Podcasts about t1dm

Do starfish have corners? Do you think we can make immune organs interesting? There's no explanation to do this two parter justice. Dr Edward Roper, everyone. Pathologist extraordinare. Go forth and learn

What treatment options are available for children and adolescents with obesity? Host Aaron Lohr takes on this topic with Susan J. Woolford, MD, associate professor in the Child Health Evaluation and Research Center at the University of Michigan, and Sarah Giger, MD, a clinical fellow at Cincinnati’s Children’s Hospital. Both took part in the Endocrine Society’s recent obesity fellows conference. This episode is supported by an educational grant from Lilly and Novo Nordisk. Also, this episode is available to listen for 0.5 CME credits, but you must follow the link to the show notes and read the instructions in order to earn those points. Show notes are available at https://www.endocrine.org/podcast/enp97-childhood-obesity-treatment — for helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

There is a lot of interest in automated insulin delivery systems, and they were covered in depth at the Endocrine Society’s Type 1 Diabetes Fellows Series, held earlier this year. Joining host Aaron Lohr to talk about these delivery systems is Grazia Aleppo, MD, a professor of medicine at Northwestern University and a presenter at the T1D Fellows Series. Show notes are available at https://www.endocrine.org/podcast/enp96-automated-insulin-delivery-systems — for helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

In this powerful episode of the LowCarbUSA podcast, Doug Reynolds and Pam Devine sit down with Beth McNally and Matt Miernik, the couple behind T1D Nutrition, to discuss their journey with type 1 diabetes (T1D) and the transformative role of nutrition in managing the condition. Their journey began in 2015 when their son Lachlan was diagnosed with T1D at age 9. After months of frustration with conventional high-carb, insulin-heavy treatments, they adopted a very low-carb diet, which dramatically improved Lachlan's blood glucose stability and brought his A1C levels into the normal range. Now, at 18, Lachlan is a thriving athlete, and Beth and Matt are dedicated to sharing the benefits of therapeutic carbohydrate reduction with others facing similar challenges. A central theme of the conversation is the recently published Position Paper by The SMHP on therapeutic carbohydrate reduction for type 1 diabetes, to which Beth, Matt, and a team of experts have made significant contributions. This paper will revolutionize T1D management by advocating for therapeutic carbohydrate reduction as a viable, evidence-based option. It calls for healthcare providers to support patients choosing this approach and underscores the importance of continued research and education on low-carb nutritional strategies. Beth expresses her enthusiasm for the Position Paper, noting its potential to challenge current T1D care practices. With only about 17% of youth and 21% of adults meeting the American Diabetes Association's A1C target of 7.0, this paper could be a game-changer, providing clinicians with new guidelines and resources to enhance patient outcomes. It advocates for open access and support for those exploring low-carb diets as a therapeutic intervention, signaling a much-needed shift in mindset. Throughout the episode, Beth and Matt stress how this Position Paper will empower both patients and clinicians, offering a solid foundation for discussing low-carb options within healthcare teams and integrating evidence-backed guidelines into mainstream T1D care. They encourage families to share the Position Paper with their doctors, fostering more comprehensive and supportive care. The couple also reflects on their involvement in the January 2024 LowCarbUSA Boca Raton Symposium for Metabolic Health, which featured a dedicated Type 1 Day. This event assembled international experts in T1D management, including Dr. Ian Lake, Dr. Suzanne Schneider, Dr. Eric Westman, Dr. Belinda Lennerz, and Dr. Robert Cywes, who shared innovative insights into how nutrition can stabilize blood glucose levels and improve the quality of life for those with T1D. These presentations set the stage for the Position Paper and underscored the need for a low-carb approach to gain wider recognition and support within the medical community. Matt offers additional insights into why therapeutic carbohydrate reduction is so effective, explaining how reducing carbohydrate intake decreases insulin dependency, leading to more stable blood glucose levels. He compares it to "removing logs from a fire," minimizing the blood glucose fluctuations that make T1D so difficult to manage. This Position Paper will address these scientific principles, equipping clinicians with the knowledge and tools to guide their patients more effectively. Matt also discusses the phenomenon of "double diabetes," a condition where individuals with type 1 diabetes develop insulin resistance, resembling type 2 diabetes. He explains how the conventional high-carb diet paired with large insulin doses can lead to this dangerous overlap, increasing health risks and complications. By adopting a low-carb approach, insulin needs are minimized, reducing the chances of developing double diabetes and supporting better metabolic health in people with T1D. Doug and Pam share how eye-opening the Type 1 Day event was for them and other attendees, with many healthcare professionals admitting they gained more insight into T1D management in one day than they had in their entire careers.  Click here to listen and discover the latest advancements in therapeutic carbohydrate reduction. Additionally, LowCarbUSA® has released all the Dedicated Type 1 Diabetes Workshop & Presenter videos from the recent LCUSA & SMHP Symposium for Metabolic Health, held in January. This video playlist features expert presentations that explore therapeutic carbohydrate reduction, optimal protein intake, healthy fats, and low-carb strategies for T1D. Featured speakers in this series include: Dr. Èvelyne Bourdua-Roy, MD & Dr. Tro Kalayjian, DO- Workshops intro & Prevailing outcomes in T1D Beth McNally, MS MA CNS LDN - Therapeutic Carbohydrate Reduction (TCR)/Low-carb Diet Implementation for T1D Dr. Ian Lake, BSc, BM,MRCGP - Low-Carb in T1D: Getting started, troubleshooting and guidance Dr. Belinda Lennerz, MD - Medication & Technology Implementation Allison Herschede, BSN, RN, CDCES - Hormonal Challenges for Women with T1D Dr. Ian Lake, BSc, BM,MRCGP - Exercise how to & Fasting (intermittent and multi-day) Lester Hightower & Beth McNally, MS MA CNS LDN - Parents Perspective - TCR/Low-carb for Type 1 diabetes Dr. Eric Westman, MD, MHS - Standard of Care - Advances and challenges in Type 1 diabetes care Dr. Jessica Turton, PhD, MND, B.App.Sc (ExSpSc) - Current research on low-carbohydrate diets for Type 1 diabetes management Dr. Belinda Lennerz, MD - Children living with Type one Diabetes - Current and future research questions pertaining to therapeutic dietary carbohydrate reduction in children Dr. Eric Westman, MD, MHS, Dr. Jessica Turton, PhD, MND, B.App.Sc (ExSpSc), & Dr Belinda Lennerz, MD - Panel Discussion Dr. Robert Cywes, MD, PhD - Clinical implementation of low-carbohydrate diets in T1DM – experiences from adults and children Dr. Ian Lake, BSc, BM,MRCGP - Exercise and Therapeutic Carbohydrate Reduction – Current research and clinical experiences Suzanne Schneider, PhD Researcher, MSc, Bcomm - Cognitive and Psychological Implications of Carbohydrate Reduction in T1DM Dr. Robert Cywes, MD, PhD, Dr. Ian Lake, BSc, BM,MRCGP, & Suzanne Schneider, PhD Researcher, MSc, Bcomm - Panel Discussion These videos are available for free on the LowCarbUSA® YouTube channel in the "Type 1 Workshop - Symposium for Metabolic Health - Boca 2024" Playlist. Explore this valuable resource to gain insights from the leading voices in T1D management and be part of the growing community dedicated to improving outcomes for those living with type 1 diabetes. Links: T1D Nutrition website

Evaluation and Credit:  https://www.surveymonkey.com/r/Medchat72 Target Audience This activity is targeted toward primary care physicians and advanced providers. Statement of NeedAdolescents with Type 1 diabetes mellitus (T1DM) face a significantly higher risk of developing cardiovascular disease (CVD) compared to their peers without diabetes. Regular physical activity is crucial for these young individuals, as it helps mitigate CVD risk and improves cardiorespiratory fitness (CRF). Therefore, promoting lifelong physical activity, with appropriate insulin and dietary adjustments, is essential for managing T1DM and preventing CVD. This podcast will highlight the benefits of exercise in preventing cardiovascular disease, describe the advantages of sports activities, and outline clinical guidelines for safe exercise practices in adolescents with T1DM. Objectives At the conclusion of this offering, the participant will be able to:  Discuss the benefits of exercise in the management of adolescent patients with Type 1 diabetes.  Describe potential glycemic management strategies during times of sport/activity in adolescents with Type 1 diabetes. Review the role of technology and future advancements in the management of diabetes.  Moderator Mark McDonald, M.D., MHA, CPE System Vice President Pediatric Medical Affairs Medical Director, Norton Children's Louisville, Kentucky  Professor Department of Pediatrics Division of Critical Care UofL School of Medicine Louisville, Kentucky Speaker Brad Thrasher, D.O., MBAPediatric Endocrinologist Medical Director, Pediatric Diabetes Medical Director, Sport & Activity Wendy Novak Diabetes Institute Norton Children's Endocrinology Louisville, Kentucky Associate Professor UofL School of Medicine Louisville, Kentucky    Moderator, Speaker and Planner Disclosures  The planners, moderator and speaker of this activity do not have any relevant financial relationships with ineligible companies to disclose.   Commercial Support  There was no commercial support for this activity.  Physician Credits Accreditation Norton Healthcare is accredited by the Kentucky Medical Association to provide continuing medical education for physicians. Designation Norton Healthcare designates this enduring material for a maximum of .50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   For more information about continuing medical education, please send an email to cme@nortonhealthcare.org.  Nursing CreditaNorton Healthcare Institute for Education and Development is approved with distinction as a provider of nursing continuing professional development by the South Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation. This continuing professional development activity has been approved for .50 contact hours. In order for nursing participants to obtain credits, they must claim attendance by attesting to the number of hours in attendance.   For more information related to nursing credits, contact Sally Sturgeon, DNP, RN, SANE-A, AFN-BC at (502) 446-5889 or sally.sturgeon@nortonhealthcare.org. Resources for Additional Study/References Chang, Xinyi, et. Al.  “Effect of Physician Activity/Exercise on Cardiorespiratory Fitness in Children and Adolescents with Type I Diabetes: A Scoping Review”; International Journal of Environmental Research and Public Health, Jan. 12, 2023; https://doi.org/10.3390/ijerph20021407 Cockcroft et al. “Factors affecting the support for physical activity in children and adolescents with type 1 diabetes mellitus: a national survey of health care professionals' perceptions”; BMC Pediatrics (2023) 23:131. https://doi.org/10.1186/s12887-023-03940-3   Date of Original Release | Nov. 2024; Information is current as of the time of recording. Course Termination Date | Nov. 2026 Contact Information | Center for Continuing Medical Education; (502) 446-5955 or cme@nortonhealthcare.org Also listen to Norton Healthcare's podcast Stronger After Stroke. This podcast, produced by the Norton Neuroscience Institute, discusses difficult topics, answers frequently asked questions and provides survivor stories that provide hope. Norton Healthcare, a not for profit health care system, is a leader in serving adult and pediatric patients throughout Greater Louisville, Southern Indiana, the commonwealth of Kentucky and beyond. More information about Norton Healthcare is available at NortonHealthcare.com.

Another insightful voice with the wonderfully articulate and fierce Diabetes Type 1 advocate Faye. Faye was diagnosed as a baby at just 16 months old with Type 1 diabetes which is an incurable endocrine disorder whereby the body can not produce its own natural insulin. We talk about the lack of awareness in the public (and associated stigma) of the difference between Type 2 and Type 1 diabetes. Type 1 carries far more life risks and Faye talks openly about growing up with the disease, and how she manages needing at least 4 injections every single day, along with the frightening risks of life-threatening hypos. However Faye is a very good advocate for how to not let your disease define you, how she continues to live life well. Faye works with young adults newly diagnosed with T1DM and has helped create the first adapted Duke of Edinburgh award to make it more accessible for people with diabetes to take part. Another brilliant example of someone proving that even when facing your mortality, and living with a relentless condition that in Faye's words 'every single day there is no escaping' - Faye still continues to live her life on her terms. A brilliant voice and grateful to have Faye join our campaign and share her story with us.Shining the spotlight on women facing their own mortality - those affected at a young age by a life changing illness or disease. 100 Voices sharing messages of hope and strength through our podcast with a powerful photography series ‘Scars of Gold' inspired by kintsugi. Building a platform to provide health awareness, support and education to change the face of disease in young people. For more information visit our website.#mortalandstrong #scarsofgold #kintsugi #art #artist #doctor #charity #campaign #womenshealth #cancer #nonhodgkinslymphoma #thyroidcancer #breastcancer #stemcelltransplant #secondarycancer #ovariancancer #germcelltumour #germcellcancer #ca125 #leydigsertolicancer #sarcoma #pcos #gynaecancerFor more information on support available for these issues discussed in todays episode, including direction to medical information, visit our website. This episode is not intended as specific medical advice, always see your own GP/physician if you have any concerns regarding your own health. Hosted on Acast. See acast.com/privacy for more information.

Today's episode features my husband Zack talking about his type 1 diabetes diagnosis. Zack was diagnosed with type 1 diabetes almost a year ago now. For those that don't know, T1DM is an autoimmune condition where his pancreas stops producing insulin, meaning that he will be insulin dependent for the rest of his life. He either uses shots or a pump, luckily, his lifestyle didn't have to change too much because he has a dietitian as a wife. ;) But, thank you for listening and I hope you enjoy this one and learn a little something new! Follow for more: Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@simplyhealthyrd⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ TikTok: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@simplyhealthyrd⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Website: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠simplyhealthynutrition.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Apply for coaching: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠1:1 Coaching Application⁠⁠⁠⁠⁠⁠⁠⁠ --- Send in a voice message: https://podcasters.spotify.com/pod/show/taylor-grasso/message

Semaglutdie-containing medications (like Ozempic, Wegovy, Rybelsus) have recently made headlines after some reports of gastroparesis. And experts don't know for sure if this side effect is linked to semaglutide itself.  Keep in mind that several other medications and health conditions can cause gastroparesis. There were no reports of gastroparesis in a 2-year clinical study of semaglutide use in patients with overweight or obesity. And while semaglutide and other GLP-1 agonists like tirzepatide (Mounjaro, Zepbound) and liraglutide (Victoza, Sexenda) cause stomach-related side effects like nausea, vomiting, upset stomach, diarrhea, and constipation, we know these effects happen because the medications slow down how quickly food leaves your stomach (delayed gastric emptying).  The good news is that these side effects are reported to be reduced after about 5 months (20 weeks) of use. In this podcast, we'll discuss gastroparesis, what causes gastroparesis, and how to lower your risk of gastroparesis. What is Gastroparesis? Gastroparesis occurs when the stomach muscles fail to function properly, leading to slowed or incomplete movement of food and liquid from the stomach to the small intestine, even though there isn't a blockage.  This delay can result in digestive issues and discomfort for individuals with gastroparesis. Symptoms include stomach pain, ulcers, and heartburn. You may also experience nausea and vomiting. What Causes Gastroparesis? One of the most common causes of gastroparesis is diabetes (T1DM or T2DM). High blood sugar levels over time can damage the vagus nerve, which controls the stomach muscles. Some individuals may develop gastroparesis as a complication of abdominal surgery, particularly those involving the stomach or intestines. Certain neurological conditions, such as Parkinson's disease and multiple sclerosis, can affect the nerves that control stomach function, leading to gastroparesis. It can also be caused by certain medications, including some opioid pain medications, antidepressants like venlafaxine, and allergy medications like diphenhydramine (Benadryl). It can also be caused by viral infections that can damage the stomach nerves and marijuana use. How can you lower your risk of gastroparesis? If you have diabetes, you can lower your risk by keeping good control of your blood sugar. You can also avoid medications that can cause gastroparesis. But it's important to know that 40% of gastroparesis cases are idiopathic (unknown reason). GLP-1 agonists and gastroparesis Research on semaglutide-induced gastroparesis is limited, but there have been patient reports of gastroparesis with GLP-1 agonists like tirzepatide, liraglutide, and semaglutide. However, the majority of the people who reported gastroparesis symptoms also had diabetes and their gastroparesis resolved after temporarily discontinuing the GLP-1 agonist. In some cases, diet changes (eating small frequent meals that are low in fiber and fat and avoiding carbonated beverages that may bloat the stomach) also helped resolve symptoms. Keep in mind: We mentioned earlier there were no reports of gastroparesis in a 2 year clinical study of semaglutide use in patients with overweight or obesity. The FDA states that they can't confirm if GLP-1 agonists directly cause gastroparesis or an underlying health condition. Remember: Gastroparesis symptoms are very similar to common semaglutide side effects. But just because these symptoms occur, it doesn't mean there's a problem. If your symptoms become severe, aren't going away, or worsen, you should let your healthcare provider know. They can help determine what steps you should take next. Thanks again for listening to The Peptide Podcast. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! We're huge advocates of elevating your health game with nutrition, supplements, and vitamins. Whether it's a daily boost or targeted support, we trust and use Momentous products to supercharge our wellness journey.  Momentous only uses the highest-quality ingredients, and every single product is rigorously tested by independent third parties to ensure their products deliver on their promise to bring you the best supplements on the market. 

The prevalence of obesity is increasing globally, which  increases the risk of type 2 diabetes mellitus, hypertension, dyslipidemia, cardiovascular diseases etc.  Around 70 % of people with diabetes are either overweight or obese. In last 1-2 decades, obesity is also affecting children / people with T1DM, primarily due to changing dietary habits and poor exercise compliance.  Individuals with T1DM who are overweight/ obese, have clinical features of insulin resistance (as that of Type 2 DM), are known as "double diabetes". It is challenging for a person with double diabetes to achieve reasonable glycemic control.  A sedentary lifestyle, a high-calorie diet rich in fats and simple sugars, and a low-fibre diet in T1DM also lead to poor metabolic control, weight gain, and other disorders like depression that further aggravate the condition. Proper treatment & lifestyle modification helps to achieve better control.To prevent double diabetes, every child / person with T1DM should practice regular outdoor sports or regular exercise. They should consume healthy diet through the concept of mindful eating. Yoga may compliment for the better management of double diabetes….! Broadcasted on 24.11.2023

Peptide therapies have garnered significant attention in healthcare due to their potential to address muscle growth, inflammation, immune modulation, skin rejuvenation, metabolic regulation, and even certain chronic diseases. From fitness enthusiasts seeking enhanced performance and faster recovery to individuals exploring innovative treatments for specific health conditions, peptides have piqued curiosity and raised numerous questions.  Let's dive into some of the most commonly asked questions about peptide therapies to shed light on their applications and safety. 1. What are peptides, and how do they work in the body? Peptides are short chains of amino acids. They play important roles in cellular signaling, acting as messengers that regulate biological processes. Peptides can influence hormone production, cell communication, immune response, and tissue repair by binding to specific receptors in the body. 2. What conditions or purposes can peptide therapies address? Peptide therapies have a wide array of potential applications. Some peptides are used for  muscle growth and recovery in fitness and sports medicine. Others may target specific health concerns such as inflammation, immune system modulation, skin rejuvenation, or even metabolic regulation in conditions like diabetes or obesity. Research is ongoing to explore their efficacy in wound healing, neurodegenerative diseases, cancer, and more. 3. Are peptide therapies safe? When administered under proper medical supervision by qualified healthcare professionals, peptide therapies are generally considered safe. However, like any medical intervention, there may be potential side effects or risks, mainly if misused or in excessive doses. It's important to adhere to prescribed dosages and follow guidelines provided by healthcare providers. 4. How are peptide therapies administered? Peptides can be administered through various methods, including injections (e.g., intramuscular, subcutaneous, and intraarticular injections), oral tablets, nasal sprays, or topical creams, depending on the specific peptide and its intended purpose. How a peptide is administered often varies based on the peptide's stability, bioavailability (the amount of a medication that enters the bloodstream to have an effect), and desired effects. 5. Are peptide therapies legal and regulated? Regulations regarding peptide therapies differ from country to country. Specific peptides are legally available in many places with a prescription from a licensed healthcare provider. However, some peptides may fall into legal grey areas or be prohibited for use without proper authorization due to their potential misuse in sports or performance enhancement.  This is when choosing a peptide clinic or provider becomes important. As the demand for these therapies grows, so does the number of peptide clinics catering to people looking for these innovative treatments. You'll want to make sure you choose a reputable clinic with providers with appropriate qualifications, experience, and specialization in peptide therapies to ensure you're in capable hands. A reputable peptide clinic should have staff that stay updated with the latest research in peptide therapies. An evidence-based approach ensures you receive treatments rooted in scientific knowledge. You'll also want to opt for clinics that follow safety protocols and have accessible and responsive communication channels to make it easy to ask questions, address concerns, and schedule appointments (e.g., website, text, email, phone call).  The truth is that many peptides are FDA-approved and have been used safely in conventional medicine for several decades. Insulin used for T1DM, Byetta for T2DM, and oxytocin used to induce labor are great examples. Keep in mind what's changed is the commercialization of peptides, which has made the general public more aware of peptide therapies. 6. How long does it take to see results from peptide therapies? The timeline for experiencing results varies based on the specific peptide being used, its intended purpose, dosage, underlying health conditions, and individual response. Some individuals may notice effects relatively quickly, while others might require a longer duration for noticeable changes. Patience and adherence to prescribed peptide regimens are essential. 7. Are there any potential side effects of peptide therapies? Side effects can occur with peptide therapies, although they may vary depending on the type of peptide and individual response. Common side effects might include injection site reactions, mild headaches, nausea, or changes in appetite. Serious side effects like allergic reactions are rare but can occur, emphasizing the importance of proper medical guidance. As research continues to uncover peptides' full potential and therapeutic applications, it's important to stay informed about their benefits, limitations, and the evolving landscape of regulations governing their use. Always consult a healthcare provider before starting any peptide therapy regimen to determine its suitability for your needs and health goals. Thanks again for listening to The Peptide Podcast. We love having you as part of our community. If you love this podcast, please share it with your friends and family on social media, and have a happy, healthy week! Pro Tips We're huge advocates of using daily greens in your routine to help with gut, skin, nail, bone, and joint health. We take AG1 (athletic greens) every day. It has vitamins, minerals, a diverse range of whole-food sourced ingredients, and probiotics to promote a healthy gut microbiome and adaptogens to help with focus and mood balance. It's vegan, paleo, and keto-friendly.

People with T1DM have to take insulin every day, often 4 or 5 times daily. There are different types of insulin & are grouped according to their action profile and content like Rapid or short acting insulin helps to reduce meal time blood glucose, while intermediate and long- acting insulin acts as basal insulin. Mixed insulin are combination of either rapid acting or short acting along with intermediate insulin. Every insulin has its own action profile. Insulin needs to be stored correctly at temperature of 2-8◦C in freeze during hot summers and can be stored at room temperature during winters and rainy season. Correct insulin technique, storage, site rotation all plays a vital role in insulin absorption. Diet also plays a vital role in management of T1DM. To achieve target A1C goal and target blood sugars, it is important to understand how to balance between food intake, physical activity and insulin. Making healthy food choices & portion control has long term effects on blood sugars. Eating constant amount of food daily and adjusting insulin accordingly helps to improve blood glucose levels. What to eat, how much to eat plays crucial role in blood sugar control. They need to keep balance between macronutrients & micronutrients. Carbohydrates are the main source of the energy & have great impact on blood glucose levels. The amount of carbohydrates in meals can be calculated with the help of carb counting. Keeping watch on carbs in your meals can help match your insulin according to blood glucose and also helps in maintaining target blood glucose levels. Recorded on 28.07.2023.

Children and adults with Type 1 Diabetes Mellitus (T1DM) are at high risk of the acute and chronic complications. The acute complications are Hypoglycemia (low sugar attack) and Diabetic ketoacidosis (DKA). Diabetic ketoacidosis (DKA) is a life-threatening problem that usually affects people with T1DM. It occurs when the body starts breaking down fat at a rate that is much too fast. The liver processes the fat into a fuel as ketones, which causes the blood to become acidic. Diabetic Ketoacidosis begins with mild ketosis in a person with T1DM due to their high blood glucose, dehydration, infection or same precipitating cause. It should be checked in urine ( by keto-Diastix ) if fasting glucose is more than 250mg/dl or Postmeal / Random Glucose is> 350 mg/dl or during any episode of vomiting, fever abdominal pain, drowsiness or any sick day symptoms. (Recorded on July 14 2023 at Akashvani Nagpur) Hypoglycemia means when the blood glucose falls to below 70mg/dl, which requires to be corrected by oral glucose or Sweets or any available food. Mild and moderated hypoglycemia can be managed at home, but severe hypoglycemia presents with unconsciousness, abnormal behaviour, seizures or rarely paralysis which needs hospitalization. To prevent hypoglycemia, much effort must be invested in education regarding risk factors, warning signs, and treatment of hypoglycemia at an early stage. Also Diabetic Identity Card (DIC) plays an important role. Every diabetic should have DIC which will help them in emergency conditions to get the immediate treatment.

Host Aaron Lohr went to Chicago in June to interview researchers presenting at the Endocrine Society’s annual meeting, ENDO 2023. Here he talks with Julie Hens, PhD, from Yale University about her team’s research, titled “Protective Effects of Lactation on Maternal Metabolism.” After that interview, listen to a sneak peek of our other, members-only podcast, Endocrine Feedback Loop, an episode from November 2022 about changes in glucose throughout the menstrual cycle in type 1 diabetes. For helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

Host Aaron Lohr went to Chicago in June to interview researchers presenting at the Endocrine Society’s annual meeting, ENDO 2023. Here he talks with Julie Hens, PhD, from Yale University about her team’s research, titled “Protective Effects of Lactation on Maternal Metabolism.” After that interview, listen to a sneak peek of our other, members-only podcast, Endocrine Feedback Loop, an episode from November 2022 about changes in glucose throughout the menstrual cycle in type 1 diabetes. Show notes are available at https://www.endocrine.org/podcast/enp71-lactation-and-maternal-metabolism — for helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

Host Aaron Lohr went to Chicago in June to interview researchers presenting at the Endocrine Society’s annual meeting, ENDO 2023. Here he talks with Julie Hens, PhD, from Yale University about her team’s research, titled “Protective Effects of Lactation on Maternal Metabolism.” After that interview, listen to a sneak peek of our other, members-only podcast, Endocrine Feedback Loop, an episode from November 2022 about changes in glucose throughout the menstrual cycle in type 1 diabetes. Show notes are available at https://www.endocrine.org/podcast/enp71-lactation-and-maternal-metabolism — for helpful links or to hear more podcast episodes, visit https://www.endocrine.org/podcast

Type 1 Diabetes Mellitus(T1DM) is also known as Juvenile or Insulin Dependent Diabetes Mellitus. In This, Beta Cells of Pancreas produce either very little or no Insulin thus they need to take insulin injections for their whole life. Type 1 DM most commonly occurs between 5 to 15 years of age, but it can occurs at any age after 6 months of birth and even in elderly people. In T1DM beta–cells of pancreas get destroyed completely due to autoimmunity or post-viral infection or idiopathic (Unknown Cause). India ranks at first position in the prevalence of Type 1 Diabetes Mellitus in the World. It's common symptoms include polyuria.(increased urination), polydipsia (increased thirst), polyphagia (increased appetite) & weight loss. Their treatment includes Insulin and medical nutrition therapy. They have to take insulin injection 4 times a day or sometimes even more Acute complications of T1DM includes Diabetic Ketoacidosis (DKA) & hypoglycemia, which needs immediate action. Some important diagnostic tests for T1DM include fasting C-Peptide, GAD 65 antibodies test and antibody to Celiac Disease etc. Recorded on the 12th May 2023 at Aakashwani Nagpur.

Episode 138: SGLT-2 Inhibitors in heart failureFuture doctor Enuka explains the use of sodium-glucose-linked cotransporter-2 inhibitors (SGLT-2 inhibitors) in heart failure. Dr. Arreaza adds his experience with these medications and emphasizes their role as an effective treatment for type 2 diabetes.  Written by  Princess Enuka, MSIV, Ross University School of Medicine. Editing 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.Intro:Heart failure is a major medical condition that affects millions of people worldwide. It is one of the leading causes of hospitalization and death in developed countries. Recently, SGLT2 inhibitors have emerged as a promising treatment option for heart failure. Today, we will discuss their benefits, their effectiveness, and their adverse effects.SGLT2 inhibitors, also known as sodium-glucose-linked cotransporter-2 inhibitors, are a relatively novel class of drugs that have shown promise in heart failure treatment. This transporter reabsorbs glucose from the glomerular filtrate back into the bloodstream. Under normal circumstances, SGLT-2 reabsorbs 100% of the filtered glucose unless it is saturated (as in hyperglycemia) or blocked by medications. SGLT2 inhibitors increase the amount of glucose excreted in the urine, which leads to blood glucose reduction. Examples include empagliflozin, dapagliflozin, and canagliflozin.SGLT-2 inhibitors have become a first-line therapy for diabetes mellitus. I heard before that it was used in Europe for T1DM, but it seems like they are no longer used, according to my most recent review of articles. SGLT2 inhibitors are not approved by the FDA for use in type 1 diabetes due to the risk of DKA. Princess, besides the benefits in diabetes, what else did you find in your review?Benefits/Efficacy:SGLT2 inhibitors have additional benefits beyond their glucose-lowering effects. One of the benefits of SGLT2 inhibitors is their ability to increase myocardial energy production, alleviate systemic microvascular dysfunction, and improve systemic endothelial function. Natriuresis and glucosuria mediated by SGLT2 inhibitors have been shown to lower cardiac pre-load and reduce pulmonary congestion and systemic edema, which is beneficial for heart failure management.Studies have shown that these drugs can also improve cardiovascular outcomes in patients with heart failure with a reduced ejection fraction. Some studies:The EMPEROR-Reduced trial demonstrated that empagliflozin, brand name Jardiance®, reduced the risk of cardiovascular death and hospitalization for heart failure in patients with reduced ejection fraction by 25% compared to placebo. Several clinical trials have also shown that this result is significant whether patients have type 2 diabetes or not. Also, in a multicenter, double-blind, randomized, placebo-controlled trial in patients with heart failure, treatment with dapagliflozin, brand name Farxiga®, improved heart failure-related symptoms and physical limitations after only 12 weeks of treatment. Patients treated with dapagliflozin had a significant, clinically meaningful improvement in the 6-minute walking test distance. The magnitude of these benefits was statistically and clinically significant, spanning all subgroups categorized. This included patients with and without type 2 diabetes and those with an ejection fraction above or below 60%.Anecdote:During a previous clinical rotation, I had a patient taking Jardiance for heart failure. He also had a history of chronic kidney disease and managed his condition well with medications and regular follow-ups. Interestingly, he was prescribed Jardiance®, which I initially believed was solely for diabetes management. When I asked him about it, he explained that his cardiologist prescribed Jardiance specifically for his heart. At the time, I did not understand the rationale behind prescribing Jardiance®, especially since the patient did not have type 2 diabetes. But after researching the medication, I figured that his cardiologist had chosen Jardiance® due to its demonstrated benefits in reducing the risk of cardiovascular death and hospitalization for heart failure. Although initially considered to be only glucose-lowering agents, the effects of SGLT2 inhibitors have expanded far beyond that. Their use has expanded to include heart failure and chronic kidney disease, even in patients without diabetes. It is, therefore, essential that cardiologists, diabetologists, nephrologists, and primary care physicians are familiar with this drug class.Adverse effects:It is worthwhile to note that SGLT2 inhibitors are not typically used as first-line treatment for heart failure, and not all patients with heart failure are appropriate candidates for these medications. SGLT2 inhibitors are generally well-tolerated, but they can cause adverse effects. Genital and urinary tract infections and euglycemic diabetic ketoacidosis are the most common side effects experienced by patients. The incidence of these adverse effects is generally low and can be managed with appropriate monitoring and treatment. In addition, SGLT2 inhibitors can also cause dehydration, electrolyte imbalances, hypotension, and acute kidney injury (AKI). These imbalances are more common in elderly patients or those with renal impairment, like the patient I discussed earlier. Genital yeast infections: Diabetes is also a risk factor for genital yeast infections because glucose in the urine is used as a substrate by microorganisms to grow in the GU tract. UTI and genital yeast infections are prevented by staying well hydrated while taking these meds. Increased intake of water will dilute the urine and decrease the concentration of glucose in urine. UTI/genital yeast infections are treated as usual, and the SGLT-2 can be resumed after infections are treated. In case of recurrence, the clinician may consider discontinuation of medication based on a case-by-case assessment. Patients using SGLT2 inhibitors for treatment should have regular follow-ups with their physicians for the early detection of adverse effects. Bladder cancer: It is not clear if chronic glucosuria is tumorigenic since there are no long-term data. In clinical trials, 10 cases of bladder cancer were diagnosed among dapagliflozin users, five of which occurred only in the first six months of treatment. The FDA has recommended postmarketing surveillance studies. Dapagliflozin is not recommended in patients with active bladder cancer. Bone fractures and limb amputation: One trial (CANVAS) demonstrated an increased incidence of bone fractures and limb amputations among users of canagliflozin, but another trial (CREDENCE) did not demonstrate such an increased incidence of bone fractures or limb amputations. This increased risk has not been proven with empagliflozin. Summary: SGLT2 inhibitors have shown promise in heart failure treatment, particularly in patients with a reduced ejection fraction. Even though the specific mechanism of action through which they work on the cardiovascular system is currently unknown, they have been shown to reduce the risk of hospitalization for heart failure and cardiovascular death in several clinical trials. These medications lower blood glucose levels and have other beneficial effects on the cardiovascular system that make them good options for the management of heart failure.____________________Conclusion: Now we conclude episode number 138, “SGLT-2 inhibitors in heart failure.” Princess explained that SGLT-2 inhibitors have many benefits that go beyond their glucose-lowering properties. Recently, the use of SGLT-2 inhibitors has been extended to include heart failure with reduced ejection fraction and chronic kidney disease, even in patients without diabetes. Dr. Arreaza also explained that FDA has not approved the use of SGLT-2 inhibitors for the treatment of type 1 diabetes because of the reported increased risk of diabetic ketoacidosis or DKA. There is ongoing research about additional uses of SGLT-2 inhibitors, and we are looking forward to hearing more about these medications in the future.This week we thank Hector Arreaza and Princess Enuka. 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! _________________Links:Packer M, Anker SD, Butler J, et al. Cardiovascular and renal outcomes with empagliflozin in heart failure. N Engl J Med. 2020;383(15):1413-1424. https://pubmed.ncbi.nlm.nih.gov/32865377/Cosentino F, Grant PJ, Aboyans V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255-323. https://pubmed.ncbi.nlm.nih.gov/31497854/Heerspink HJL, Perkins BA, Fitchett DH, et al. Sodium glucose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovascular and kidney effects, potential mechanisms, and clinical applications. Circulation. 2016;134(10):752-772. https://pubmed.ncbi.nlm.nih.gov/27470878/Zelniker TA, Braunwald E. Mechanisms of cardiorenal effects of sodium-glucose cotransporter 2 inhibitors: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75(4):422-434. https://pubmed.ncbi.nlm.nih.gov/32000955/Nassif, M. E., et al. (2020). The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: A multicenter randomized trial. Nature Medicine, 27(11), 1954-1960. https://doi.org/10.1038/s41591-021-01536-xRoyalty-free music used for this episode: "Tempting Tango." Downloaded on October 13, 2022, from https://www.videvo.net/

To clam your Mainpro credit please use the link below: https://cfpclearn.ca/podcast/bs-medicine-episode-534-come-spy-with-me-continuous-glucose-monitoring-in-diabetes/  In episode 534, Mike and James bring Jamie Falk to go through all the evidence for continuous glucose monitors that use subcutaneous sensors. There certainly seems to be evidence of benefit for T1DM but when it comes to T2DM the evidence for a benefit is not clear at all. Have a listen to get all the details. Show Notes Tools for Practice Come Spy with Me: Continuous glucose monitoring in diabetes  

In episode 534, Mike and James bring Jamie Falk to go through all the evidence for continuous glucose monitors that use subcutaneous sensors. There certainly seems to be evidence of benefit for T1DM but when it comes to T2DM the evidence for a benefit is not clear at all. Have a listen to get all […]

This week on Pharm5: BCEMP starting in 2023 FDA hints at OTC naloxone Elahere for advanced ovarian cancer Pharmacogenomics reduces risk of ADRs Tzield delays T1DM symptom onset Connect with us! Listen to our podcast: Pharm5 Follow us on Twitter: @LizHearnPharmD References: Jean-Baptiste A. First Administration of the emergency medicine pharmacy certification examination announced for 2023. Board of Pharmacy Specialties. http://bit.ly/3EeGIQx. Published November 10, 2022. Accessed November 17, 2022. The Federal Register. Safety and Effectiveness of Certain Naloxone Hydrochloride Drug Products for Nonprescription Use; Request for Comments. http://bit.ly/3tGEQLu. Published November 16, 2022. Accessed November 17, 2022. Pharmacy Practice News. http://bit.ly/3EepDq5. Published November 16, 2022. Accessed November 16, 2022. Dunleavy K. Four decades in, immunogen gets landmark green light in Advanced ovarian cancer. Fierce Pharma. http://bit.ly/3Ao8Hw9. Published November 15, 2022. Accessed November 17, 2022. Immunogen announces FDA accelerated approval of ELAHERE™ (Mirvetuximab Soravtansine-gynx) for the treatment of platinum-resistant ovarian cancer. ImmunoGen, Inc. http://bit.ly/3gjvHp5. Accessed November 17, 2022. Robinson J. Adverse drug reactions reduced by nearly one third after genetic testing, major trial results to show. The Pharmaceutical Journal. http://bit.ly/3TQK1TQ. Published November 14, 2022. Accessed November 17, 2022. FDA approves first drug that can delay onset of type 1 diabetes. U.S. Food and Drug Administration. http://bit.ly/3gd9j0G. Published November 17, 2022. Accessed November 17, 2022.

For the first time on the podcast, we are talking all about Type One Diabetes in this exciting deep dive with holistic and Restorative Dietitian, Therese Martinez! Navigating type 1 diabetes at any age can pose different challenges, and Therese wants to make it feel as simple as possible. In this episode, we talk about the modern approaches to type 1 diabetes, such as: Misinformation upon type 1 diabetes diagnosis How to feel supported throughout diagnosis and beyond Breaking down what type 1 diabetes is, and how it operates in the body The immune system and immunity play a role in overall blood sugar levels Variability of blood sugars throughout cycles: life, menstrual, and even day-cycles Other variables that will likely impact your blood sugar levels (i.e., stress, exercise, gut health, inflammation, etc.) Overcoming the ‘good vs. bad' mindset of carbohydrates Take a listen to our newest epsiode! Enjoyed Therese's approach to type 1 diabetes and overall wellness? We do too! Learn more about Therese, her practice, and her resources on her website or on her Instagram. Prefer to watch instead of listen? We've got you covered. You can see our livesteamed chat on our YouTube channel. Want to learn more about our one-on-one nutrition coaching? Book a free chemistry call to discuss your story and see if we're a good fit. Think your metabolism could some healing or a reboot? That's our specialty. We have recently launched our Lean for Life Membership phase one and two called “Heal” and "Optimize" where you will be empowered to reverse previous metabolic damage with the assistance of our team of Registered Dietitian Nutritionists. Check out more details on our website! Enjoying the podcast? Please review the Empowered Nutrition Podcast on Apple Podcasts or wherever you listen! Then, send me a screenshot of your positive review to podcast@empowerednutrition.health as a DM on Instagram (empowerednutrition.health). Include a brief description of what you're working on with your health and/or nutrition and I'll send you a free custom meal plan! Do you have questions you would like answered on the Empowered Nutrition podcast? You can propose your questions/ideas here or reach out to me at podcast@empowerednutrition.health Thanks so much for listening, we hope you enjoy it!

Nick Heath, Ph.D., is the creator of The Breathing Diabetic. He was diagnosed with type 1 diabetes when he was 11. At age 30, Nick began practicing simple breathing exercises that helped improve his blood sugars, improve his sleep, and increase his energy levels, all of which helped him better manage his diabetes. With a background in scientific research, Nick wanted to understand how something as simple as breathing could be so beneficial for diabetes. This put him on a mission to understand the science behind breathing and health and wellness, which he shares through The Breathing Diabetic. Nick's formal education is in atmospheric science, but he is also a certified Oxygen Advantage instructor and lifelong learner. Nick lives on Florida's east coast with his wife and daughter and dog. In this episode we delve into Nicks diabetes journey and how he found sleep, breathing and maintaining a orderly lifestyle have significantly helped manage his T1DM.

In this episode of the Hot Topics Podcast, Neal Tucker considers if there is a crisis of identity in GP and how the ever-increasing workload has changed the traditional role of a GP. Is there a solution? Possibly, but not everyone will agree.In new research, we focus on new technology. Are implantable rhythm monitors helpful after stroke? Do wearable glucose monitors improve diabetes care? Is more data always better?References:BJGP Editorial from Euan LawsonBJGP Editorial from Clare GeradaBJGP Editorial on crisis of identity in GPNICE Diagnostic Guideline Implantable Arrythmia MonitorsJAMA Implantable arrythmia monitors after strokeJAMA continuous glucose monitoring in T2DMLancet continuous glucose monitoring in T1DM

毛頭的店解憂專賣 「糖尿病」你一定聽過，但小孩也會得糖尿病你聽說過嗎？ 糖尿病最常見分類為第一型(T1DM)、第二型，而兒童期的糖尿病多屬於第一型糖尿病， 臺灣約有一萬多名病人，是兒童及青少年重要的慢性疾病之一。 第一型糖尿病好發於兒童、青少年身上，病人的胰臟製造胰島素（Insulin） 的細胞因自體免疫或病毒等問題遭到破壞，造成胰島素缺乏，必須終生注射胰島素， 否則可能發生低血糖昏迷、高血糖酮酸中毒等急性併發症，一不小心就危及生命。 本集節目邀請暢銷書「幸福瘦」作者、新店耕莘醫院新陳代謝內分泌科主任馬文雅醫師， 帶著我們一起來認識第一型糖尿病及全國最優質的糖尿病童夏令營。 感謝您的支持。 祝福您 身心康泰 平安喜樂！ 開場曲歌名: Dutty 作者: Vibe Tracks 結尾曲歌名: About That Oldie 作者: Vibe Tracks 感謝免費授權

Part one of our two part special on diabetes focuses on the firsthand experience of a patient living with diabetes. We discuss what it is like to be diagnosed with Type 1 diabetes and to live with and manage the condition day-to-day. We hope that this episode will be useful for students, medical professionals, and anyone who wants to understand more about the challenges of managing this condition. Guest: Ashwin Bali

Dr. Adriana Carrillo-Iregui, pediatric endocrinologist within the Division of Pediatric Endocrinology at Nicklaus Children's Hospital discusses the TEDDY study (The Environmental Determinants of Diabetes in the Young), a national study to find out why type 1 diabetes mellitus (T1DM) is on the rise in children. Early data shows that genetic predisposition and environmental factors play a role in the cause of T1 diabetes. Dr. Carrillo-Iregui is a pediatric endocrinologist within the Division of Pediatric Endocrinology at Nicklaus Children’s Hospital. Dr. Carrillo-Iregui received her medical degree at the Universidad El Bosque in Bogota, Colombia and completed a pediatric residency at Nicklaus Children’s Hospital followed by a fellowship in pediatric endocrinology at the University of Miami, Jackson Memorial Hospital. She is board certified in pediatrics and pediatric endocrinology. Before joining Nicklaus Children's she was an Assistant Professor of Pediatrics in the Division of Pediatric Endocrinology at the University of Miami, Miller School of Medicine. Her research and clinical interest has focused on metabolic disorders related to obesity, polycystic ovarian syndrome and type 2 diabetes. She has published extensively and lectured nationally and internationally.

FDA 首次批准治疗Grave's眼病的新药JAMA 连续发表3篇文章讨论连续血糖监测在1型糖尿病患者中的意义Lancet子刊 胰岛素在中枢神经系统中能控制代谢和食物摄取替妥木单抗（teprotumumab）替妥木单抗（teprotumumab）是胰岛素样生长因子Ⅰ受体（IGF-ⅠR）的单克隆抗体，2019年11月，FDA批准替妥木单抗用于治疗活动性Grave's眼病，这是第一个获批治疗此病症的药物。《OPTIC研究：替妥木单抗治疗活动性Grave's眼病的3期临床研究》New England Journal of Medicine，2020年1月 (1)该研究旨在评估替妥木单抗对活动性Grave's眼病的安全性和有效性。这项随机、双盲、安慰剂对照、3期多中心试验中，共招募83名活动性Grave's眼病的患者，随机分为干预组（替妥木单抗 首剂为10mg/kg，之后为20 mg/kg，每3周一次）或安慰剂组，治疗共持续21周。24周后，干预组和安慰剂组中，眼球突出减少≥2mm的比例分别为38%和10%，总体缓解率分别为78%和7%；临床活动度评分0-1分的比例分别为59%和21%；复视症状缓解的比例分别为68%和29%。影像学检查的替妥木单抗组的6例患者中，观察到眼外肌缩小、或眼眶脂肪量减少。结论：21周的替妥木单抗治疗相比安慰剂，可以显著改善Grave's患者突眼症状、临床活动度评分、复视。1型糖尿病的连续血糖检测1型糖尿病患者中，血糖控制的目标是糖化血红蛋白

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot! 

Type 1 Diabetes - this episode is definitely a sweet one! Join us for a conversation with our guest Dr. Hussein Abdullatif (UAB), covering the diagnosis, workup, and management of Type 1 Diabetes Mellitus. We discuss the initial lab work-up, approach to treatment, atypical presentation, and how it’s okay to eat donuts around the time of an insulin shot!    NOTE: The show notes and CME for this episode will not be available until Wednesday September 2, 2020 at https://thecribsiders.com/ and cribsiders.vcuhealth.org respectively.   Credits Written and Produced by: Shannon Snellgrove Infographic: Shannon Snellgrove Cover Art: Christopher Chiu MD (Cribsiders); Shannon Snellgrove (Curbsiders) Hosts: Justin Berk MD and Christopher Chiu MD Editor:Justin Berk MD; Clair Morgan of nodderly.com Guest(s): Hussein Abdullatif MD   *Sponsors*   POCUS Fellowship at University of Pennsylvania A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates!  In 2016 we leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship.  Our graduating fellows have made us proud by accepting leadership positions, and if you want to be on the cutting edge, you should join our team.   Interview season is in full swing and we’re actively accepting applications.  Please go to pennultrasound.org or contact nathaniel.reisinger@pennmedicine.upenn for information.  You can apply for fellowship using the eusfellowships.com portal.     VCU Health CE The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. See info sheet for further directions. Note: A free VCU Health CloudCME account is required in order to seek credit.   Time Stamps Diagnosis of T1DM 6:50 Presentation of T1DM 10:10 Explaining T1DM to a parent 12:00 Genetic Predisposition to Diabetes 15:20 T1DM Antibodies 17:10 Initial work-up for concomitant autoimmune disease 21:10 Atypical Presentation of T1DM 22:44 Treatment of T1DM 29:10 Dietary Modifications in T1DM 33:10 Checking blood sugars 39:50 Honeymoon Period 42:25 Hypoglycemia 44:00 Sports, Sickness, Alcohol and Glucose levels 48:25 Periop glucose management 51:10 Long-term complications of T1DM 53:50 Closed Loop System and Future Treatments 56:10   Goal Listeners will feel confident in the presentation, diagnostic workup, and management of Type 1 Diabetes.   Learning objectives After listening to this episode listeners will…   Identify the signs and symptoms of type 1 diabetes  Practice appropriate work-up in the diagnosis of type 1 diabetes Manage type 1 diabetes with evidence-based therapies Identify the appropriate insulin analogues in daily diabetes management using basal/bolus concepts Educate patients and have meaningful discussions about effective self-management of type 1 diabetes (including diet and lifestyle changes)   Disclosures Dr Abdul-Latif reports no relevant financial disclosures. The Cribsiders report no relevant financial disclosures.    Citation Abdullatif H, Snellgrove S, Chiu C, Berk J. “Type 1 Diabetes”. The Cribsiders Pediatrics Podcast. https:/www.thecribsiders.com/ September 2, 2020 (link goes live on 9/2/2020)

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of type 1 diabetes (in most instances). It may also constitute the first presentation of T1DM in a patient.  In this episode, we discuss: The diagnosis of DKA How it presents How to explain this condition to parents  Management of DKA Potential complications to watch out for Links and resources: Follow us on Instagram: https://www.instagram.com/yourekiddingright.pod/  Follow us on Facebook: https://www.facebook.com/yourekiddingrightpod-107273607638323/ Make sure you hit SUBSCRIBE/FOLLOW so you don’t miss out on any pearls of wisdom and RATE if you can to help other people find us!

This episode covers type 1 diabetes in children.Written notes can be found at https://zerotofinals.com/paediatrics/endocrinology/type1diabetes/ or in the endocrinology section in the Zero to Finals paediatrics.The audio in the episode was expertly edited by Harry Watchman.

Editor's Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the June 16, 2020 issue

In this week's episode, I talk about about Type 1 Diabetes (T1DM). T1DM is where the pancreas isn't producing enough insulin to safely lower your blood glucose levels, causing your body to starve itself and have a dangerous level of glucose in the blood, causing many problems down the line if not managed properly. I talk to my good friend, Corey, and we talk about how he found out he was Type 1 diabetic at the age of 28 years old, how he gets glucose updates on his phone, and also what his favorite snack is for when he gets too low blood glucose levels. Websites Corey mentioned to learn more about Diabetes; www.tcoyd.org www.diabetes.org If you want to be a guest on the show, please send me an email with a short biography about yourself and what you have to; thepatientwillseeyounow@gmail.com (you can also email me letting me know how I can improve this podcast, and what you might want to hear more or less on the show as well!) Logo made by David Falcone, find him here; https://www.davidfalcone.com/

This week, Henry, Mark and John discuss: statins for primary prevention in the elderly (https://www.ncbi.nlm.nih.gov/pubmed/30712900); beer before wine or vice versa (https://www.ncbi.nlm.nih.gov/pubmed/30753321); and the impact on control on school performance in kids with T1DM (https://www.ncbi.nlm.nih.gov/pubmed/30721295). Plus a beer themed quiz.

Dr Jimmy is back in the Humerus Hacks studio again to sweeten up our day and teach us about diabetes! Join us on this delicious journey to learn about the difference of type 1 and type 2, and let your heart go giddy up as we love mnemonics lots!   

JAMA Pediatrics Editors’ Summary by Frederick Rivara, MD, MPH, Editor in Chief, and Dimitri Christakis, MD, MPH, Associate Editor, for the December 04, 2017 issue

Editor's Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the November 21, 2017 issue

Editor's Audio Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the September 25, 2013 issue

This episode is the first in a two part series on Type 1 diabetes. This episode addresses the pathophysiology of T1DM and also reviews acute complications. This podcast was written by Alkarim Velji and Dr. Rose Girgis. Alkarim is a medical student at the University of Alberta. Dr. Girgis is a Pediatric Endocrinologist and Divisional Director of Pediatric Endocrinology at the Stollery Children’s Hospital in Edmonton and an Associate Professor of Pediatrics at the University of Alberta. These podcasts are designed to give medical students an overview of key topics in pediatrics. The audio versions are accessible on iTunes. You can find more great pediatrics content at www.pedscases.com. Related Content: Podcast: Type 2 Diabetes

Background: Type 1 diabetes mellitus is a generally accepted atherogenic risk factor. The aim of this prospective longitudinal study was to evaluate changes in carotid intima media thickness (cIMT) in children and adolescents with type 1 diabetes mellitus (T1DM) using standardized methods. Methods: We re-evaluated cIMT in 70 (38 f) of initial 150 (80 f) patients with T1DM after 4 years. At re-evaluation, mean (+/- SD) age was 16.45 +/- 2.59 y, mean diabetes duration was 9.2 +/- 3.24 y and patients had a mean HbA1c of 8.14 +/- 1.06%. Results: Mean cIMT z-scores increased significantly during 4 years (0.58 +/- 0.75, p < 0.001) as well as BMI-z-score (0.41 +/- 0.81, p < 0.01), systolic blood pressure (0.77 +/- 1.15, p < 0.01) and HbA1c (0.90 +/- 1.07, < 0.001). In a linear regression model systolic blood pressure z-score at first measurement (0.02, CI: 0.01, 0.04) was a significant predictor for the mean effect on cIMT z-score. In a logistic regression model significant risk factors for an increase in IMT of >= 1.5 z-scores were BMI z-scores (OR: 3.02, CI: 1.11, 10.14), diabetes duration (OR: 1.32, CI: 1.04, 1.77) and systolic blood pressure (OR: 1.14, CI: 1.04, 1.27) at first measurement each. Conclusions: Longitudinal cIMT measurements revealed progression in subclinical atherosclerosis during a four year period in diabetic children and adolescents. Systolic blood pressure and BMI were related to cIMT increment. Control of these risk factors by lifestyle and medical intervention may prevent progression of cIMT in diabetic children.

Die Regulation der postprandialen Hyperglykämie hat eine große Bedeutung für die Glykämiekontrolle bei Patienten mit Diabetes mellitus. Früheren Untersuchungen entsprechend werden postprandiale Blutzuckerexkursionen wesentlich auch durch die Geschwindigkeit der Magenentleerung determiniert. Umgekehrt hemmt eine akute Hyperglykämie die Magenentleerung. Ziel dieser prospektiven, randomisierten, einfach-blinden cross-over Studie war die Bedeutung der Magenentleerung für die postprandialen Glukoseflüsse und die Wechselwirkung zwischen Magenentleerung und Hyperglykämie bei 14 gesunden Probanden und 15 altersentsprechenden Patienten mit Typ 1 Diabetes mellitus (T1DM). In einem ersten Ansatz wurde die Magenentleerung bei normoglykämischen Gesunden selektiv durch den Amylin-Agonisten Pramlintide gehemmt. In einem zweiten Teil wurde der Effekt einer akuten Hyperglykämie auf Magenentleerung und postprandiale Glukoseflüsse bei Amylin-defizienten Patienten mit T1DM untersucht und mit Gesunden verglichen. In einem dritten Teil wurde die Magenentleerung hyperglykämischer Patienten mit T1DM durch das Amylin-Analogon Pramlintide verzögert. Die Magenentleerung wurde mit zeitlich hochauflösender Szintigraphie gemessen, die Glukoseflüsse wurden unter Einsatz nicht-radioaktiver Tracer zur Markierung der oralen Glukose und des systemischen Glukosepools kalkuliert. Die durch Pramlintide induzierte Verzögerung der initialen Magenentleerung bei Gesunden führte zu einer Reduktion der Erscheinerate von Glukose im Plasma und einer deutlichen Reduktion sowohl der postprandialen Blutzuckerexkursionen als auch der Insulinplasmakonzentrationen. Die Reduktion der Gesamterscheinerate von Glukose war bei gleichzeitiger Steigerung der endogenen (hepatischen) Glukoseproduktion ausschließlich durch die reduzierte Erscheinerate exogener Mahlzeitglukose bedingt. Zudem wurde ein größerer Teil der oralen Glukose hepatisch sequestriert und auch peripher trotz niedrigerem Plasmainsulin suffizienter eliminiert. Bei den Patienten mit T1DM war die Magenentleerung unter Euglykämie (5 mM) im Vergleich zu Gesunden gering, aber signifikant beschleunigt. Die Magenentleerung ließ sich im Gegensatz zu Gesunden durch eine akute Hyperglykämie (10 mM) nicht hemmen. Entsprechend war die Erscheinerate der Mahlzeitglukose im Vergleich zu Gesunden höher, und die akute Hyperglykämie beeinflusste bei den Diabetikern weder die Erscheineraten der exogenen noch der endogenen Glukose. Bei Gesunden ist die Sekretion des in der ß-Zelle mit Insulin kolokalisierten Amylin eng an die Freisetzung von Insulin geknüpft. Amylin ist ein humoraler inhibitorischer Regulator der Magenentleeerung. Mechanismus ist wahrscheinlich eine reversible vagal-cholinerge Hemmung. Unter Hyperglykämie kam es bei den Gesunden parallel zu der Verzögerung der Magenentleerung zu einem starken Anstieg der Plasmaamylinkonzentration. Bei den Patienten mit T1DM war Amylin auch unter Hyperglykämie nicht nachweisbar. Die pharmakologische Wiederherstellung einer der unter akuter Hyperglykämie Gesunder vergleichbaren Verzögerung der Magenentleerung bei den Patienten mit T1DM durch das Amylin-Analogon Pramlintide führte bei identischer Insulinsubstitution zu einer deutlichen Reduktion der postprandialen Blutglukoseexkursionen und zu einer signifikant niedrigeren Erscheinerate exogener Mahlzeitglukose bei unveränderter postprandialer Suppression der hepatischen Glukoseproduktion. Eine Magenentleerungsverzögerung führt somit insulinunabhängig zu einer verbesserten Glukosetoleranz durch eine reduzierte Erscheinerate der Mahlzeitglukose, eine Steigerung der hepatischen Glukosesequestration und eine verbesserte periphere Glukoseelimination. Die unter akuter Hyperglykämie zu beobachtende Magenentleerungsverzögerung ist ein physiologischer Schutzmechanismus zur Wahrung der Glukosehomöostase. Diese Magenentleerungsverzögerung ist zumindest zum Teil durch Amylin vermittelt. Bei Amylin- defizienten Patienten mit T1DM existiert diese feedback- Hemmung auf die Magenentleerung nicht mehr. Wir vermuten, dass eine gestörte Magenentleerungsregulation bei T1DM mitverantwortlich ist für die gestörte postprandiale Blutzuckerregulation bzw. einen relativ hohen Bedarf an exogenem Insulin. Bei Patienten mit T1DM ohne Nachweis einer autonomen Neuropathie ist eine medikamentöse Therapie zur bedarfsgerechten postprandialen Verzögerung der Magenentleerung pathophysiologisch sinnvoll. Inwiefern dies auch für Patienten mit T2DM gilt, bleibt zu untersuchen.

Sowohl normale als auch deutlich verminderte Knochendichtewerte wurden bei Kindern und Jugendlichen mit Typ 1 Diabetes mellitus (T1DM) beschrieben. Die Faktoren, die die sog. diabetische Osteopenie beeinflussen, sind nicht bekannt. Um mögliche Auswirkungen der chronischen Stoffwechselerkrankung auf das muskuloskelettale System (MSS) aufzeigen zu können wurde bei 88 T1DM-Patienten im Alter zwischen 6-18 Jahren eine osteodensitometrische Messung mittels peripherer quantitativer Computertomographie durchgeführt. Bezüglich der Knochendichteparameter ließen sich keine Auffälligkeiten finden. Verminderte Werte ließen sich in den Parametern der Knochengeometrie aufzeigen. Neben der Gesamtknochenquerschnittsfläche und der Cortikalisfläche erweist sich außerdem die Muskelfläche als erniedrigt. Die Einheit zwischen Knochen und Muskel ist erhalten. Ein Einfluss der diabetesspezifischen Daten wie Insulindosis, Diabetesdauer und HbA1c auf das MSS kann nicht nachgewiesen werden. Als potentieller Risikofaktor für verminderte Knochengeometrie- und Muskelmassenparameter kann in diesem Kollektiv ein junges Erstmanifestationsalter herausgearbeitet werden. Longitudinale Daten der Knochenentwicklung bei T1DM-Patienten mit frühem und späterem Erstmanifestationsalter werden benötigt, um endgültige Rückschlüsse ziehen zu können.