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments/tablets-and-medication/sglt2-inhibitors Kidney Care UK Patient Booklets: https://kidneycareuk.org/get-support/free-resources/patient-information-booklets/ Pumping Marvellous Heart Failure Charity with patient resources: https://pumpingmarvellous.org/ International Society for Nephrology Toolkit for Initiating or Changing RAASi - Renin Angiotensin Aldosterone System Inhibitors (like ACEis such as Lisinopril or Ramipril, or ARBs like Candesartan on Losartan): https://www.theisn.org/initiatives/toolkits/raasi-toolkit/ Royal College of General Practitioners Acute Renal Failure Toolkit: https://elearning.rcgp.org.uk/course/info.php?id=899 CONFIDENCE trial: Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes | New England Journal of Medicine: https://www.nejm.org/doi/full/10.1056/NEJMoa2410659 ATLAS trial: Efficacy and safety of high-dose lisinopril in chronic heart failure patients at high cardiovascular risk, including those with diabetes mellitus: https://pubmed.ncbi.nlm.nih.gov/11071803/ Metformin lactic acidosis Metformin in Patients With Type 2 Diabetes and Kidney Disease: A Systematic Review: https://jamanetwork.com/journals/jama/article-abstract/2084896 UK AKI Summit report UKKA AKI Summit Report + Recommendations: https://share.google/7uw1GPQ5sV2riJtiV RCGP AKI follow up post discharge recommendations: https://bjgpopen.org/content/early/2020/06/15/bjgpopen20X101054/tab-figures-data?versioned=true ___ We really want to make these episodes relevant and helpful: if you have any questions or want any particular areas covered then contact us on Twitter @PCKBpodcast, or leave a comment on our quick anonymous survey here: https://pckb.org/feedback Email us at: primarycarepodcasts@gmail.com ___ This podcast has been made with the support of GP Excellence and Greater Manchester Integrated Care Board. Given that it is recorded with Greater Manchester clinicians, the information discussed may not be applicable elsewhere and it is important to consult local guidelines before making any treatment decisions. The information presented is the personal opinion of the healthcare professional interviewed and might not be representative to all clinicians. It is based on their interpretation of current best practice and guidelines when the episode was recorded. Guidelines can change; To the best of our knowledge the information in this episode is up to date as of it's release but it is the listeners responsibility to review the information and make sure it is still up to date when they listen. Dr Lisa Adams, Dr Sara MacDermott and their interviewees are not liable for any advice, investigations, course of treatment, diagnosis or any other information, services or products listeners might pursue as a result of listening to this podcast - it is the clinicians responsibility to appraise the information given and review local and national guidelines before making treatment decisions. Reliance on information provided in this podcast is solely at the listeners risk. The podcast is designed to be used by trained healthcare professionals for education only. We do not recommend these for patients or the general public and they are not to be used as a method of diagnosis, opinion, treatment or medical advice for the general public. Do not delay seeking medical advice based on the information contained in this podcast. If you have questions regarding your health or feel you may have a medical condition then promptly seek the opinion of a trained healthcare professional.
In this in-depth conversation, Dr. Brad Stanfield sits down with Dr Matt Kaeberlein to discuss his journey from a primary care physician in New Zealand to a leading voice in the evidence-based longevity space. We cover the launch and philosophy behind his YouTube channel, the challenges and exciting results of his self-funded rapamycin clinical trial, and his critical perspective on supplements, medical guidelines, and the future of aging research.Dr. Stanfield provides a unique clinician's viewpoint on hot topics like GLP-1 agonists (Ozempic), SGLT2 inhibitors, vitamin D testing, and the pitfalls of biological age clocks. We also dive into a spirited debate on the role of medical societies, the balance between risk and benefit in prescribing medications, and why he believes the field of longevity is still in its early stages of discovery.Key Topics & Timestamps:00:00 - Introduction00:52 - Brad's Background02:47 - Starting the YouTube Channel & Philosophy on Science Communication07:39 - The Rigor of Clinical Data vs. Misinformation10:14 - Admitting Mistakes in Public (Resveratrol, Metformin)14:40 - Funding and Designing the Rapamycin Clinical Trial19:25 - Rapamycin Trial Results Submitted & Plans for a PhD23:28 - Preventative Care: New Zealand vs. US Healthcare Systems27:59 - The Vitamin D Debate: To Test or Not to Test?35:18 - Trust in Medical Guidelines & The Hormone Replacement Therapy Controversy43:42 - The Problem with Biological Age Clocks46:22 - Patient-Centered Care: Inform vs. Decide in Medicine49:49 - How to Judge the Quality of a Clinical Trial (CONSORT)53:44 - Risk vs. Benefit: When Should We Prescribe Preventative Drugs?58:05 - GLP-1 Agonists (Ozempic) and SGLT2 Inhibitors in Practice01:02:00 - Brad's Personal Use of an SGLT2 Inhibitor01:05:38 - The State of Longevity Research: How Much Do We Really Know?01:08:34 - Closing RemarksDISCLAIMER: The information provided on the Optispan podcast is intended solely for general educational purposes and is not meant to be, nor should it be construed as, personalized medical advice. No doctor-patient relationship is established by your use of this channel. The information and materials presented are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. We strongly advise that you consult with a licensed healthcare professional for all matters concerning your health, especially before undertaking any changes based on content provided by this channel. The hosts and guests on this channel are not liable for any direct, indirect, or other damages or adverse effects that may arise from the application of the information discussed. Medical knowledge is constantly evolving; therefore, the information provided should be verified against current medical standards and practices.Dr. Brad Stanfield's Socials:Website: https://drstanfield.com/YouTube: https://www.youtube.com/@DrBradStanfieldX: https://x.com/BradStanfieldMDMore places to find us:Twitter: https://x.com/Optispan_IncTwitter: https://x.com/mkaeberlein Linkedin: https://www.linkedin.com/company/optispan/Instagram: https://www.instagram.com/optispan_/ TikTok: https://www.tiktok.com/@optispanhttps://www.optispan.life/
Email List: https://huntershealthhacks.beehiiv.com/Get My Book On Amazon: https://a.co/d/avbaV48DownloadThe Peptide Cheat Sheet: https://peptidecheatsheet.carrd.co/Download The Bioregulator Cheat Sheet: https://bioregulatorcheatsheet.carrd.co/1 On 1 Coaching Application: https://hunterwilliamscoaching.carrd.co/Book A Call With Me: https://hunterwilliamscall.carrd.co/Supplement Sources: https://hunterwilliamssupplements.carrd.co/Amazon Storefront: https://www.amazon.com/shop/hunterwilliams/list/WE16G2223BXA?ref_=cm_sw_r_cp_ud_aipsflist_R7QWQC0P1RACB2ETY3DYSocials:Instagram: https://www.instagram.com/hunterwilliamscoaching/Video Topic Request: https://hunterwilliamsvideotopic.carrd.co/In this episode, I dive deep into what I believe could be the most powerful synergy in the entire world of longevity and metabolic optimization — the combination of SGLT2 inhibitors (like Jardiance and Farxiga) with GLP-1 agonists (like Retatrutide, Tirzepatide, and Semaglutide).These medications were originally created for diabetics, but what we're learning now is that they may be rewriting the entire playbook on healthspan and lifespan extension. I break down the research showing how SGLT2 inhibitors not only lower blood glucose but also improve cardiovascular health, protect the kidneys, reduce inflammation, and even clear senescent cells — all while mimicking the effects of caloric restriction and fasting.Then, I explain how pairing them with a GLP-1 creates a metabolic symphony unlike anything else we've ever seen. Together, they reduce insulin resistance, improve energy metabolism, and activate the same longevity pathways linked to caloric restriction, AMPK activation, and mitochondrial renewal.If you care about living longer, staying leaner, and protecting every organ system in your body, this episode is a must-listen. I share what I've seen personally, what's happening in clinical data, and why I believe the GLP-1 + SGLT2 combo could end up being one of the greatest discoveries in modern medicine for both health and performance.
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter In this “Ask Me Anything” (AMA) episode, Peter revisits the “proven, promising, fuzzy, noise, nonsense” scale and applies it to a variety of popular topics. He begins with a refresher on what each category represents before classifying a range of interventions based on the strength of their supporting evidence. The conversation spans three main areas: drugs for geroprotection (including GLP-1 receptor agonists, SGLT2 inhibitors, methylene blue, and telomere-lengthening supplements), the use of low-dose aspirin for cardiovascular disease prevention, and strategies to improve muscle mass through optimal protein intake and follistatin gene therapy. This episode provides a clear, evidence-based overview for listeners seeking to understand where these popular health and longevity interventions stand on the spectrum of scientific credibility. If you're not a subscriber and are listening on a podcast player, you'll only be able to hear a preview of the AMA. If you're a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #76 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here. We discuss: A scale for evaluating scientific claims: proven, promising, fuzzy, noise, or nonsense [1:30]; Strong convictions, loosely held: the mindset that separates great scientists from the rest [7:30]; GLP-1 receptor agonists: are there benefits beyond improving metabolic health and promoting weight loss? [12:45]; GLP-1 drugs and the brain: exploring the potential cognitive benefits [18:45]; GLP-1 drugs and lifespan: examining the evidence for potential geroprotective effects [23:00]; Rapamycin and geroprotection: why it remains in the “promising” category [25:45]; SGLT2 inhibitors and their potential geroprotective effect [27:30]; Methylene blue: examining the evidence of an anti-aging effect [34:45]; Methylene blue's potential neuroprotective effects: limited and inconsistent evidence in humans, and the challenges of dosing and safety [41:15]; Telomeres: what they are, how they relate to aging, and why telomere-lengthening supplements lack credible scientific evidence [43:45]; Does the idea of targeting telomere length to extend lifespan have scientific merit? [50:15]; Low-dose aspirin for cardiovascular disease prevention: weighing its clot-prevention benefits against bleeding risks across different populations [55:00]; Rethinking the protein RDA: why most people need twice the recommended amount for muscle health [1:00:45]; Debunking the protein–cancer myth: why higher protein intake doesn't promote tumor growth [1:06:15]; The biology of follistatin and myostatin, and why follistatin gene therapy has become an emerging topic of interest for muscle growth [1:13:15]; Follistatin gene therapy for muscle growth: state of the evidence in animals and humans, and the technical challenges and regulatory barriers [1:17:00]; Why injectable follistatin is theoretically possible but impractical for real-world use [1:23:15]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
In this education program through Vividh Bharati (All India Radio), Dr. Sunil Gupta explained in detail that diabetes is a multifactorial disease that can affect multiple organs including the eyes, nerves, liver, kidneys, heart, and even sexual health. He highlighted that non-alcoholic fatty liver disease (NAFLD), sleep disturbances, frozen shoulder, and sexual dysfunction are among the common complications associated with diabetes. He elaborated that diabetes medications—such as Metformin, Glitazones, and SGLT2 inhibitors—work in different ways: some drugs like sulfonylureas increase insulin secretion, others improve insulin sensitivity, while some help eliminate excess sugar through urine. Dr. Gupta clarified that starting medication does not necessarily mean lifelong dependency; if blood sugar levels remain under good control, the dosage can be reduced under dose monitoring or, in some cases, the medication can be stopped under medical supervision. Concluding his address, he emphasized that “the true treatment of diabetes is not just controlling blood sugar but taking care of the whole body through a disciplined and healthy lifestyle.” Expert- Dr Sunil Gupta Anchor- Mrs. Shraddha Bharadwaj Podcast: 22/02/2019 Recorded at: Akashwani Nagpur Episode: 87
A large real-world study of over 1.2 million adults with type 2 diabetes found that SGLT2 inhibitors and GLP-1 receptor agonists reduced major cardiovascular events compared with metformin, while sulfonylureas and insulin increased risk. A separate French population study showed no association between first-trimester mRNA COVID-19 vaccination and congenital malformations, supporting vaccine safety in pregnancy. Finally, researchers at Mass General Brigham reported that large language models can produce “sycophantic” but incorrect medical advice, emphasizing the need for clinician oversight when using AI in healthcare.
What if your patient's blood sugar looks “okay,” but their kidneys are already under attack?In this episode of ReInvent Healthcare, Dr. Ritamarie uncovers the common progression of kidney damage fueled by insulin resistance and elevated glucose. Most practitioners miss the early clues. And most patients never feel symptoms… until it's too late.Discover the early biochemical markers, the overlooked tests, and the clinical action steps you can take now to prevent progression to fibrosis, dialysis, and even renal failure.What's Inside This Episode?The silent mechanisms linking insulin resistance to kidney scarring and declineWhy normal creatinine and BUN may be misleading and what to test insteadWhich labs signal decline before patients show symptomsThe food patterns and protein levels that support vs. stress the kidneysTargeted botanicals, nutrients, and fasting strategies for protecting kidney functionHow to approach intermittent fasting, inflammation, and oxalates with nuanceWhen medications like SGLT2 inhibitors or ACE inhibitors may be protectiveThe practitioner's role in prevention, education, and root-cause reversalResources and Links:Download our FREE Health Detective Checklist.Download our FREE Guide to for Lab Test RecommendationsJoin the Next-Level Health Practitioner Facebook group here for free resources and community supportReserve your spot for our Reinvent Healthcare Online Event Nov 7-9! It's the event of the year for practitioners serious about root-cause healing. Visit INEMethod.com for advanced health practitioner training and tools to elevate your clinical skills and grow your practice by getting life-changing results. Check out other podcast episodes here
In this VETgirl veterinary continuing education podcast, we interview Dr. Christopher G. Byers, DACVIM, DACVECC about SGLT2 inhibitors for the treatment of diabetes mellitus to manage hyperglycemia in cats. Tune in to know how to select the ideal feline diabetic candidate for this diabetes mellitus treatment option!Sponsored By: Boehringer Ingelheim
Heart failure remains a leading cause of hospitalization, prompting ongoing research into treatment strategies that improve outcomes for patients. A recent study explores the potential of combining an MRA agent and SGLT2 inhibitor, showing meaningful clinical benefit while also reinforcing the need for thoughtful patient selection and safety monitoring. Tune in to explore how this evidence may shape pharmacist-driven care and contribute to more confident, individualized treatment decisions.HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTZachary Cox, PharmDProfessorLipscomb University College of PharmacyJoshua Davis Kinsey has no relevant financial relationships to disclose. Zachary Cox is a consultant for Roche, Reprieve Cardiovascular, Abiomed, Vectorious, Kestra Medical Technologies, and WhiteSwell. He was also a consultant for Lexicon Pharmaceuticals (ended 2025) and conducted research for AstraZeneca (ended 2024). All relevant financial relationships have been mitigated. Pharmacists, REDEEM YOUR CPE HERE!CPE is available to Health Mart franchise members onlyTo learn more about Health Mart, click here: https://join.healthmart.com/CPE INFORMATION Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the clinical evidence supporting the use of multiple drug classes in combination therapy for heart failure.2. Identify pharmacist considerations for evaluating patient-specific factors related to efficacy and safety of combination treatment approaches.0.05 CEU/0.5 HrUAN: 0107-0000-25-299-H01-PInitial release date: 10/20/2025Expiration date: 10/20/2026Additional CPE details can be found here.
Heart failure remains a leading cause of hospitalization, prompting ongoing research into treatment strategies that improve outcomes for patients. A recent study explores the potential of combining an MRA agent and SGLT2 inhibitor, showing meaningful clinical benefit while also reinforcing the need for thoughtful patient selection and safety monitoring. Tune in to explore how this evidence may shape pharmacist-driven care and contribute to more confident, individualized treatment decisions.HOSTJoshua Davis Kinsey, PharmDVP, EducationCEimpactGUESTZachary Cox, PharmDProfessorLipscomb University College of PharmacyJoshua Davis Kinsey has no relevant financial relationships to disclose. Zachary Cox is a consultant for Roche, Reprieve Cardiovascular, Abiomed, Vectorious, Kestra Medical Technologies, and WhiteSwell. He was also a consultant for Lexicon Pharmaceuticals (ended 2025) and conducted research for AstraZeneca (ended 2024). All relevant financial relationships have been mitigated. Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE INFORMATIONLearning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the clinical evidence supporting the use of multiple drug classes in combination therapy for heart failure.2. Identify pharmacist considerations for evaluating patient-specific factors related to efficacy and safety of combination treatment approaches.0.05 CEU/0.5 HrUAN: 0107-0000-25-299-H01-PInitial release date: 10/20/2025Expiration date: 10/20/2026Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagram
Qual é a relação entre a função renal e a eficácia dos inibidores do SGLT2? Endocrinologia descomplicada para médicos e residentes.Aqui você encontra conteúdos sobre atualização médica, casos clínicos e preparação para provas de título.
Os inibidores do SGLT2 são amplamente utilizados, mas qual é o real risco de cetoacidose em pacientes que precisam ser hospitalizados? Abordamos as evidências atuais e os cuidados necessários neste vídeo.Endocrinologia descomplicada para médicos e residentes.Aqui você encontra conteúdos sobre atualização médica, casos clínicos e preparação para provas de título.
A new meta-analysis in HeartRhythm found that SGLT2 inhibitors reduced sudden cardiac death risk by about 18% across patients with type 2 diabetes, heart failure, or chronic kidney disease, with consistent effects and minimal trial variation. A Cochrane review of over 100,000 participants showed RSV vaccines are highly effective and safe: protein-based shots cut severe lower respiratory infections in older adults by ~75% and protected infants when given to pregnant mothers, halving RSV-related care and hospitalizations. Finally, WHO and EMA reaffirmed acetaminophen's safety in pregnancy, rejecting suggested links to autism or neurodevelopmental harm, noting decades of safe use and the risks of untreated pain or fever.
How do you take one complex medical concept and make it clear, accurate, and actionable for both clinicians and patients, without losing credibility?If you're a CME writer, you know the challenge of translating science into education that actually sticks. But as more CME projects tether clinician education with patient-facing components, the real test is flexing your craft to serve two very different audiences at once. Get this right, and you not only improve learning, you expand your professional scope and impact.In this episode, you'll discover:How to apply practical frameworks to dual-audience writing.Structural techniques that make content engaging, empathetic, and accessible.A simple 3-sentence exercise to sharpen clarity for patients and precision for clinicians—anytime, anywhere.
In this Healthed lecture, Dr Ted Wu explores the impact of cardiovascular outcomes trials in patients with type 2 diabetes, which have led to significant advances in cardioprotective therapies. As a result of these trials, medications such as SGLT2 inhibitors and GLP1 receptor agonists are now recommended as first-line treatments for individuals with, or at risk of, cardiovascular disease. Dr Wu addresses the pressing question of what comes next in this evolving field. This lecture focuses on the opportunities and challenges that future research is likely to face as it continues to investigate cardiovascular outcomes in patients living with type 2 diabetes.See omnystudio.com/listener for privacy information.
Type 2 diabetes is one of the most common chronic conditions in the U.S., but it doesn't have to define or limit your life. In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus—two endocrinologists with decades of experience—break down practical strategies for living well with type 2. From the latest medications and tools to everyday lifestyle choices, they highlight what really makes a difference in the long run. Their goal? To show you that type 2 diabetes is not only manageable but that taking control can actually improve your health and quality of life.Get Educated About What's Happening in Your Body: Understanding insulin resistance, metabolic syndrome, and why type 2 diabetes is more than just “high blood sugar.”Know Your Numbers: The key benchmarks for A1c, blood sugar, cholesterol, and blood pressure—and why even small improvements matter.Build the Right Care Team: How to find and work with providers who can guide you through treatment options and keep you on track.Food and Drink That Work for You: Why portion control, balance, and smart substitutions matter more than strict diets or deprivation.Move Your Body (Without Overthinking Exercise): How realistic activity goals—walking, stretching, or even gardening—can improve insulin sensitivity and overall health.The Medications Changing the Game: Why GLP-1s, SGLT2 inhibitors, and CGMs are considered life-changing tools in type 2 diabetes care—and what you should know about them.And That's Just the Start…: From mental health to long-term complication prevention, there are even more strategies in this episode to help you thrive with type 2 diabetes. ★ Support this podcast ★
In this episode of the Laura Dowling Experience, Matt Kaeberlein, a global leader in ageing science, discusses his mission to help people and animals live longer and healthier lives by modifying the biological mechanisms of ageing. Matt, CEO of Optisan, a healthcare technology company, talks about his transition from academia to entrepreneurship and highlights the importance of lifestyle factors—nutrition, exercise, sleep, and social connection—in maximising health span. The conversation explores emerging approaches to longevity, including hormone therapy, therapeutic plasma exchange, and the use of drugs such as rapamycin and SGLT2 inhibitors. Matt shares personal experiences with ageing-related health strategies and offers valuable insights into the role of love and altruism in achieving a fulfilling life.Timestamps02:48 – Introduction: Meet Matt Kaeberlein, global leader in ageing science03:13 – What does Matt Kaeberlein do? Biological mechanisms of ageing04:40 – The concept of health span vs. lifespan06:55 – Four pillars of health span: Eat, Move, Sleep, Connect09:04 – The importance of human and animal connection11:06 – Beyond lifestyle: Hormones and health span16:06 – Menopause, HRT, and women's health24:55 – Testosterone therapy for men: Risks and benefits31:35 – Alcohol, lifestyle, and longevity34:34 – Environmental exposures: Heavy metals, microplastics, and health39:44 – Therapeutic plasma exchange and ageing research47:09 – Rapamycin: The science, trials, and potential for longevity59:46 – Diet, fasting, and inflammation: What Matt Kaeberlein eats1:07:32 – Continuous glucose monitoring and behaviour change1:14:07 – SGLT2 inhibitors and other promising drugs1:19:07 – Final advice: Choose love, not fear; the meaning of lifeThanks for listening! You can watch the full episode on YouTube here. Don't forget to follow The Laura Dowling Experience podcast on Instagram @lauradowlingexperience for updates and more information. You can also follow our host, Laura Dowling, @fabulouspharmacist for more insights and tips. If you enjoyed this episode, please subscribe and leave a review—it really helps us out! Stay tuned for more great conversations. Hosted on Acast. See acast.com/privacy for more information.
In this episode, we give a wrap-up of late-breaking clinical science presented at the ESC Congress 2025 in Madrid. First, David Berg presents the DAPA ACT HF-TIMI 68 trial, reporting on dapagliflozin in patients hospitalized for acute heart failure, along with a meta-analysis of SGLT2 inhibitors in this setting. Next, Javed Butler highlights results of the VICTOR trial, a large phase 3 study of vericiguat in chronic heart failure with reduced ejection fraction. Then, Andre Zimerman discusses the PhysioSync-HF trial, comparing conduction system pacing with biventricular resynchronization therapy in patients with HFrEF. Finally, Kieran Docherty shares insights from a community-based study on the benefits of early initiation of disease-modifying therapy in suspected heart failure. Additional information: Topic 1: With Gregorio Tersalvi, Mayo Clinic, Rochester, MN - USA, David Berg, Brigham and Women's Hospital, Boston - USA and Novi Yanti Sari, Siloam Hospitals Group, Jakarta - Indonesia Results paper: Dapagliflozin in Patients Hospitalized for Heart Failure: Primary Results of the DAPA ACT HF-TIMI 68 Randomized Clinical Trial and Meta-Analysis of Sodium-Glucose Cotransporter-2 Inhibitors in Patients Hospitalized for Heart Failure Replay ESC Congress Hot Line: https://esc365.escardio.org/presentation/312142 Circulation. 2025 Aug 29. doi: 10.1161/CIRCULATIONAHA.125.076575. Topic 2: With Javed Butler, Baylor Scott & White Health, Dallas - USA and Henrike Arfsten, Medical University of Vienna, Vienna - Austria Results papers: Vericiguat in patients with chronic heart failure and reduced ejection fraction (VICTOR): a double-blind, placebo-controlled, randomised, phase 3 trial Lancet. 2025 Replay ESC Congress hotline: https://esc365.escardio.org/presentation/312148 doi: 10.1016/S0140-6736(25)01665-4. Vericiguat for patients with heart failure and reduced ejection fraction across the risk spectrum: an individual participant data analysis of the VICTORIA and VICTOR trials Lancet. 2025 Aug 29:S0140-6736(25)01682-4. doi: 10.1016/S0140-6736(25)01682-4. Topic 3: With Andre Zimerman, Hospital Moinhos De Vento, Porto Alegre - Brazil and Floran Sahiti, University Hospital of Wurzburg, Wurzburg - Germany Methods paper: Conduction system pacing vs biventricular resynchronization in heart failure with reduced ejection fraction and left bundle branch block: Rationale and design of the PhysioSync-HF Trial Am Heart J. 2025 Dec:290:38-45. Replay ESC Congress: https://esc365.escardio.org/session/50327 doi: 10.1016/j.ahj.2025.06.002. Topic 3: With Kieran Docherty, University of Glasgow, Glasgow - UK and Jolie Bruno, Inserm UMR-S942, Paris - France Results paper: Benefit of early initiation of disease-modifying therapy in community-based patients with suspected heart failure Eur Heart J. 2025 Aug 29:ehaf675. doi: 10.1093/eurheartj/ehaf675. This 2025 HFA Cardio Talk podcast series is supported by Bayer AG in the form of an unrestricted financial support. The discussion has not been influenced in any way by its sponsor.
Disclaimer: The views expressed in this video should not be used for medical diagnosis or treatment or as a substitute for professional medical advice. Individual symptoms, situations and circumstances may vary. Sponsored by Abbott Summary In this episode, Dr. Eden Miller discusses the concept of Euglycemic DKA, a condition that can occur even when blood sugar levels are normal. The conversation covers the importance of understanding the symptoms, the role of medications like SGLT2 and GLP1 in increasing the risk of DKA, and the necessity of regular ketone checks. Dr. Miller emphasizes the need for education and empowerment in managing diabetes, especially in unique situations like pregnancy and prolonged fasting. The episode concludes with strategies for preventing Euglycemic DKA. Chapters 00:00 Introduction to Euglycemic DKA 02:00 Understanding Euglycemic DKA 04:08 Impact of Medications on DKA 07:10 Symptoms and Confirmation of DKA 09:20 The Importance of Regular Ketone Checks 11:07 Exploring GLP-1 Medications 12:30 Other Causes of DKA 16:22 Preventing Euglycemic DKA Resources: https://diabetesandobesity-care.com/ https://www.linkedin.com/in/eden-miller-b02a5a178
Here is the second part of my conversation with biochemist Jon Brudvig to delve into the fascinating world of longevity and contemporary health interventions. We tackle topics ranging from SGLT2 inhibitors and their unexpected benefits to the controversial nature of microplastics in our environment. This dialogue is a treasure trove for anyone interested in the intersections of health, science, and longevity. What You'll Learn: Exploring SGLT2 Inhibitors: Discover the multifaceted benefits of SGLT2 inhibitors, originally diabetes drugs, for heart, kidney, and possibly cognitive health. Metformin: A Mixed Bag: Get an overview of the metformin debate, examining its potential benefits and the contentious nature of the research. Fasting Fundamentals: Gain insights into intermittent fasting, its impact on metabolism, potential benefits, and the critical role of resistance training to mitigate muscle loss. Microplastics: An Underestimated Threat: Learn about the insidious presence of microplastics in human tissues and their potential health repercussions. Potential Interventions: Hear about experimental approaches to reducing microplastics in the body, including the potential role of sulforaphane. Key Takeaways: SGLT2 inhibitors: These drugs have shown promising longevity benefits beyond their initial purpose for diabetes management. Metformin's Controversy: While some data suggests potential longevity benefits, criticism exists regarding its exercise interference and study methodologies. The Role of Fasting: Intermittent fasting can be beneficial, particularly for metabolic health, but must be carefully balanced with nutritional needs and physical activity. Microplastics Concern: Ubiquitous in the environment, microplastics are potentially linked to inflammation and adverse health outcomes, necessitating further research and interventions. Self-Experimentation: Personal health experiments, like those done by Jon Brudvig, highlight the importance of understanding one’s own biology in response to health interventions. Resources: Connect with Dr. Jon Brudvig for more insights into longevity and health: LinkedIn: Jon Brudvig Substack: https://jonbrudvig.substack.com/ Support the Podcast: If you found this episode valuable, please consider subscribing to our podcast and leaving a review. Your feedback helps us continue bringing important conversations like these to a wider audience. Whether you're driven by personal health challenges or broader scientific curiosity, this conversation provides a unique peek into the current and future possibilities of living healthier, longer lives. Share this with individuals passionate about health and longevity, and join the ongoing dialogue to advance our understanding and well-being. 00:12 Understanding SGLT2 Inhibitors 02:51 Mendelian Randomization and SGLT2 Inhibitors 06:24 Benefits and Mechanisms of SGLT2 Inhibitors 09:47 Discussion on Metformin 14:36 Intermittent Fasting and Ketone Supplements 17:46 Fasting, Autophagy, and Muscle Health 22:38 Exploring Glycine and N-Acetyl Cysteine 24:48 Microplastics: A Growing Concern 26:25 The Impact of Microplastics on Health 31:54 Self-Experimentation with Sulforaphane 38:33 Final Thoughts and Future Work See omnystudio.com/listener for privacy information.
Diabetic ketoacidosis can be life-threatening but there's some variability in the way it's managed between health settings. Intervention involves intravenous insulin administration, hydration, electrolyte replacement and treatment of the underlying precipitant. In a survey of practitioners from 31 different hospitals in Australia there was an even split between those organisations which followed a fixed rate insulin infusion protocol, usually based on bodyweight, or a variable rate infusion protocol, titrated against blood glucose concentration. Three quarters of survey respondents had worked at another hospital that had different DKA management protocols raising concerns about the cognitive load on junior health staff moving between institutions. In Europe there has been some normalisation towards fixed rate protocols, despite there being no good quality evidence for superiority. In this podcast we hear some theories from two of the authors of the study published recently in the Internal Medicine Journal.12:40 SGLT2 inhbitor-associated ketoacidosis17:26 The cognitive burden of variation across settings25:11 the challenges of researching this questionsGuestsDr Lisa Raven FRACP PhD (St Vincent's Hospital, Sydney)Dr Mahesh Umapathysivam FRACP DPhil (Southern Adelaide Diabetes and Endocrine Service; Royal Adelaide Hospital) Guest HostDr Mervyn Kyi FRACP PhD (Royal Melbourne Hospital; Northern Hospital)ProductionProduced by Dr Mervyn Kyi and Mic Cavazzini DPhil. Music licenced from Epidemic Sound ‘Tree Tops' by Autohacker and ‘Fugent' by Lupus Nocte. Image created and copyrighted by RACP. Editorial feedback kindly provided by RACP physicians Aidan Tan, Hugh Murray, Stephen Bacchi and Aafreen Khalid. Key Reference“Heterogeneity in the management of diabetic ketoacidosis in Australia: a national survey” [IMJ. 2025]Please visit the Pomegranate Health web page for a transcript and supporting references.Login to MyCPD to record listening and reading as a prefilled learning activity. Subscribe to new episode email alerts or search for ‘Pomegranate Health' in Apple Podcasts, Spotify,Castbox or any podcasting app.
Join Kate, Mark, Gary and Henry as they discuss 4 great new POEMs (studies with the potential to change practice): a digital mental health intervention, the risk of DKA in patients using SGLT2 inhibitors, esketamine's effects on suicidal ideation and unresponsive depression, and whether “one-size-fits-all” thyroid reference ranges misleading.Links:Essential Evidence Plus: www.essentialevidenceplus.comDigital mental health app for depression: https://pubmed.ncbi.nlm.nih.gov/40227715/RIsk of DKA with SGLT2s: pubmed.ncbi.nlm.nih.gov/40070044/Esketamine and resistant depression or suicidality: pubmed.ncbi.nlm.nih.gov/39790081/ What is a normal TSH: https://pubmed.ncbi.nlm.nih.gov/40324200/ Joseph O'Connor and the Escape Line Trilogy (2 great novels): https://www.amazon.com/The-Rome-Escape-Line-Trilogy-2-book-series/dp/B0BSNX3C89
CME credits: 0.25 Valid until: 27-08-2026 Claim your CME credit at https://reachmd.com/programs/cme/optimizing-igan-care-achieving-lower-proteinuria-targets-with-combination-therapy/26631/ In this episode of Clinical Countdown, Professors Jonathan Barratt and Sydney Tang discuss the evolving treatment strategies for IgA nephropathy, focusing on lowering proteinuria through combination therapy. They examine differences in disease presentation across global populations and emphasize updated KDIGO guidance on aggressive proteinuria reduction targets. The discussion includes evidence from the PROTECT trial supporting sparsentan's efficacy as a dual endothelin–angiotensin receptor antagonist and considers the role of SGLT2 inhibitors based on outcomes from the DAPA-CKD and EMPA-KIDNEY trials. Our experts also review recent real-world data showing that when added to SGLT2 inhibitors and RAS blockade, sparsentan can significantly reduce proteinuria without notable safety concerns.=
CME credits: 0.25 Valid until: 27-08-2026 Claim your CME credit at https://reachmd.com/programs/cme/optimizing-igan-care-achieving-lower-proteinuria-targets-with-combination-therapy/26631/ In this episode of Clinical Countdown, Professors Jonathan Barratt and Sydney Tang discuss the evolving treatment strategies for IgA nephropathy, focusing on lowering proteinuria through combination therapy. They examine differences in disease presentation across global populations and emphasize updated KDIGO guidance on aggressive proteinuria reduction targets. The discussion includes evidence from the PROTECT trial supporting sparsentan's efficacy as a dual endothelin–angiotensin receptor antagonist and considers the role of SGLT2 inhibitors based on outcomes from the DAPA-CKD and EMPA-KIDNEY trials. Our experts also review recent real-world data showing that when added to SGLT2 inhibitors and RAS blockade, sparsentan can significantly reduce proteinuria without notable safety concerns.=
In this essential episode of Parallax, Dr Ankur Kalra welcomes Dr Shelley Zieroth, Professor of Medicine, clinician-scientist, and advanced heart failure and transplant cardiologist in Winnipeg, Canada. As we mark the 10-year anniversary of the landmark EMPA-REG OUTCOME trial, Dr Zieroth provides a comprehensive update on how SGLT2 inhibitors have revolutionized cardiovascular care. Dr Zieroth takes us through the remarkable journey from the initial 2015 trial that transformed SGLT2 inhibitors from anti-diabetic agents into cardiovascular powerhouses, delivering highly significant reductions in cardiovascular death and heart failure hospitalization. She explores how these medications have become fundamental pillars of cardio-kidney-metabolic medicine, with evidence spanning the entire ejection fraction spectrum. Dr Zieroth discusses prescribing these agents in heart failure - including the straightforward 10-mg daily dosing, monitoring strategies, and crucial patient selection criteria. She shares insights from the recent EMPULSE trial on safe in-hospital initiation, addresses important considerations for diabetic patients, and highlights key contraindications like indwelling catheters that clinicians must recognize. Beyond the basics, Dr Kalra and Dr Zieroth examine the evolving role of SGLT2 inhibitors in valvular disease and diastolic dysfunction, tackle the ongoing reimbursement challenges across different healthcare systems, and discuss the critical importance of multidisciplinary collaboration in the cardio-kidney-metabolic space. They also look ahead to exciting combination therapies on the horizon that promise to further advance heart failure prevention and treatment. Questions and comments can be sent to "podcast@radcliffe-group.com" and may be answered by Ankur in the next episode. Host: @AnkurKalraMD and produced by: @RadcliffeCardio Parallax is Ranked in the Top 100 Health Science Podcasts (#48) by Million Podcasts.
Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I'm a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Doctor Warick Bishop, a cardiologist, author, and keynote speaker, discusses heart failure with preserved ejection fraction (HF PEF) in this podcast episode featuring Dr. Fiona Foo, a cardiologist in the Sydney Cardiology Group. They delve into HF PEF diagnosis, treatment, and prevention strategies, focusing on managing blood pressure, weight, and other risk factors like diabetes and kidney disease. They elaborate on medications such as SGLT2 inhibitors and GLP1 receptor agonists, which have shown benefits in reducing HF PEF hospitalizations and cardiovascular risks. By emphasizing lifestyle changes and pharmaceutical support, their conversation underscores the importance of maintaining a healthy weight and managing related conditions to reduce the risk of heart failure. It's a comprehensive discussion aimed at empowering listeners to prioritize heart health and make informed choices.
Dr. Robert Baron outlines major updates in type 2 diabetes care, emphasizing that blood sugar control alone does not significantly reduce cardiovascular risk, though it helps prevent microvascular complications. New guidelines now prioritize medications with proven cardiovascular and kidney benefits—GLP-1 receptor agonists and SGLT2 inhibitors—over traditional first-line therapy like metformin. Baron explains how these newer drugs not only lower blood sugar but also reduce the risk of heart attack, stroke, kidney disease, and heart failure, with added benefits such as weight loss. He also covers changes in screening, diagnosis, blood pressure goals, and individualized treatment strategies based on age, comorbidities, and patient preferences. [Health and Medicine] [Show ID: 40756]
Dr. Robert Baron outlines major updates in type 2 diabetes care, emphasizing that blood sugar control alone does not significantly reduce cardiovascular risk, though it helps prevent microvascular complications. New guidelines now prioritize medications with proven cardiovascular and kidney benefits—GLP-1 receptor agonists and SGLT2 inhibitors—over traditional first-line therapy like metformin. Baron explains how these newer drugs not only lower blood sugar but also reduce the risk of heart attack, stroke, kidney disease, and heart failure, with added benefits such as weight loss. He also covers changes in screening, diagnosis, blood pressure goals, and individualized treatment strategies based on age, comorbidities, and patient preferences. [Health and Medicine] [Show ID: 40756]
Dr. Robert Baron outlines major updates in type 2 diabetes care, emphasizing that blood sugar control alone does not significantly reduce cardiovascular risk, though it helps prevent microvascular complications. New guidelines now prioritize medications with proven cardiovascular and kidney benefits—GLP-1 receptor agonists and SGLT2 inhibitors—over traditional first-line therapy like metformin. Baron explains how these newer drugs not only lower blood sugar but also reduce the risk of heart attack, stroke, kidney disease, and heart failure, with added benefits such as weight loss. He also covers changes in screening, diagnosis, blood pressure goals, and individualized treatment strategies based on age, comorbidities, and patient preferences. [Health and Medicine] [Show ID: 40756]
This week, we explore the potential role of sodium-glucose cotransporter-2 (SGLT2) inhibitors in patients with systemic lupus erythematosus (SLE) and comorbid type 2 diabetes (T2D)—a population historically excluded from landmark SGLT2i trials. Our guest, Dr. Karen Costenbader, discusses the rationale behind the study, the nuances of trial emulation design, and key findings regarding cardiovascular and renal outcomes, infection risk, and prescribing patterns in this complex cohort. We also unpack implications for clinical decision-making and the evolving landscape of metabolic and cardiovascular care in autoimmune disease.
CME credits: 0.50 Valid until: 30-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/addressing-ckm-mortality-morbidity-in-patients-with-ckd-and-t2d-the-role-of-combined-ns-mra-sglt2i-therapy/29907/ This three-part panel series explores how emerging evidence from the CONFIDENCE trial is shaping the future of cardio-kidney-metabolic (CKM) care. In Chapter 1, the experts discuss the additive benefits and safety of combining a nonsteroidal MRA and an SGLT2 inhibitor. Chapter 2 focuses on patient selection and individualized strategies for initiating combination therapy. Chapter 3 shifts to real-world implementation, highlighting multidisciplinary collaboration and strategies to improve adherence and continuity of care. Together, this series provides a roadmap to optimize outcomes in patients with CKD and T2D.=
CME credits: 0.50 Valid until: 30-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/addressing-ckm-mortality-morbidity-in-patients-with-ckd-and-t2d-the-role-of-combined-ns-mra-sglt2i-therapy/29907/ This three-part panel series explores how emerging evidence from the CONFIDENCE trial is shaping the future of cardio-kidney-metabolic (CKM) care. In Chapter 1, the experts discuss the additive benefits and safety of combining a nonsteroidal MRA and an SGLT2 inhibitor. Chapter 2 focuses on patient selection and individualized strategies for initiating combination therapy. Chapter 3 shifts to real-world implementation, highlighting multidisciplinary collaboration and strategies to improve adherence and continuity of care. Together, this series provides a roadmap to optimize outcomes in patients with CKD and T2D.=
In this focus issue on Heart Failure in Practice, JACC Editor-in-Chief Dr. Harlan Krumholz examines how contemporary research continues to refine and at times challenge our understanding of heart failure management. This week's episode features a first-of-its-kind trial on dual therapy with SGLT2 inhibitors and MRAs, new real-world data on heart failure with improved EF, and sobering insights into what happens when foundational therapies are withdrawn. Also explored: sex-specific risks in genetic cardiomyopathies, the limitations of standard stroke prediction tools, and the case for modernizing ICD eligibility criteria. As always, the episode concludes with a synthesized summary of key takeaways for clinicians.
Klinisch Relevant ist Dein Wissenspartner für das Gesundheitswesen. Drei mal pro Woche, nämlich dienstags, donnerstags und samstags, versorgen wir Dich mit unserem Podcast und liefern Dir Fachwissen für Deine klinische Praxis. Weitere Infos findest Du unter https://klinisch-relevant.de
Send us a textWelcome back Rounds Table Listeners! Today we have a solo episode with Dr. Mike Fralick. This week, he discusses a recently published trial exploring the simultaneous initiation of SGLT2 inhibitors and finerenone (a nonsteroidal mineralocorticoid receptor antagonist) in persons with chronic kidney disease and type 2 diabetes. Here we go!Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes (0:00 – 9:28).Calling keen trainees! (9:29 - 10:28)Trainees, med students, residents: The Rounds Table and Trial Files are looking for keen individuals to support our efforts.Trial Files is a free monthly newsletter on practice-changing trials, delivered straight to your inbox (https://trialfiles.substack.com/).Reach out to fralickmpf@gmail.com if you are interested in getting involved. Questions? Comments? Feedback? We'd love to hear from you! @roundstable @InternAtWork @MedicinePods
Kidney Translation Podcast discusses cardiovascular and kidney disease studies: CKM syndrome stages and mortality prediction, cardiac risk prediction in patients with kidney failure undergoing noncardiac surgery, and SGLT2 inhibition in type 1 diabetes.
CME credits: 0.25 Valid until: 22-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/optimize-outcomes-in-ckd-t2d-a-practical-approach-to-initiating-and-monitoring-combination-ns-mra-sglt2i-therapy/29904/ The CONFIDENCE trial shows that combining an SGLT2 inhibitor with finerenone cuts albuminuria by more than 50% in patients with chronic kidney disease and type 2 diabetes. In this video, 2 nephrologists discuss how they apply these insights in clinical practice. A compelling real-world case highlights the power of 4-pillar therapy to optimize cardio-renal outcomes. Tune in to see how modern treatment strategies are transforming patient care. =
CME credits: 0.25 Valid until: 22-07-2026 Claim your CME credit at https://reachmd.com/programs/cme/optimize-outcomes-in-ckd-t2d-a-practical-approach-to-initiating-and-monitoring-combination-ns-mra-sglt2i-therapy/29904/ The CONFIDENCE trial shows that combining an SGLT2 inhibitor with finerenone cuts albuminuria by more than 50% in patients with chronic kidney disease and type 2 diabetes. In this video, 2 nephrologists discuss how they apply these insights in clinical practice. A compelling real-world case highlights the power of 4-pillar therapy to optimize cardio-renal outcomes. Tune in to see how modern treatment strategies are transforming patient care. =
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Brian Kennedy is a renowned biologist, leader in aging research, and director of the Center for Healthy Longevity at the National University of Singapore. In this episode, Brian shares insights from ongoing human aging studies, including clinical trials of rapamycin and how dosing strategies, timing, and exercise may influence outcomes. He presents two key models of aging—one as a linear accumulation of biological decline and the other as an exponential rise in mortality risk—and explains why traditional models of aging fall short. He also explains why most current aging biomarkers lack clinical utility and describes how his team is working to develop a more actionable biological clock. Additional topics include the potential of compounds like alpha-ketoglutarate, urolithin A, and NAD boosters, along with how lifestyle interventions—such as VO2 max training, strength building, and the use of GLP-1 and SGLT2 drugs—may contribute to longer, healthier lives. We discuss: Brian's journey from the Buck Institute to Singapore, and the global evolution of aging research [2:45]; Rethinking the biology of aging: why models like the hallmarks of aging fall short [9:45]; How inflammation and mTOR signaling may play a central, causal role in aging [14:15]; The biological role of mTOR in aging, and the potential of rapamycin to slow aging and enhance immune resilience [17:30]; Aging as a linear decline in resilience overlaid with non-linear health fluctuations [22:30]; Speculating on the future of longevity: slowing biological aging through noise reduction and reprogramming [33:30]; Evaluating the role of the epigenome in aging, and the limits of methylation clocks [39:00]; Balancing the quest for immortality with the urgent need to improve late-life healthspan [43:00]; Comparing the big 4 chronic diseases: which are the most inevitable and modifiable? [47:15]; Exploring potential benefits of rapamycin: how Brian is testing this and other interventions in humans [51:45]; Testing alpha-ketoglutarate (AKG) for healthspan benefits in aging [1:01:45]; Exploring urolithin A's potential to enhance mitochondrial health, reduce frailty, and slow aging [1:05:30]; The potential of sublingual NAD for longevity, and the combination of NAD and AKG for metabolic and exercise enhancement [1:09:00]; Other interventions that may promote longevity: spermidine, 17
In this episode, CardioNerds Dr. Anna Radakrishnan and Dr. Apoorva Gangavelli are joined by prevention expert Dr. Martha Gulati and heart failure expert Dr. Anu Lala to discuss heart failure with preserved ejection fraction (HFpEF), a multifactorial, evolving challenge, particularly in women. In this episode, we delve into the distinctive clinical presentation and pathophysiology of HFpEF among women, exploring both traditional and gender-specific risk factors, from metabolic and inflammatory processes to the impact of obesity, sleep apnea, and gender-specific conditions. We also discussed the latest evidence on prevention strategies and emerging therapies that not only target HFpEF symptoms but also address underlying risk factors. This conversation highlights the importance of multidisciplinary, holistic care to advance diagnosis, management, and ultimately, patient outcomes for women with HFpEF. Audio editing by CardioNerds academy intern, Christiana Dangas. Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values. CardioNerds Heart Success Series PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls - HFpEF in Women HFpEF Is a Multisystem Syndrome:HFpEF in women involves more than just diastolic dysfunction—it represents a convergence of metabolic, inflammatory, and hormonal factors that make its diagnosis and management uniquely challenging. Visceral Adiposity Drives Risk:Obesity isn't just excess weight; central or visceral adiposity actively promotes inflammation, insulin resistance, and microvascular dysfunction, which are crucial in triggering HFpEF in women. Early Identification Is Key:Recognizing—and treating—subtle risk factors such as sleep-disordered breathing, hypertension, and subtle metabolic dysfunction early, especially in women who may underreport symptoms, can prevent progression to HFpEF. Holistic, Lifespan Approach Matters:Effective HFpEF care involves managing the whole cardiometabolic profile with tailored lifestyle interventions, advanced medications (e.g., SGLT2 inhibitors, GLP-1 agonists), and even cardiac rehabilitation, which remain critical at every stage, even after diagnosis. Tailoring Prevention to Unique Risks in Women:Gender-specific factors such as postmenopausal hormonal changes, pregnancy-related complications, and autoimmune conditions demand a customized prevention strategy, reminding us that prevention isn't one-size-fits-all. Show notes - HFpEF in Women Notes drafted by Dr. Apoorva Gangavelli 1. What are the gender-based differences in HFpEF presentation? HFpEF in women often presents with more subtle symptoms such as exertional dyspnea and fatigue, which may be mistakenly attributed to aging or obesity. Women tend to have a higher prevalence of preserved ejection fraction despite a similar heart failure symptom burden to men. The diagnostic challenge is compounded by lower natriuretic peptide levels influenced by hormonal factors, particularly postmenopausal estrogen deficiency, leading to false negatives and underdiagnosis. 2. How do traditional and gender-specific risk factors contribute to the development of HFpEF in women? Traditional risk factors include obesity, hypertension, diabetes, and metabolic syndrome. Gender-specific risk factors encompass pregnancy-related complications, menopause, and autoimmune diseases, which may uniquely affect cardiovascular structure and function in women. The interaction between visceral adiposity and systemic inflammation is central in predisposing women to HFpEF. 3. What underlying pathophysiological mechanisms make women more susceptible to HFpEF? Chronic inflammation and endothelial dysfunction contribute to myocardial stiffness and diastolic dysfunction. ...
SGLT2 Inhibitors Cardiovascular and Safety Outcomes in Chronic Diseases by Citeline
Sodium-glucose cotransporter-2 (SGLT2) inhibitors have revolutionized treatment for type 2 diabetes, heart failure, and chronic kidney disease—but they're creating new challenges for anesthesia professionals. With more patients on these medications heading to surgery, understanding their unique perioperative risks has never been more critical.At the heart of this issue lies euglycemic ketoacidosis—a potentially life-threatening complication that's particularly insidious because it lacks the classic hyperglycemia that would normally trigger suspicion. We dive deep into the latest evidence, revealing that patients on SGLT2 inhibitors have an increased risk of developing postoperative ketoacidosis compared to those not taking these medications, with significantly worse outcomes when complications occur.We present a practical algorithm for risk stratification, considering factors like procedure duration, anesthesia type, diabetes control, and comorbidities. You'll learn which patients should hold their medication, which can proceed with caution, and what monitoring strategies to implement when patients haven't properly discontinued their medication before surgery. This guidance is especially valuable for emergency cases where postponement isn't an option.Whether you're developing institutional protocols or making decisions for individual patients, this episode equips you with the knowledge to navigate the complexities of SGLT2 inhibitor management in the perioperative period. Subscribe to stay informed about the latest in anesthesia patient safety and join our mission to ensure no one is harmed by anesthesia care.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/257-sweet-trouble-perioperative-management-of-sglt2-inhibitors/© 2025, The Anesthesia Patient Safety Foundation
In this podcast, Dr. Valentin Fuster explores a study on the effects of SGLT2 inhibitors, like empagliflozin, on erythropoiesis and iron mobilization in heart failure patients. The research reveals how these drugs activate key metabolic pathways, potentially enhancing iron utilization and improving clinical outcomes, with significant implications for treatment in heart failure and chronic kidney disease.
PODCAST - LAS NOTICIAS CON CALLE DE 25 DE ABRIL - Ninguna empresa quiere venir a PR a administrar sistema eléctrico - El Nuevo Día - APPLE va a cambiar a producir de India en vez de China para iPhones hacia Estados Unidos - Financial Times- Vacas que aguantan calor nacen en PR - El Vocero - Gobernadora dijo que no va a retirar nombramiento de Estado - Cuarto Poder - Todos los actores en caso del BDE y su corrupción finalmente llegan a proceso judicial - El Nuevo Día - Presidenta CEE se auto dio un bono sin autorización de la Junta - El Nuevo Día - Podrían aumentar la luz para poder pagar gastos operacionales - El Vocero - Piden a federales que le den permisos ya a LUMA para vegetación - El Vocero - Placas solares llegan al aeropuerto - El Vocero - Caos brutal en hospital Auxilio Mutuo - El Vocero - Dicen leyes de cabotaje son buenas para PR - El Vocero - Maltrato animal por las nubes y sueltan 20 perros en Isabela - Primera Hora- China le dice a Trump que si quiere negociar empiece con quitar tarifas - Financial Times- Trump quiere presionar a Ucrania a aceptar acuerdo de paz que básicamente le da todo a Putin - Tapón por camión volcado de Caguas a Cayey - Policía- China considera exenciones a algunos productos para evitar tarifas - CNBC- Trump vende gorras de Trump 2028 - Cuarto Poder - 500 personas pidieron protección para huir de parejas maltratases - Metro - Trump a Europa para el sepelio del Papa Participa de este estudio de clínico: TRANSEND-T2D-3¿Tienes diabetes tipo 2 y enfermedad renal crónica?Este estudio de investigación clínica podría interesarte
A polygenic risk score significantly improved prostate cancer detection beyond PSA testing, identifying more treatable and aggressive cancers in high-risk men. New WHO guidelines aim to reduce global meningitis deaths by standardizing early diagnosis, treatment, and care across settings. GLP-1 receptor agonists and SGLT2 inhibitors were linked to reduced Alzheimer's risk, with GLP-1s showing the most consistent neuroprotective effects in recent studies. Lastly, breast cancer mortality was 47% higher among Black women living in disadvantaged neighborhoods, underscoring the impact of social determinants on survival.
Join us as we review recent practice-changing articles on suzetrigine for acute pain, the risk of PAD events from SGLT2 inhibitors, the safety of very low LDL, and the benefits of restrictive vs liberal transfusion strategies in acute MI with anemia. Fill your brain hole with a delicious stack of hotcakes! Featuring Rahul Ganatra (@rbganatra), Matt Watto (@doctorwatto), and special guest Molly Brett (Paul Williams got a break and took a much-needed vacation this week!). Claim CME for this episode at curbsiders.vcuhealth.org! Patreon | Episodes | Subscribe | Spotify | YouTube | Newsletter | Contact | Swag! | CME Credits Written and Hosted by: Rahul Ganatra MD, MPH; Molly Brett MD, and Matthew Watto MD, FACP Cover Art: Matthew Watto MD, FACP Reviewer: Leah Witt, MD Technical Production: Pod Paste Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP Show Segments Intro, guest introduction, disclaimer Cognitive safety of very low LDL Cholesterol Suzetrigine for acute pain Risk for amputation associated with SGLT2 inhibitors Transfusion strategies in acute MI with anemia revisited Outro Sponsor: Freed Visit Freed.ai and usecode: CURB50 to get $50 off your first month when you subscribe. Sponsor: Ezeresus Listeners of the Curbsiders podcast get access to a 2-month free trial, letting them use 100% of the features of the app. For more information visit www.ezresus.com/curbsiders Sponsor: Bombas Enjoy worldwide shipping to over two hundred countries. Head over to Bombas.com/curb and use code curb for 20% off your first purchase. Sponsor: Continuing Education Company Special offer for Curbsiders listeners: Save30% on all online courses and live webcasts with promocode CURB30. Visit www.CMEmeeting.org/curbsiders to explore all offerings and claim your discount.
View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Ralph DeFronzo is a distinguished diabetes researcher and clinician whose groundbreaking work on insulin resistance has reshaped the understanding and treatment of type 2 diabetes. In this episode, Ralph shares insights from his five decades of research, including his pivotal role in bringing metformin to the U.S. and developing SGLT2 inhibitors. Ralph explores the impacts of insulin resistance on specific organs, the pharmacologic interventions available, and the gold-standard euglycemic clamp method for measuring insulin resistance. This episode is a masterclass in the pathophysiology and treatment of type 2 diabetes, featuring an in-depth discussion of GLP-1 receptor agonists, metformin, and a lesser-known class of drugs that opened Peter's eyes to new possibilities in diabetes care. We discuss: Metabolic disease as a foundational driver of chronic illness [4:00]; Defining insulin resistance: effects on glucose, fat, and protein metabolism, and how it varies between healthy, obese, and diabetic individuals [8:15]; The historical significance of the development of the euglycemic clamp technique for measuring insulin resistance [11:45]; How insulin affects different tissues: liver, muscle, and fat cells [15:00]; The different ways insulin resistance manifests in various tissues: Alzheimer's disease, cardiovascular disease, and more [25:00]; The dangers of hyperinsulinemia, and the importance of keeping insulin levels within a physiological range [29:00]; The challenges of identifying the genetic basis of insulin resistance and type 2 diabetes [37:00]; The “ominous octet”—a more comprehensive model of type 2 diabetes than the traditional triumvirate [45:45]; The kidneys' unexpected role in worsening diabetes, and how SGLT2 inhibitors were developed to treat diabetes [55:45]; How insulin resistance in the brain and neurocircuitry dysfunction contribute to overeating and metabolic disease [1:04:15]; Lipotoxicity: how overeating fuels insulin resistance and mitochondrial dysfunction [1:07:30]; Pioglitazone: an underappreciated and misunderstood treatment for insulin resistance [1:10:15]; Metformin: debunking the misconception that it is an insulin sensitizer and explaining its true mechanism of action [1:19:15]; Treating diabetes with triple therapy vs. the ADA approach: a better path for diabetes management [1:24:00]; GLP-1 agonists, the Qatar study, and rethinking diabetes treatment [1:31:30]; Using a hyperglycemic clamp to look for genes that cause diabetes [1:45:15]; The superiority of measuring C-peptide instead of insulin to assess beta-cell function [1:46:45]; How GLP-1-induced weight loss affects muscle mass, the benefits and risks of myostatin inhibitors, and the need for better methods of evaluating functional outcomes of increased muscle mass [1:51:30]; The growing crisis of childhood obesity and challenges in treating it [2:02:15]; The environmental and neurological factors driving the obesity epidemic [2:07:30]; The role of genetics, insulin signaling defects, and lipotoxicity in insulin resistance and diabetes treatment challenges [2:11:00]; The oral glucose tolerance test (OGTT): detecting early insulin resistance and beta cell dysfunction [2:18:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube