Diabetes Knowledge into Practice Podcast: Recent Episodes

Diabetes Knowledge into Practice

A summary of new trial data, guideline recommendations and expert opinion across diabetes care, run by Diabetes Knowledge into Practice (https://diabetes.knowledgeintopractice.com), featuring interviews with leading experts from across the globe.

This podcast is intended for healthcare professionals only. Funding information is available in each episode's notes.

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Join Prof. Francesco Giorgino and Dr. Darren McGuire as they discuss personalisation of treatment for patients with both type 2 diabetes and cardiovascular disease.

For more free education, go to ⁠⁠⁠⁠⁠diabetes.knowledgeintopractice.com⁠⁠⁠⁠⁠⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (⁠⁠⁠⁠⁠@dkipractice⁠⁠⁠⁠⁠⁠) or connect on ⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠.

Faculty disclosures

Prof. Francesco Giorgino

Grants or contracts: Eli Lilly, Roche Diabetes Care

Consulting: Eli Lilly, Novo Nordisk

Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim

Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune

Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE

Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk

Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi

Dr. Darren K. McGuire

Clinical trial leadership:

  • Former: Esperion, AstraZeneca, CSL Behring

  • Current: Novo Nordisk, Lilly USA, Pfizer, Boehringer Ingelheim, NewAmsterdam

Consultancy:

  • Former: Merck & Co

  • Current: Lilly USA, Boehringer Ingelheim, Novo Nordisk, Bayer, Lexicon, Altimmune, Esperion, Intercept Pharmaceuticals, Applied Therapeutics

Funding Information: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.Accreditation information

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

ACHL requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

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Join Prof. Francesco Giorgino and Dr. Shehla Shaikh as they discuss strategies to help support type 2 diabetes patients during cultural events, such as observation of Ramadan.

For more free education, go to ⁠⁠⁠⁠diabetes.knowledgeintopractice.com⁠⁠⁠⁠⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (⁠⁠⁠⁠@dkipractice⁠⁠⁠⁠⁠) or connect on ⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠.Prof. Francesco Giorgino

Grants or contracts: Eli Lilly, Roche Diabetes Care

Consulting: Eli Lilly, Novo Nordisk

Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim

Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune

Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE

Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk

Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi

Dr. Shehla Shaikh

Dr. Shaikh declares no current financial conflict of interest

Funding Information: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.Accreditation information

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

ACHL requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

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Join Prof. Francesco Giorgino and Dr. Alice Cheng for a discussion on the importance of being culturally sensitive during shared decision-making in type 2 diabetes care.

For more free education, go to ⁠⁠diabetes.knowledgeintopractice.com⁠⁠⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (⁠⁠@dkipractice⁠⁠⁠) or connect on ⁠⁠LinkedIn⁠⁠⁠.

Faculty disclosures

Prof. Francesco Giorgino

Grants or contracts: Eli Lilly, Roche Diabetes Care

Consulting: Eli Lilly, Novo Nordisk

Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim

Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune

Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE

Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk

Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi

Dr. Alice Cheng

Advisory Board: Abbott, AstraZeneca, Bayer

Speakers Bureau: Abbott, Amgen, AstraZeneca, Bausch, Bayer

Funding Information:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.

Accreditation information

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

ACHL requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

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Join Prof. Francesco Giorgino and Dr. Erika Bezerra Parente as they identify some takeaways from EASD 2023, including data and discussions on treatment non-adherence, SGLT2 inhibitors, and stigma

For more free education, go to ⁠diabetes.knowledgeintopractice.com⁠⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (⁠@dkipractice⁠⁠) or connect on ⁠LinkedIn⁠⁠.

Faculty disclosures

Prof. Francesco Giorgino

Grants or contracts: Eli Lilly, Roche Diabetes Care

Consulting: Eli Lilly, Novo Nordisk

Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim

Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune

Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE

Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk

Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi

Dr. Erika Bezerra Parente

Honoraria for lectures, presentations and education events: Sanofi

Funding Information:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.

Accreditation information

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

ACHL requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

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In this epsisode Prof. Francisco Giorgino & Dr. Vanita Aroda explore how vital it is that we aim to control more than blood glucose levels when treating type 2 diabetes patients and whether we should strive for a balance by achieving weight, cardiovascular and renal targets as well.

For more free education, go to diabetes.knowledgeintopractice.com⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice⁠) or connect on LinkedIn⁠.

Disclosures

Prof. Francisco Giorgino:

Grants or contracts: Eli Lilly, Roche Diabetes Care

Consulting: Eli Lilly, Novo Nordisk

Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim

Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune

Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE

Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk

Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi

Dr. Vanita Aroda:

Consulting: Applied Therapeutics, Fractyl, Pfizer, Novo Nordisk, Sanofi

Research Support: Applied Therapeutics, Eli Lilly, Fractyl, Novo Nordisk, Sanofi

Target Audience:

Specialty: Primary care physicians (PCPs), endocrinologists, cardiologists, diabetologists

Geographic: Global (ex US and UK audiences)

Funding Information:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.

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Join Prof. Francisco Giorgino & Dr. Richard E. Pratley as they discuss their highlights from the 83rd American Diabetes Association (ADA 2023) congress. The congress featured over 200 scientific sessions and symposia, and 1,400 posters. Among the topics discussed are trials investigating therapies to treat obesity in patients with type 2 diabetes (T2D), as well as discussion about remission and what it really means for T2D.

For more free education, go to ⁠diabetes.knowledgeintopractice.com⁠, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (⁠@dkipractice⁠) or connect on ⁠LinkedIn⁠.Disclosures

Prof. Francisco Giorgino:

Grants or contracts: Eli Lilly, Roche Diabetes Care

Consulting: Eli Lilly, Novo Nordisk

Honoraria for lectures, presentations and education events: Astra-Zeneca, Boehringer-Ingelheim

Advisory boards: Eli Lilly, Lifescan, Merck Sharp & Dohme, Medimmune

Leadership or fiduciary role in other board: EASD/EFSD, (SIE), Fo.Ri SIE

Receipt of equipment, materials, drugs, medical writing, gifts or other services: AstraZeneca, Eli Lilly, Novo Nordisk

Unlabelled use of drugs or devices: Roche Diabetes Care, Sanofi

Dr. Richard E. Pratley

Research grant: Dompe, Novo Nordisk

Honoraria for lectures, presentations and education events: Merck, Novo Nordisk

Consulting: Bayer AG, Endogenex Inc., Gasherbrum Bio Inc., Henguri (USA) Ltd. Intas Pharmaceuticals Inc. Eli Lilly, Merck, Novo Nordisk, Pfizer, Rivus Pharmaceuticals Inc., Sun Pharmaceutical Industries

Target Audience:

Specialty: Primary care physicians (PCPs), endocrinologists, cardiologists, diabetologists

Geographic: Global (ex US and UK audiences)

Funding Information:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, has had no influence on the content of this education.

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Description:

This year’s EASD was a hybrid event, with delegates able to join either in person in Stockholm, or online via the virtual platform. As usual, the congress featured a huge number of presented abstracts, symposia and other sessions. This year also saw the publication of the updated ADA-EASD consensus report on the management of hyperglycaemia in type 2 diabetes.

Join us as we speak to Professor Apostolos Tsapas about his conference highlights, including:

  • 2022 ADA-EASD consensus report on the management of hyperglycaemia in type 2 diabetes

  • 44-year follow-up results from the UKPDS trial

  • Results from the DELIVER trial of dapagliflozin in heart failure

  • New data on once-weekly insulins

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com.

Learning objectives available here

References available here

Disclosures:

Prof. Apostolos Tsapas declares the following financial relationships from the past 24 months:

Consultant: Novo Nordisk

Educational grant support: Eli Lilly

Investigator: Boehringer Ingelheim

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships within 24 months (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any ineligible companies. All relevant financial relationships have been mitigated prior to this activity.

The content for this activity was developed independently of the ineligible companies. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors.

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Funding:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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The SURPASS program of phase 3 clinical trials led to the 2022 FDA approval and positive CHMP opinion of the first GIP/GLP-1 receptor agonist, tirzepatide. Join Prof Carol Wysham for an examination of the clinical data from these trials and their potential impact on type 2 diabetes management.

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

Learning objective

After listening to this podcast series, learners will be able torecall the results of recent clinical trials for GIP/GLP-1 dual agonists

References available here

Disclosures

Prof. Carol Wysham declares the following financial relationships from the past 24 months:

Research Funding: Novo Nordisk; Eli Lilly

Liberum IME staff, ACHL staff, and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

The content for this series was developed independently of the ineligible companies. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors.

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Funding:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

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Heterogeneity across available glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for type 2 diabetes means that agents should be prescribed based on patient characteristics and preferences. So how can we best make that decision?

Join Dr Harpreet Bajaj for a discussion of tailoring GLP-1 RA regimens to patient characteristics, including considerations for dosing and treatment intensification.

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment.

References available here

Dr Harpreet Bajaj declares the following financial relationships from the past 24 months:

Grants/Research Support: Eli Lilly, Novo Nordisk, Sanofi

Liberum IME staff, ACHL staff, and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

The content for this series was developed independently of the ineligible companies. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantors.

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education. Recommendations involving clinical medicine in continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications and/or devices that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires its speakers to disclose that a product is not labeled for the use under discussion.

Target Audience

This educational activity is intended for an international audience of non-US and non-UK HCPs.

Funding:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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The last two years have provided updated guidelines on management of chronic kidney disease in type 2 diabetes alongside new regulatory approvals of pharmacotherapies. In this episode we speak to Dr David Cherney about the implications of these updates and advancements.

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References available here

Disclosures:

Dr David Cherney declares the following financial relationships from the past 24 months:

Honoraria: Boehringer Ingelheim-Lilly, Merck, AstraZeneca, Sanofi, Mitsubishi-Tanabe, Abbvie, Janssen, Bayer, Prometic, BMS, Maze, Gilead, CSL-Behring, Otsuka, Novartis, Youngene and Novo-Nordisk

Grant/Research support: Boehringer Ingelheim-Lilly, Merck, Janssen, Sanofi, AstraZeneca, CSL-Behring, and Novo-Nordisk.

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

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The past year has included the release of new guidelines on cardiovascular disease prevention and further data on cardioprotective agents in type 2 diabetes. In this episode we speak to Prof. Naveed Sattar about these guidelines and how best to help people with type 2 diabetes to reduce their cardiovascular risk.

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References available here

Disclosures:

Prof. Naveed Sattar declares the following financial relationships from the past 24 months:

Advisory - Afimmune, Amgen, Eli Lilly, Hanmi Pharmaceuticals, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Sanofi

Consulting - Abbott Laboratories, Afimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Sanofi

Speaker honoraria - Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Sanofi

Grant funding - AstraZeneca, Boehringer Ingelheim, Novartis, Roche Diagnostics

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use: Efpeglenatide for type 2 diabetes

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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This year saw the regulatory approval of the first dual GIP/GLP-1 dual agonist for type 2 diabetes. With several other multi-agonists in development, what does this mean for clinicians caring for people with type 2 diabetes?

Join Prof. Filip Knop for an overview of these new and emerging agents.

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References available here

Disclosures:

Prof. Filip Knop declares the following financial relationships from the past 24 months:

Honorarium recipient: AstraZeneca, Eli Lilly, Novo Nordisk, Sanofi

Speakers Bureau: AstraZeneca, Eli Lilly, Novo Nordisk, Sanofi

Consultant (Occasional): AstraZeneca, Eli Lilly, Novo Nordisk, Sanofi

Advisor or Review Panel member: Eli Lilly, Novo Nordisk, Sanofi

Discussion of Off-Label, Investigational, or Experimental Drug Use: None

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

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The importance of weight loss in type 2 diabetes was a major topic at the recent American Diabetes Association (ADA) 2022 Scientific Sessions. As weight management is a complex issue affected by both genetic and environmental factors, we shed light on the latest advances in obesity care for individuals with type 2 diabetes.

Join us as we examine the effect of lifestyle interventions, metabolic surgery and the latest pharmaceutical agents, and discuss the state of the field with Dr Robert Kushner.

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References available here

Dr Robert Kushner declares the following financial relationships from the past 24 months:

Consultant: Lilly, Pfizer

Board member: Novo Nordisk, WW

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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The ADA 2022 was full of interesting symposia, updates on ongoing clinical trials, and a draft of an updated ADA-EASD consensus report. This year’s conference also put particular emphasis on weight [EP1] management in the setting of type 2 diabetes as well as its associated cardiovascular and kidney comorbidities.

Join us as we speak to Professor Jennifer Green about her conference highlights, including:

  • Draft ADA-EASD Consensus Report

  • Results from the SURMOUNT-1 clinical trial of tirzepatide in people with obesity

  • Further data for dual and triple incretin agonists and their potential future role

By completing this activity, you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References available here

Disclosures:

Prof. Jennifer Green declares the following financial relationships from the past 24 months:

Consultant: AstraZeneca, Bayer, Boehringer Ingelheim/Lilly, Hawthorne Effect/Omada (ended), Pfizer, NovoNordisk, Sanofi/Lexicon, ICON/Vertex, and Anji.

Research support: Boehringer Ingelheim/Lilly, Merck, and Roche.

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

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NASH has historically had very few treatment options, with none currently indicated specifically for NASH. But a large number of ongoing clinical trials means that treatment may look different in the future.

Join Professor Philip Newsome for an overview of current treatments in NASH, as well as how treatment may change in the future.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References:

References are available here

Disclosures:

Prof. Philip Newsome declares the following:

Consultant on behalf of the University of Birmingham: Boehringer Ingelheim, Novo Nordisk, Intercept, BMS, Gilead, Poxel Pharmaceuticals

Grants/Research Support recipient: Novo Nordisk, Boehringer Ingelheim

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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GLP-1 receptor agonists including semaglutide have been shown to offer benefits for glycemic control, weight loss and cardiovascular protection in type 2 diabetes. But where a patient requires more glycemic control, would a higher dose be of help?

The SUSTAIN FORTE trial was a randomized, double-blind, phase 3B trial that aimed to establish whether a higher dose of semaglutide was superior to the highest approved maintenance dose for glycemic control. Join Dr Juan Pablo Frias for a summary of the trial data and its potential implications for clinical practice.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

Reference:

Frías JP, et al. Efficacy and safety of once-weekly semaglutide 2·0 mg versus 1·0 mg in patients with type 2 diabetes (SUSTAIN FORTE): a double-blind, randomised, phase 3B trial. Lancet Diabetes Endocrinol. 2021;9(9):563-574.

Disclosures:

Dr Juan Pablo Frías declares the following:

Grants/Research Support, Advisory Boards, Honoraria receipt - Novo Nordisk, Eli Lilly, Sanofi, Pfizer

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

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In late 2020, we published an episode looking at the management of diabetes and heart failure when both present together. Since then, a wealth of evidence has been published on the effects of sodium glucose cotransporter type 2 (SGLT2) inhibitors in people with heart failure with or without type 2 diabetes. These findings have led to expanded indications for some of these agents to include heart failure. Today we will examine these data and their relevance in clinical practice in the setting of type 2 diabetes with heart failure.

Joining us to discuss what these data mean for clinical practice is Prof. Javed Butler, who is Professor and Chairman of the Department of Medicine at the University of Mississippi Medical Centre in Jackson, Mississippi.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

Disclosures:

Prof. Javed Butler declares the following:

Consultant: Abbott, Adrenomed, Amgen, Applied Therapeutics, Array, Astra Zeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, CVRx, G3 Pharma, Impulse Dynamics, Innolife, Janssen, LivaNova, Luitpold, Medtronic, Merck, Novartis, NovoNordisk, Relypsa, Roche, Sequana Medical, and Vifor

Speakers Bureaus: Novartis, Boehringer Ingelheim-Lilly, Astra Zeneca, Janssen

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

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The 2022 Standards of Medical Care in Diabetes is published every year by the American Diabetes Association to reflect the latest available clinical evidence. The most significant updates this year include a lower age to begin screening for prediabetes and diabetes, an increased emphasis on individualization of treatment, and further recommendations around the use of technologies such as continuous glucose monitoring and treatment of obesity.

To hear more about some of these updates and their rationale, we’re joined by Professor Anne Peters, a member of the ADA’s Professional Practice Committee which reviews and updates the Standards.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

Reference:

American Diabetes Association. Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Suppl 1):S1-S264.

Disclosures:

Prof. Anne Peters disclosures are as follows:

Participation on an advisory board - Abbott Diabetes Care, Astra Zeneca, Eli Lilly, Medscape, Novo Nordisk, ShouTi Inc, Vertex, Zealand

Research support - Abbott Diabetes Care, Dexcom, Insulet

Stock - Teladoc

Stock options - Omada Health

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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NASH occurs in around 20% of individuals with NAFLD, and puts patients at high risk of poor outcomes including cardiovascular events and hepatocellular carcinoma. With people with type 2 diabetes and obesity at significantly increased risk for developing NAFLD, how can we identify those with NASH?

In this podcast episode, we are joined by Dr Kenneth Cusi to discuss how patients can be risk stratified using non-invasive biomarkers and imaging techniques.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References:

Nones RB et al. Can FIB4 and NAFLD fibrosis scores help endocrinologists refer patients with non-alcoholic fat liver disease to a hepatologist? Arch Endocrinol Metab. 2017 May-Jun;61(3):276-281.

Shah AG et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009 Oct;7(10):1104-12.

Newsome PN et al. FibroScan-AST (FAST) score for the non-invasive identification of patients with non-alcoholic steatohepatitis with significant activity and fibrosis: a prospective derivation and global validation study. Lancet Gastroenterol Hepatol. 2020 Apr;5(4):362-373.

European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. Obes Facts 2016;9(2):65-90.

Disclosures:

Dr Kenneth Cusi disclosures are as follows:

Research Support - Poxel, Zydus, Echosens, Inventiva, Novo Nordisk

Consultant - Allergan, Altimmune, Arrowhead, AstraZeneca, BMS, Boehringer Ingelheim, Coherus, Eli Lilly, Genentech, Gilead, Intercept, Janssen, Pfizer, Prosciento, Madrigal, and Novo Nordisk.

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Description:

A year ago, we published an episode looking at diabetes management in the context of ongoing restrictions in many parts of the world. Since then, a wealth of clinical data has continued to be published on the bidirectional relationship between diabetes and Covid-19, so today we’re taking a closer look at these data.

We’re joined by Professor Partha Kar, National Specialty Advisor, Diabetes for NHS England, to discuss what the data mean for clinical practice.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at https://diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References:

  • Kamrath C, et al. Incidence of Type 1 Diabetes in Children and Adolescents During the COVID-19 Pandemic in Germany: Results From the DPV Registry. Diabetes Care. 2022 Jan 17:dc210969.
  • Gottesman BL, et al. Incidence of New-Onset Type 1 Diabetes Among US Children During the COVID-19 Global Pandemic. JAMA Pediatr. 2022 Apr 1;176(4):414-415.
  • McGlacken-Byrne SM, et al. The SARS-CoV-2 pandemic is associated with increased severity of presentation of childhood onset type 1 diabetes mellitus: A multi-centre study of the first COVID-19 wave. Diabet Med. Sep 2021;38(9):e14640.
  • Barrett CE, et al. Risk for Newly Diagnosed Diabetes >30 Days After SARS-CoV-2 Infection Among Persons Aged <18 Years - United States, March 1, 2020-June 28, 2021. MMWR Morb Mortal Wkly Rep. Jan 14 2022;71(2):59-65.
  • Xie Y, Al-Aly Z. Risks and burdens of incident diabetes in long COVID: a cohort study. Lancet Diabetes Endocrinol. 2022 Mar 21:S2213-8587(22)00044-4.
  • Rathmann W, et al. Incidence of newly diagnosed diabetes after Covid-19. Diabetologia. 2022 Mar 16:1-6.
  • Misra S, et al. Temporal trends in emergency admissions for diabetic ketoacidosis in people with diabetes in England before and during the COVID-19 pandemic: a population-based study. Lancet Diabetes Endocrinol. 2021 Oct;9(10):671-680.
  • Khunti K, et al. COVID-19, Hyperglycemia, and New-Onset Diabetes. Diabetes Care. 2021 Dec;44(12):2645-2655.
  • Apicella M, et al. COVID-19 in people with diabetes: understanding the reasons for worse outcomes. Lancet Diabetes Endocrinol. 2020 Sep;8(9):782-792.
  • Khunti K, et al. Prescription of glucose-lowering therapies and risk of COVID-19 mortality in people with type 2 diabetes: a nationwide observational study in England. Lancet Diabetes Endocrinol. 2021 May;9(5):293-303.

Disclosures:

Prof. Partha Kar has no relevant disclosures to report at this time.

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding:

This independent educational activity is supported by an educational grant from Eli Lilly. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Eli Lilly has had no influence on the content of this education.

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This is a special episode brought to you in association with Hepatology Knowledge into Practice.

People with type 2 diabetes or obesity are at higher risk of developing non-alcoholic fatty liver disease (NAFLD) including non-alcoholic steatohepatitis (NASH). Some estimates report a prevalence of NAFLD of 60% in people with type 2 diabetes, rising to 78% in those who also have obesity. So what’s behind this link?

In this podcast episode, Professor Giulio Marchesini explores the relationships between NAFLD, type 2 diabetes and obesity and offers advice for healthcare professionals caring for people with one or more of these conditions.

By completing this activity you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References:

  • Dai W, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: A meta-analysis. Medicine (Baltimore). 2017 Sep;96(39):e8179.
  • Padda J, et al. Non-Alcoholic Fatty Liver Disease and Its Association With Diabetes Mellitus. Cureus. 2021 Aug 20;13(8):e17321.
  • Mantovani A, et al. Nonalcoholic Fatty Liver Disease and Risk of Incident Type 2 Diabetes: A Meta-analysis. Diabetes Care. 2018 Feb; 41(2):372-382.
  • Targher G, et al. Diabetologia. 2008 Mar; 51(3):444-50.
  • Godoy-Matos AF, et al. NAFLD as a continuum: from obesity to metabolic syndrome and diabetes. Diabetol Metab Syndr. 2020 Jul 14;12:60.
  • Eslam M, Sanyal AJ, George J; International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020 May;158(7):1999-2014.e1.
  • Kim D, et al. Body Fat Distribution and Risk of Incident and Regressed Nonalcoholic Fatty Liver Disease. Clin Gastroenterol Hepatol. 2016 Jan;14(1):132-8.e4.

Disclosures: Prof. Giulio Marchesini declares the following:

Advisory Board: Novartis, Eli Lilly, Gilead, MSD, Pfzier, Astra-Zeneca

Liberum IME staff, ACHL staff and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.

The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

Funding: This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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This is a special episode brought to you in association with Hepatology Knowledge into Practice. Non-alcoholic fatty liver disease (NAFLD) is a spectrum of liver disease, of which an advanced form is non-alcoholic steatohepatitis (NASH). But how does this condition develop, and why is it associated with poor outcomes? In this podcast episode, Professor Zobair Younossi discusses the latest evidence on the pathogenesis and pathophysiology of NASH, and how it can lead to poor outcomes.

By completing this module you can qualify for 0.25 CME credits. To claim your credits, you must listen to the podcast and successfully pass the post-module assessment at diabetes.knowledgeintopractice.com, where you can find all past episodes of the podcast as well as other free CME resources.

References:

Eslam M, Sanyal AJ, George J; International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020 May;158(7):1999-2014.e1.

Marjot T, Moolla A, Cobbold JF, Hodson L, Tomlinson JW. Nonalcoholic Fatty Liver Disease in Adults: Current Concepts in Etiology, Outcomes, and Management. Endocr Rev. 2020 Jan 1;41(1):bnz009.

Wild SH, Walker JJ, Morling JR, McAllister DA, Colhoun HM, Farran B, McGurnaghan S, McCrimmon R, Read SH, Sattar N, Byrne CD; Scottish Diabetes Research Network Epidemiology Group. Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission. Diabetes Care. 2018 Feb;41(2):341-347. Disclosures: Prof. Zobair Younossi declares XYZ. All conflicts of interest have been mitigated prior to this activity.

Disclosures:

Professor Zobair Younossi declares the following:

Consultant: Merck, Gilead, Siemens, Intercept, Bristol Myers Squibb

Funding:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Despite the ongoing challenges of the COVID-19 pandemic, 2021 brought us many more significant developments in type 2 diabetes research. In our final episode of the year, join Dr Kevin Fernando to hear his highlights from 2021 and thoughts about the year ahead. Dr Fernando is a GP partner with a special interest in diabetes, and is Scottish Lead for the UK Primary Care Diabetes Society.

For more free CME, go to diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

Butler J, et al. Empagliflozin, Health Status, and Quality of Life in Patients with Heart Failure and Preserved Ejection Fraction: The EMPEROR-Preserved Trial. Circulation. 2021 Nov 15. doi: 10.1161/CIRCULATIONAHA.121.057812. Epub ahead of print.

Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021 Mar 18;384(11):989. doi: 10.1056/NEJMoa2032183. Epub 2021 Feb 10.

Taylor R, et al. Intra-organ fat content during weight loss-induced remission of type 2 diabetes in people with normal or raised BMI. Abstract 110 presented at the 57th Annual Meeting of the European Association for the Study of Diabetes, 27 September – 1 October 2021, virtual. Diabetologia. 2021 Sep 64:1–380.

Disclosures:

Dr Kevin Fernando has no relevant disclosures to report at this time.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Today we’re joined by Professor Naveed Sattar for a summary of some of the key takeaways from the International Diabetes Federation Virtual Congress 2021. Professor Sattar is Professor of Metabolic Medicine at the University of Glasgow, and was Committee Lead for the Cardiovascular Disease & Hypertension stream at the congress.

For more free education, go to diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Professor Naveed Sattar declares the following: 

Advisory board: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Sanofi

Speaker honoraria: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Sanofi

Institutional research grant: Boehringer Ingelheim

All conflicts have been mitigated prior to this activity.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Novel insulin-based therapies that are currently in development center around convenience and patient adherence, in addition to safety and efficacy. With once-weekly insulins and glucose-sensitive insulins under clinical study, there is hope for expanded treatment options for people with type 2 diabetes who need insulin, many of which take into account patient lifestyles and personal preferences. Join Prof. Simon Heller for a discussion of potential future uses of these technologies.

Visit our website diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Prof. Simon Heller declares the following:

Advisory Board: NovoNordisk, Sanofi Aventis, Eli Lilly, Zealand Pharma

Speakers Bureau: NovoNordisk, Astra Zeneca

Consultancy: Zealand Pharma

All conflicts have been mitigated prior to this activity.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

References:

Home PD, Mehta R. Insulin therapy development beyond 100 years. Lancet Diabetes Endocrinol. 2021;9(10):695-707.

Frias JP, Chien J, Zhang Q, et al. Once Weekly Basal Insulin Fc (BIF) is Safe and Efficacious in Patients with Type 2 Diabetes Mellitus (T2DM) Previously Treated With Basal Insulin. J Endocr Soc. 2021;5(s1):A448-A449.

Rosenstock J, Bajaj HS, Janež A, Silver R, Begtrup K, Hansen MV, Jia T, Goldenberg R; NN1436-4383 Investigators. Once-Weekly Insulin for Type 2 Diabetes without Previous Insulin Treatment. N Engl J Med. 2020 Nov 26;383(22):2107-2116. doi: 10.1056/NEJMoa2022474. Epub 2020 Sep 22.

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Listen to a 5-minute summary of a study investigating the effects of variation in sleep duration and quality on postprandial blood sugar responses after breakfast the following morning, published in Diabetologia. A quick overview of the key findings is presented.

Publication: Tsereteli N, Vallat R, Fernandez-Tajes J, et al. Impact of insufficient sleep on dysregulated blood glucose control under standardised meal conditions. Diabetologia. 2021 Nov 30. doi: 10.1007/s00125-021-05608-y Epub ahead of print.

Additional references:

Zee PC, Turek FW (2006) Sleep and health: everywhere and in both directions. Arch Intern Med. 166(16):1686–1688.

Lee SWH, Ng KY, Chin WK (2017) The impact of sleep amount and sleep quality on glycemic control in type 2 diabetes: a systematic review and meta-analysis. Sleep Med Rev 31:91–101.

Kim D, Hoyos CM, Mokhlesi B, Pamidi S and Jun JC (2020) Editorial: Metabolic Health in Normal and Abnormal Sleep. Front. Endocrinol. 11:131. doi: 10.3389/fendo.2020.00131

Kothari V, Cardona Z, Chirakalwasan N, Anothaisintawee T, Reutrakul S (2021) Sleep interventions and glucose metabolism: systematic review and meta-analysis. Sleep Med 78:24–35.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Listen to a 5-minute summary of a study investigating how mortality for type 1 and type 2 diabetes varies in an incident population in England and Wales, analysed by sex and age of diagnosis, published in the Lancet Diabetes and Endocrinology. A quick overview of the key findings is presented.

Publication: Holman N, Wild SH, Gregg EW, Valabhji J, Sattar N, Khunti K; National Diabetes Audit Research Group. Comparison of mortality in people with type 1 and type 2 diabetes by age of diagnosis: an incident population-based study in England and Wales. Lancet Diabetes Endocrinol. 2021 Nov 22:S2213-8587(21)00293-X. doi: 10.1016/S2213-8587(21)00293-X. Epub ahead of print.

Additional references:

Chan JCN, Lim LL, Wareham NJ, et al. The Lancet Commission on diabetes: using data to transform diabetes care and patient lives. Lancet2020; 396: 2019–82.

Constantino MI, Molyneaux L, Limacher-Gisler F, et al. Long-term complications and mortality in young-onset diabetes: type 2 diabetes is more hazardous and lethal than type 1 diabetes. Diabetes Care. 2013; 36: 3863–69.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Listen to a 5-minute summary of a linear regression modelling analysis investigating the linkage between sub-clinical cognitive impairment and diabetic peripheral neuropathy in adults with type 2 diabetes for < 10 years, published in the Journal of Diabetes and its Complications. A quick overview of the key findings is presented.

Publication: Barzilay JI, Ghosh A, Busui RP, et al. The cross-sectional association of cognition with diabetic peripheral and autonomic neuropathy-The GRADE study. J Diabetes Complications. 2021;35(12):108047.

Additional references:

Hicks CW, Selvin E. Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Curr Diab Rep;19(10):86.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Which diet is best for weight management in type 2 diabetes? And which diet might give the best chances of remission? Hear a 5-minute summary of an umbrella review of meta-analyses looking at dietary approaches to weight management in type 2 diabetes, and a systematic review of trials of diets targeting remission.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Publication: Churuangsuk C, et al. Diets for weight management in adults with type 2 diabetes: an umbrella review of published meta-analyses and systematic review of trials of diets for diabetes remission. Diabetologia. 2021 Nov 17.

Additional references:

American Diabetes Association. Diabetes Care. 2021;44(Supplement 1)

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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While sometimes thought of as an issue only in type 1 diabetes, hypoglycemia is a concern for anyone taking insulin, and, to a lesser extent, other antihyperglycemic agents. This episode we’re joined by Brian Frier, Honorary Professor of Diabetes at the University of Edinburgh, who has published extensively in this field, to hear his advice on mitigating risk and why this is important for long-term outcomes.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn. 

Disclosures:

Prof. Brian Frier declares the following:

Speakers Bureau: Eli Lilly, Novo Nordisk, Abbott

Advisory Board member: Zucara Therapeutics

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Hear a 5-minute summary of a post hoc analysis of the LEADER trial investigating whether frequency of non-severe hypoglycemic episodes is associated with severe hypoglycemia, major adverse cardiovascular events, cardiovascular death, and all-cause mortality. Listen for a quick overview of the key findings.

Publication: Heller SR, Geybels MS, Iqbal A, et al. A higher non-severe hypoglycaemia rate is associated with an increased risk of subsequent severe hypoglycaemia and major adverse cardiovascular events in individuals with type 2 diabetes in the LEADER study. Diabetologia (2021) https://doi.org/10.1007/s00125-021-05556-7

Additional references: Heller S, Lingway I, Marso SP, et al. Risk of severe hypoglycaemia and its impact in type 2 diabetes in DEVOTE. Diabetes, Obes Metab. 2020;22(12):2241-2247.

Zinman B, Marso SP, Christiansen E, et al. Hypoglycaemia, cardiovascular outcomes, and death: the LEADER experience. Diabetes Care. 2018;41(8):1783-1791.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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This week we’re joined by Prof. Tina Vilsbøll to discuss how different second-line agents for type 2 diabetes compare, and what we should consider when selecting between them. Listen for a summary of what the data tells us about GLP-1 RAs, SGLT2is and DPP-4is.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Prof. Tina Vilsbøll declares the following:  

Consultant, ad. board: Astra, Novo, BMS, Merck, Lilly, Sanofi; Gilead, Sunpharma, Boehringer, Mundipharma

All conflicts of interest have been mitigated prior to this activity.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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A 5-minute summary of a randomized controlled trial comparing the effects of a short-acting vs. long-acting GLP-1 receptor agonist on food intake, appetite and exocrine pancreas function, published in Diabetes, Obesity & Metabolism. Listen for a quick overview of the key findings.

Publication: Quast DR, et al. Macronutrient intake, appetite, food preferences and exocrine pancreas function after treatment with short- and long-acting glucagon-like peptide-1 receptor agonists in type 2 diabetes. Diabetes Obes Metab. 2021 Oct;23(10):2344-2353.

Additional references:

Meier JJ. GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2012 Dec;8(12):728-42.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn. 

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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2019 saw a dramatic change to ESC guidelines for type 2 diabetes, with SGLT2 inhibitor or GLP-1 agonist monotherapy recommended at first line in most patients. The announcement launched a debate in the diabetes community about the data behind this decision. Prof. David Matthews joins us this week to discuss what has changed since the guideline publication, and whether we are any closer to a consensus on these points.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

Cosentino F et al. Eur Heart J. 2020 Jan 7;41(2):255-323

American Diabetes Association. Diabetes Care. 2021;44(Supplement 1)

Marx N, et al. Guideline recommendations and the positioning of newer drugs in type 2 diabetes care. Lancet Diabetes Endocrinol. 2021 Jan;9(1):46-52

Disclosures:

Prof. David Matthews declares the following:

Steering committee FOCUS. Advisory Board Semaglutide - Novo Nordisk

Chair of steering committee, VERIFY trial - Novartis

Co-chair of CANVAS and CANVAS-R trials - Janssen

Servier support our Tseu fellows programme in Oxford - Servier

All conflicts of interest have been mitigated prior to this activity.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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This week we bring you our first podcast debate! Today’s motion is 'A GLP-1 receptor agonist + basal insulin supersedes the need for basal-bolus regimens in type 2 diabetes' and will be debated by two esteemed experts:

For - Prof. Anne Peters, Professor of Clinical Medicine, Keck School of Medicine, University of Southern California, USA.

Against - Prof. Richard Holt, Professor in Diabetes and Endocrinology, University of Southampton, UK

Since 2018, guidelines have recommended that a GLP-1 RA should be attempted before advancing to insulin, meaning that most people starting insulin should, in theory, be already taking a GLP-1 RA. So is there still a place for basal-bolus regimens?

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Prof. Anne Peters declares the following:

Participation on an advisory board: Abbott Diabetes Care, Astra Zeneca, Eli Lilly, Medscape, Novo Nordisk, Zealand

Research Support: Dexcom, Insulet and donated devices from Abbott Diabetes Care

Stock Options: Omada Health, Teladoc

Prof. Richard Holt declares the following:

Research Funding: Novo Nordisk

Speaker: Eli Lilly, Novo Nordisk

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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This week we’re joined by Prof. Peter Rossing to discuss an evolving case covering glycemic control, target setting, and development of complications. Prof. Rossing is head of complications research at Steno Diabetes Center Copenhagen, professor of endocrinology at the University of Copenhagen, and an author of the ADA/EASD consensus report on the management of hyperglycemia in type 2 diabetes.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Prof. Rossing discloses the following:

Advisor (fee to institution) - Astra Zeneca, Astellas, Bayer, Novo Nordisk, Gilead, Vifor, Boehringer Ingelheim, Eli Lilly, Sanofi

Research grant to Institution - Astra Zeneca, Novo Nordisk

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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In recent years there have been significant advances in the capabilities and availability of diabetes technologies. These are more widely used in type 1 diabetes, but could devices like continuous glucose monitors (CGMs) and closed-loop systems be useful for type 2 diabetes? What about time in range as a target? Join Dr Alice Cheng for a discussion of future uses of these technologies.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

American Diabetes Association. Diabetes Care. 2021;44(Supplement 1)

Boughton CK, et al. Fully automated closed-loop glucose control compared with standard insulin therapy in adults with type 2 diabetes requiring dialysis: an open-label, randomized crossover trial. Nat Med. 2021 Aug;27(8):1471-1476. doi: 10.1038/s41591-021-01453-z. Epub 2021 Aug 4. Erratum in: Nat Med. 2021 Oct;27(10):1850.

Ajjan R, et al. The LIBERATES Trial - improving gLucose control in patIents with diaBEtes following myocaRdial infArction: The role of a novEl glycaemic monitoring Strategy. Presented at the 56th Annual Meeting of the European Association for the Study of Diabetes (EASD), 21 - 25 September 2020, virtual.

Disclosures:

Dr Alice Cheng discloses the following:

Advisory board member: Abbott, Astra Zenecea, Boehringher Ingelheim, Bayer, Dexcom, Eli Lilly, HLS Therapeutics, Insulet, Novo Nordisk, Sanofi, Takeda

Speaking honorarium: Abbott, Astra Zenecea, Boehringher Ingelheim, Bayer, Bausch, Dexcom, Eli Lilly, HLS Therapeutics, Insulet, Janssen, Medtronic, Merck, Novo Nordisk, Sanofi

All conflicts of interest have been mitigated prior to this activity.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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A 5-minute summary of an observational study investigating how glucose control affected the immune response to COVID-19 vaccination, published in Diabetes, Obesity & Metabolism. Listen for a quick overview of the key findings.

Publication: Marfella R, et al. Does poor glycaemic control affect the immunogenicity of the COVID-19 vaccination in patients with type 2 diabetes: The CAVEAT study. Diabetes Obes Metab. 2021 Sep 8. doi: 10.1111/dom.14547. Epub ahead of print.

Additional references: Rawshani A, et al. Severe COVID-19 in people with type 1 and type 2 diabetes in Sweden: A nationwide retrospective cohort study. Lancet Reg Health Eur. 2021 May;4:100105. doi: 10.1016/j.lanepe.2021.100105. Epub 2021 Apr 30.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn. 

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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While we have lots of safety and efficacy data for GLP-1 RAs, including head-to-head trials comparing therapies, real-world medication adherence and persistence is typically much lower. So how can we help patients to maximise the chances of treatment success? Join Prof. Stephen Bain for a discussion of how to implement strategies to support patients in starting GLP-1 RA therapy.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • Guerci B, et al. Lack of Treatment Persistence and Treatment Nonadherence as Barriers to Glycaemic Control in Patients with Type 2 Diabetes. Diabetes Ther. 2019 Apr;10(2):437-449.
  • van Onzenoort HA, Menger FE, Neef C, Verberk WJ, Kroon AA, de Leeuw PW, van der Kuy PH. Participation in a clinical trial enhances adherence and persistence to treatment: a retrospective cohort study. Hypertension. 2011 Oct;58(4):573-8.
  • Weeda ER, Muraoka AK, Brock MD, Cannon JM. Medication adherence to injectable glucagon-like peptide-1 (GLP-1) receptor agonists dosed once weekly vs once daily in patients with type 2 diabetes: A meta-analysis. Int J Clin Pract. 2021 Sep;75(9):e14060.

Disclosures:

Professor Stephen Bain declares no relevant financial relationships within the past 12 months.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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HbA1c is the traditional primary metric for glycemia, but as a measure of average glycemia over 3 months, how much does it really tell us about glycemic control? Should we be assessing shorter-term glycemic variability and long-term fluctuations in HbA1c? Join Dr Irl Hirsch for a discussion of how this may improve patient outcomes.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • Bedenis R et al. Association between severe hypoglycemia, adverse macrovascular events, and inflammation in the Edinburgh Type 2 Diabetes Study. Diabetes Care. 2014 Dec;37(12):3301-8
  • Bonds D et al. The association between symptomatic, severe hypoglycaemia and mortality in type 2 diabetes: retrospective epidemiological analysis of the ACCORD study. BMJ. 2010 Jan;340
  • Davis S et al. Effects of Severe Hypoglycemia on Cardiovascular Outcomes and Death in the Veterans Affairs Diabetes Trial. Diabetes Care. 2019 Jan; 42(1):157-163
  • Zinman B et al. Day-to-day fasting glycaemic variability in DEVOTE: associations with severe hypoglycaemia and cardiovascular outcomes (DEVOTE 2). Diabetologia. 2018 Jan;61(1):48-57
  • Cardoso C et al. Long-term visit-to-visit glycemic variability as predictor of micro- and macrovascular complications in patients with type 2 diabetes: The Rio de Janeiro Type 2 Diabetes Cohort Study. Cardiovasc Diabetol. 2018; 17: 33
  • Gorst C et al. Long-term Glycemic Variability and Risk of Adverse Outcomes: A Systematic Review and Meta-analysis. Diabetes Care 2015 Dec; 38(12): 2354-2369
  • Perlman JE, et al. HbA1c and Glucose Management Indicator Discordance: A Real-World Analysis. Diabetes Technol Ther. 2021 Apr;23(4):253-258.

Disclosures:

Dr Irl Hirsch declares no relevant financial relationships within the past 12 months.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Clinical inertia in type 2 diabetes is particularly pronounced for injectable agents, with delays of 6-8 years reported to move from oral agents to insulin therapy. This can be a result of many barriers at both the patient and clinician level, from perceptions of injectable agents to lack of time to provide sufficient education. Join Dr Ronald Goldenberg for a discussion of how to overcome these barriers to initiating injectable therapy.

We’ve got a new website! Find it at diabetes.knowledgeintopractice.com, where you can see all past episodes of the podcast as well as other free CME resources. Follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Dr Ronald Goldenberg discloses the following:

Speakers fees, Research fees, Consultant fees: AZ, BI, Merck, Lilly, Janssen, NovoNordisk, Sanofi

All conflicts of interest have been mitigated prior to this activity.

References:

  • Okemah J, et al. Addressing Clinical Inertia in Type 2 Diabetes Mellitus: A Review. Adv Ther. 2018 Nov;35(11):1735-1745.
  • Paul SK, et al. Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes. Cardiovasc Diabetol. 2015 Aug 7;14:100.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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This week we have more congress highlights from the 2021 annual meeting of the European Association for the Study of Diabetes (EASD), held online from the 28th September to the 1st October. Listen for commentary from Prof. Steve Bain on highlights including:

  • Results from the TriMaster study

  • Cardiovascular events with semaglutide with and without metformin (post-hoc analysis of SUSTAIN 6 and PIONEER 6)

  • More results from the SURPASS program

  • Intra-organ fat content during weight loss-induced remission of type 2 diabetes in people with normal or raised BMI (data from ReTUNE and DiRECT)

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Professor Stephen Bain declares no relevant financial relationships within the past 12 months.

References:

  • Angwin C, et al. TriMaster: randomised double-blind crossover study of a DPP4 inhibitor, SGLT2 inhibitor and thiazolidinedione as second-line or third-line therapy in patients with type 2 diabetes who have suboptimal glycaemic control on metformin treatment with or without a sulfonylurea-a MASTERMIND study protocol. BMJ Open. 2020 Dec 21;10(12):e042784.
  • Husain M., et al. Semaglutide reduced cardiovascular events regardless of metformin use: a post hoc exploratory subgroup analysis of SUSTAIN 6 and PIONEER 6. Abstract 21 presented at the 57th Annual Meeting of the European Association for the Study of Diabetes, 27 September – 1 October 2021, virtual. Diabetologia 64, 1–380 (2021).
  • Taylor R, et al. Intra-organ fat content during weight loss-induced remission of type 2 diabetes in people with normal or raised BMI. Abstract 110 presented at the 57th Annual Meeting of the European Association for the Study of Diabetes, 27 September – 1 October 2021, virtual. Diabetologia 64, 1–380 (2021).

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Hear a 5-minute summary of a retrospective study investigating whether GLP-1 receptor agonists might affect the development of glaucoma in people with diabetes, published in the British Journal of Ophthalmology. Listen for a quick overview of the key findings.

References:

Publication: Sterling J, et al. Glucagon-like peptide 1 receptor agonist use is associated with reduced risk for glaucoma. Br J Ophthalmol. 2021 Aug 19:bjophthalmol-2021-319232. Epub ahead of print.

Additional references: Zhao YX, Chen XW. Diabetes and risk of glaucoma: systematic review and a Meta-analysis of prospective cohort studies. Int J Ophthalmol. 2017 Sep 18;10(9):1430-1435.

Sterling JK, et al. GLP-1 Receptor Agonist NLY01 Reduces Retinal Inflammation and Neuron Death Secondary to Ocular Hypertension. Cell Rep. 2020 Nov 3;33(5):108271.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Hear a 5-minute summary of a small study investigating whether the GLP-1 receptor agonist liraglutide affected diastolic function in people with type 2 diabetes, presented at ESC 2021 and later published Diabetes, Obesity and Metabolism. Listen for a quick overview of the key findings.

Publication: Bojer AS, et al. Metabolic improvement with short-term, glucagon-like peptide-1 receptor agonist treatment does not improve cardiac diastolic dysfunction in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2021 Oct;23(10):2374-2384. doi: 10.1111/dom.14480. Epub 2021 Jul 26.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn. 

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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People with type 2 diabetes are at high risk of developing NASH, increasing their risk of poor outcomes. However, the only way to confirm a diagnosis of NASH is through liver biopsy, so how can we help identify people with NASH? This episode examines the currently available approaches to identifying NASH with Professor Arun Sanyal.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016 Jun;64(6):1388-402. doi: 10.1016/j.jhep.2015.11.004. Epub 2016 Apr 7. PMID: 27062661.

Chalasani N, et al. The Diagnosis and Management of Non-alcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357

Disclosures:

Professor Arun Sanyal discloses:

Consulting advisor: Conatus, GenFit, Gilead, malinckrodt, Pfizer, Salix, Boehringer Ingelhiem, Immuron, Intercept, Novartis, Bristol Myers, Merck, Hemoshear, Lilly, Novo Nordisk, Terns, Galectin, Sequana, Fractyl, Amra, Albireo, Sanofi, Jannsen, Takeda, Northsea, Owl, Poxel, 89 Bio, Siemens, Ngm Bio, Perspectum, Astra Zeneca, Biocellvia, Regeneron, Genentech, Roche, Madrigal, Inventiva, Albireo, Covance, Prosciento, Histoindex, Path Ai

Research grants: Conatus, Gilead, Echosense-sandhill, Malinckrodt, Immuron, Boehringer Ingelhiem, Novartis, Bristol Myers, Merck, Lilly, Novo Nordisk, Fractyl, Owl, Second Genome, Siemens, Madrigal, Inventiva, Covance

Royalties: Elsevier, Uptodate

Stock: Sanyal Bio, Exhalenz, Akarna, Genfit, Hemoshear, Durect, Indalo, Tiziana, Rivus

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Following last week’s discussion of the prevalence of NAFLD in people with type 2 diabetes, this week we’re joined by Dr Stephen Harrison to discuss what can be done to help reduce the risk of progressing to NASH, despite there currently being no approved therapies.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

Kenneally S, et al. BMJ Open Gastroenterol. 2017 Jun 1;4(1):e000139. doi: 10.1136/bmjgast-2017-000139.

Koutoukidis DA, et al. JAMA Intern Med. 2019 Sep 1;179(9):1262-1271. doi: 10.1001/jamainternmed.2019.2248. Erratum in: JAMA Intern Med. 2019 Sep 1;179(9):1303-1304.

Blazina I, Selph S. Syst Rev. 2019 Nov 29;8(1):295. doi: 10.1186/s13643-019-1200-8.

Harrison SA, et al. J Hepatol. 2021 Aug;75(2):284-291. doi: 10.1016/j.jhep.2021.02.034. Epub 2021 Mar 18.

Belfort R, et al. N Engl J Med. 2006 Nov 30;355(22):2297-307. doi: 10.1056/NEJMoa060326.

Disclosures:

Adv Bd/Panel: 89 Bio Ltd, Akero Therapeutics, Inc, Altimmune, Inc, Arrowhead Pharmaceuticals, Inc, Axcella Health, Inc, Civi Biopharma, Inc, Cymabay Therapeutics, Inc, Echosens North America, Inc, Foresite Labs, Llc, Galectin Therapeutics, Inc, Galmed Research & Dev, Ltd, Genfit Corp, Gilead Sciences, Inc, Hepion Pharmaceuticals, Inc, Hightide Therapeutics, Inc, Histoindex Pte. Ltd., Indalo Therapeutics, Inc, Intercept Pharmaceuticals, Inc, Madrigal Pharmaceuticals, Inc, Medpace, Inc, Metacrine, Inc, Ngm Biopharmaceuticals, Inc,Northsea Therapeutics B.v., Novartis Pharmaceuticals Corp, Novo Nordisk, Pathai, Inc, Poxel, Prometic Pharma Smt Ltd, Ridgeline Therapeutics, Sagimet Biosciences, Terns, Inc, Theratechnologies.

Consultant: Akero Therapeutics, Inc, Altimmune, Inc, Axcella Health, Inc, Boston Pharmaceuticals, B Riley Fbr Inc, Canfite Biopharma Ltd, Civi Biopharma, Inc, Cymabay Therapeutics, Inc, Echosens North America, Inc, Enyo Pharma S.a., Fibronostics, Inc, Foresite Labs, Llc, Fortress Biotech, Inc, Galectin Therapeutics, Inc, Galmed Research & Dev, Ltd, Genfit Corp, Gilead Sciences, Inc, Gns Healthcare, Inc, Hepion Pharmaceuticals, Inc, Hightide Therapeutics, Inc, Histoindex Pte. Ltd., Indalo Therapeutics, Inc, Inipharm, Inc, Intercept Pharmaceuticals, Inc, Ionis, Kowa Research Institute, Inc, Madrigal Pharmaceuticals, Inc, Medpace, Inc, Metacrine, Inc, Microba Pty, Ltd, Ngm Biopharmaceuticals, Inc, Northsea Therapeutics B.v., Novartis Pharmaceuticals Corp, Novo Nordisk, Piper Sandler & Co, Poxel, Prometic Pharma Smt Ltd, Ridgeline Therapeutics, Sagimet Biosciences, Sonic Incytes Medical Corp, Terns, Inc, Viking Therapeutics, Inc

Stocks: Akero Therapeutics, Inc, Cirius Therapeutics, Inc, Galectin Therapeutics, Inc, Genfit Corp, Hepion Pharmaceuticals, Inc, Histoindex Pte. Ltd., Metacrine, Inc, Ngm Biopharmaceuticals, Inc, Northsea Therapeutics B.v., Pathai, Inc

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporter has had no influence on the content of this education.

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Non-alcoholic fatty liver disease (NAFLD) a condition where disruptions and dysregulation of lipids in the body causes an excessive build-up of fat in the liver, and is estimated to affect 75% of people with type 2 diabetes. In around 1/5 of cases this steatosis causes chronic inflammation, which can lead to fibrosis, cirrhosis and hepatocellular carcinoma. So what do people with diabetes need to know, and how do we raise awareness? We’re joined by Prof. William Alazawi to discuss these questions.

References:

Marjot T, et al. Nonalcoholic Fatty Liver Disease in Adults: Current Concepts in Etiology, Outcomes, and Management. Endocr Rev. 2020 Jan 1;41(1):bnz009. doi: 10.1210/endrev/bnz009.

Disclosures: Prof William Alazawi declares the following:

Speaker and Consulting: Gilead Sciences, Intercept, GSK, Coherus

Competitive grants: GSK, Gilead Sciences

All conflicts of interest have been mitigated prior to this activity.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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In another news episode, hear a 5-minute summary of the VERTIS CV post hoc analysis presented at ESC 2021. VERTIS CV was the the cardiovascular outcomes trial investigating the SGLT2 inhibitor ertugliflozin in people with type 2 diabetes and cardiovascular disease; this latest analysis looked at whether the effects of ertugliflozin on cardiovascular and renal outcomes varied according to baseline metformin use. Listen for a quick overview of the key findings.

Abstract: Cosentino F, et al. Cardiorenal outcomes with ertugliflozin by baseline metformin use: post-hoc analyses of the VERTIS CV trial. Eur Heart J 2021. In press

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by educational grants from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Join us this week for another congress highlights episode covering the recent European Society of Cardiology congress, held virtually from 27-30 August 2021. Listen for commentary on the key highlights, including:

  • Professor Subodh Verma on EMPEROR-Preserved, EMPEROR-Pooled, and a post hoc analysis of SUSTAIN 6 and PIONEER 6

  • Professor Darren McGuire on FIGARO-DKD, and new guidelines for heart failure and cardiovascular disease prevention

Disclosures:

Prof. Darren McGuire declares the following:

Clinical trial leadership: AstraZeneca, Boehringer Ingelheim, Eisai Esperion, GlaxoSmithKline, Janssen, Lexicon, Merck & Co. Inc, Novo Nordisk, Sanofi, CSL Behring, Lilly

Consultancy: Affimune, Applied Therapeautics, AstraZeneca, Boehringer Ingelheim, Lilly, Merck & Co. Inc, Pfizer Inc, Novo Nordisk, Metavant, Sanofi, Bayer

Prof. Subodh Verma declares the following:

Research Grants: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Novo Nordisk

Speaker Honoraria: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Janssen, Novo Nordisk, Sanofi, Sun Pharma

Consultancy: AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Janssen, Novo Nordisk

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

References

Packer M, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021 Aug 27. doi: 10.1056/NEJMoa2107038. Online ahead of print. [EMPEROR-Preserved]

Packer M, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020 Oct 8;383(15):1413-1424. [EMPEROR-Reduced]

Packer M, et al. Empagliflozin and Major Renal Outcomes in Heart Failure. N Engl J Med. 2021 Aug 27. doi: 10.1056/NEJMc2112411. Online ahead of print. [EMPEROR-Pooled]

Verma S, et al. Neutrophil-to-lymphocyte ratio predicts cardiovascular events in patients with type 2 diabetes: post hoc analysis of SUSTAIN 6 and PIONEER 6. Eur Heart J 2021. In press

Pitt B, et al. Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes. N Engl J Med. 2021 Aug 28. doi: 10.1056/NEJMoa2110956. Epub ahead of print. [FIGARO-DKD]

Bakris GL, et al. Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med. 2020 Dec 3;383(23):2219-2229. doi: 10.1056/NEJMoa2025845. [FIDELIO-DKD]

FIDELITY analysis: Presented by Dr. Gerasimos Filippatos at the European Society of Cardiology Virtual Congress, August 28, 2021.

McDonagh TA, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021 Aug 27:ehab368. doi: 10.1093/eurheartj/ehab368. Epub ahead of print.

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Guidelines, prescribing information and patient websites alike all say that lifestyle interventions are the first line of treatment for diabetes, and that pharmacotherapies should be considered as adjunct therapies alongside these. But there is currently no consensus on what these lifestyle interventions should actually be. Should they include a specific diet, exercise type or exercise frequency? In another Unanswered Questions episode, we speak to Professor Jaakko Tuomilehto of the University of Helsinki for his advice on this area of unmet clinical need.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn. 

Disclosures:

Prof. Jaakko Tuomilehto declares the following:

Shareholder: Orion pharma

Consultant: Eli Lilly

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

Funding statement:This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S, have had no influence on the content of this education.

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In the last episode of series 3, we’re joined by Anne Peters, Professor of Clinical Medicine at the Keck School of Medicine of the University of Southern California, USA, to discuss recent data on potential new therapies in development, and what this might mean in the future.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References

Rosenstock J, et al. Lancet. 2021 Jun 25;S0140-6736(21)01324-6 [SURPASS-1].

Frias J P, et al. N Engl J Med. 2021 Jun 25. doi: 10.1056/NEJMoa2107519. Online ahead of print [SURPASS-2]

Abstract 78-LB: Efficacy and Safety of Tirzepatide, a Dual GIP/GLP-1 Receptor Agonist, Compared with Insulin Degludec in Patients with Type 2 Diabetes (SURPASS-3)

Abstract 80-LB: Tirzepatide, a Dual GIP/GLP-1 Receptor Agonist, Is Effective and Safe When Added to Basal Insulin for Treatment of Type 2 Diabetes (SURPASS-5)

Bhatt D L, et al. Late-Breaking Clinical Trials IV. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).

Disclosures:

Prof. Anne Peters declares the following:

Participation on an advisory board: Abbott Diabetes Care, Astra Zeneca, Eli Lilly, Medscape, Novo Nordisk, Zealand

Research Support: Dexcom, Insulet and donated devices from Abbott Diabetes Care

Stock Options: Omada Health, Teladoc

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by educational grants from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Another special episode looking at an in-depth case study, this time regarding use of GLP-1 receptor agonists. Joining us to discuss the case is Dr Deborah Wexler, Associate Professor of Medicine at Harvard Medical School, Boston MA, USA, who was a co-author of the ADA-EASD Consensus Statement on Management of Hyperglycemia in Type 2 Diabetes.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Dr Deborah Wexler declares the following:

Member of data monitoring committee for SOUL and FLOW trials studying semaglutide, a GLP-1 receptor agonist: Novo Nordisk

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by educational grants from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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This episode brings together much of what we have discussed so far regarding use of SLGT2 inhibitors. We’re joined for a case discussion by Professor Francesco Giorgino, who is Professor of Endocrinology at the University of Bari Aldo Moro in Italy, where he is also Chief of the Division of Endocrinology at the university hospital, and President of the Italian Society of Endocrinology.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Dr Professor Francesco Giorgino declares the following:

Grants/Research Support recipient: Eli Lilly, Roche Diabetes Care

Consultant (Occasional): Eli Lilly, Roche Diabetes Care, Boehringer Ingelheim, NovoNordisk, Sanofi

Honorarium recipient: Eli Lilly, Roche Diabetes Care, Boehringer Ingelheim, NovoNordisk, AstraZeneca, Sanofi, Mundipharma

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by educational grants from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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This year’s Scientific Sessions of the American Diabetes Association was the second in a row to be held virtually. Nevertheless, the conference was still packed with the usual informative symposia and original research we would expect from ADA. We spoke to three of the speakers to discuss the highlights, including:

  • Professor Anne Peters on STEP, SUSTAIN FORTE and AMPLITUDE-O

  • Dr Deborah Wexler on GRADE

  • Professor Francesco Giorgino on the SURPASS programme

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References

  • The Management of Type 1 Diabetes in Adults — A Consensus Report by the ADA and EASD (draft)

  • Abstract 101-OR: Efficacy and Safety of Once-Weekly Semaglutide 2.0 vs. 1.0 mg for Type 2 Diabetes: SUSTAIN FORTE Randomized Trial

  • Wilding J, et al. N Engl J Med. 2021 Mar 18;384(11):989 [STEP 1].

  • UK Prospective Diabetes Study

  • Nathan D, et al. Diabetes Care 2013 Aug; 36(8): 2254-2261 [GRADE].

  • Rosenstock J, et al. Lancet. 2021 Jun 25;S0140-6736(21)01324-6 [SURPASS-1].

  • Frias J P, et al. N Engl J Med. 2021 Jun 25. doi: 10.1056/NEJMoa2107519. Online ahead of print [SURPASS-2]

  • Abstract 78-LB: Efficacy and Safety of Tirzepatide, a Dual GIP/GLP-1 Receptor Agonist, Compared with Insulin Degludec in Patients with Type 2 Diabetes (SURPASS-3)

  • Abstract 80-LB: Tirzepatide, a Dual GIP/GLP-1 Receptor Agonist, Is Effective and Safe When Added to Basal Insulin for Treatment of Type 2 Diabetes (SURPASS-5)

Disclosures:

Prof. Anne Peters declares the following:

Participation on an advisory board: Abbott Diabetes Care, Astra Zeneca, Eli Lilly, Medscape, Novo Nordisk, Zealand

Research Support: Dexcom, Insulet and donated devices from Abbott Diabetes Care

Stock Options: Omada Health, Teladoc

Dr Deborah Wexler declares the following:

Member of data monitoring committee for SOUL and FLOW trials studying semaglutide, a GLP_1 receptor agonist: Novo Nordisk

Prof. Francesco Giorgino declares the following:

Grants/Research Support recipient: Eli Lilly, Roche Diabetes Care

Consultant (Occasional): Eli Lilly, Roche Diabetes Care, Boehringer Ingelheim, NovoNordisk, Sanofi

Honorarium recipient: Eli Lilly, Roche Diabetes Care, Boehringer Ingelheim, NovoNordisk, AstraZeneca, Sanofi, Mundipharma

Funding statement:

This independent educational activity is supported by educational grants from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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In the the latest news episode, we bring you a 5-minute summary of the SUSTAIN FORTE results presented at ADA. This trial investigated whether once-weekly semaglutide 2mg was superior at reducing HbA1c in type 2 diabetes, compared with a 1mg dose. Listen for a quick overview of the key findings.

Abstract: Frias J P, et al. Diabetes 2021 Jun; 70(Supplement 1)

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn. 

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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While GLP-1 RAs and SGLT2is have a lot of data to support their cardio and renal protective effects, the precise mode of action for these effects remains unknown. Trials like EMPEROR-reduced, DAPA-HF and DAPA-CKD have shown that these effects, in the case of SGLT2is, are independent of diabetes status, and similar trials are ongoing in GLP-1 RAs.

So what happens if we use both agents? Could this produce an additive cardioprotective effect, or might they cancel each other out? In this episode we discuss these questions with Dr Darren McGuire, Professor of Internal Medicine at the University of Texas Southwestern Medical Center in the Division of Cardiology, whose expertise is in large scale CVOTs and drug regulation in the field of diabetes and cardiology.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Dr. Darren McGuire declares the following:

Clinical trial leadership: AstraZeneca, Boehringer Ingelheim, Eisai Esperion, GlaxoSmithKline, Janssen, Lexicon, Merck & Co. Inc, Novo Nordisk, Sanofi, CSL Behring

Consultancy: Affimune, Applied Therapeautics, AstraZeneca, Boehringer Ingelheim, Lilly, Merck & Co. Inc, Pfizer Inc, Novo Nordisk, Metavant, Sanofi

All conflicts of interest have been mitigated prior to this activity.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Following the last episode focusing on GLP-1 RAs, we are now turning to SLGT2 inhibitors. Which patients would benefit most from an SGLT2 inhibitor, and who should we avoid offering one? To help answer these questions, we’re joined by Dr Kevin Fernando, GP Partner and Scottish Lead for the UK Primary Care Diabetes Society.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

Disclosures:

Dr Kevin Fernando declares the following:

Advisory Board Member - Lilly, Napp, Boehringer Ingelheim

Speaker Honorarium - Lilly, Napp, Boehringer Ingelheim

References:

  • Zinman B et al. N Engl J Med. 2015;373(22):2117-2128 [EMPA-REG OUTCOME].

  • Neal B et al. N Engl J Med. 2017;377(7):644-657 [CANVAS].

  • Wiviott SD et al. N Engl J Med. 2019;380(4):347-357 [DECLARE-TIMI 58].

  • Cannon CP et al. N Engl J Med. 2020 Oct 8;383(15):1425-1435 [VERTIS-CV].

  • Perkovic V et al. N Engl J Med. 2019;380(24):2295-2306 [CREDENCE].

  • McGuire D et al. JAMA Cardiol. 2021; 6(2): 1–11 [CVOT meta-analysis].

  • Heerspink H et al. N Engl J Med. 2020 Oct 8;383(15):1436-1446 [DAPA-CKD].

  • Packer M et al. N Engl J Med. 2020 Oct 8;383(15):1413-1424 [EMPEROR-Reduced].

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp., and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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The GLP-1 receptor agonist class offers multifactorial benefits, including reductions in blood glucose, weight loss and cardiovascular protection. But do these vary across the class, and which patients should be offered one? And given they also carry a high risk of gastrointestinal side effects, how should we approach initiating therapy? Join us for a conversation with Prof. Carel Le Roux, Professor of Experimental Pathology and Co-Director of the Metabolic Medicine Group at University College Dublin, and Reader in Investigative Science at Imperial College London.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Professor Carel Le Roux has been an advisory board member for Boehringer Ingelheim, Herbalife, GI Dynamics, Johnson & Johnson, and Novo Nordisk.

References:

  • Trujillo J et al. Ther Adv Endocrinol Metab. 2021 Mar;12
  • American Diabetes Association. Diabetes Care 2021; 44(Supplement 1)
  • Buse J et al. Diabetes Care. 2020 Feb;43(2):487-493
  • Marso S et al. N Engl J Med. 2016 Jul 28;375(4):311-22 [LEADER]
  • Marso S et al. N Engl J Med. 2016 Nov 10;375(19):1834-1844 [SUSTAIN 6]
  • Hernandez A et al. Lancet. 2018 Oct 27;392(10157):1519-1529 [Harmony Outcomes]
  • Gerstein H et al. Lancet. 2019 Jul 13;394(10193):121-130 [REWIND]
  • Husain M et al. N Engl J Med. 2019 Aug 29;381(9):841-851 [PIONEER 6]

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Multifactorial management is essential in diabetes and can often require multidisciplinary care. In order to help patients reduce their risk of kidney disease, or to help manage the condition of someone with a confirmed diagnosis, effective collaboration with nephrology colleagues is key. So how can diabetes and nephrology specialists best work together?

Providing the perspective of a nephrology specialist is Professor Ian de Boer, Professor of Medicine and Associate Director of the Kidney Research Institute at the University of Washington in Seattle, and co-chair of the 2020 Diabetes in CKD Guideline published by Kidney Disease: Improving Global Outcomes or KDIGO.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Professor Ian de Boer declares the following:

Advisor: AstraZeneca, Bayer, Boehringer-Ingelheim

Received equipment and supplies for research: DexCom

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp., and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Chronic kidney disease is a significant concern in diabetes. In this episode we discuss how best to manage the risk of developing or worsening of CKD, through factors such as blood pressure, blood lipids, lifestyle and the use of nephroprotective agents. We are joined by Dr David Cherney, whose research focuses on the development of renal disease in diabetes. Dr Cherney is Associate Professor in the Department of Medicine, University of Toronto and a Clinician Scientist at the University Health Network and Mount Sinai Hospitals, where he is director of the Renal Physiology Laboratory.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • Thomas M. Adv Chronic Kidney Dis. 2014;21(3):311-7
  • Laiteerapong N et al. Diabetes Care. 2019; 42(3): 416–426.
  • Duan J et al. Sci Rep. 2019; 9(1):10408
  • Kidney Disease Improving Global Outcomes. Kidney International. 2020 98, S1–S115
  • Cosentino F et al. Eur Heart J. 2020; 41(2):255-323
  • Heerspink H et al. N Engl J Med. 2020;383(15):1436-1446.
  • American Diabetes Association. Diabetes Care 2021; 44(Supplement 1)
  • Zelniker T et al. Circulation. 2019 ;139(17):2022-2031

Disclosures:

Dr. David Cherney declares the following:

Grants/research support: Boehringer Ingelheim-Lilly, Merck, Janssen, Sanofi, AstraZeneca and Novo-Nordisk

Consulting, speaking honoraria: Boehringer Ingelheim-Lilly, Merck, AstraZeneca, Sanofi, Mitsubishi-Tanabe, Abbvie, Janssen, Bayer, Prometic, BMS and Novo-Nordisk

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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In the first of a series of special news episodes, we bring you a 5-minute summary of the latest secondary analysis of EMPEROR-Reduced: the cardiovascular outcomes trial investigating the SGLT2 inhibitor empagliflozin in people with heart failure with reduced ejection fraction (HFrEF).

This analysis investigated whether the effects of empagliflozin on cardiovascular outcomes varied according to baseline health status. Here we present a rapid summary of the key findings.

Full publication: Butler J, et al. Eur Heart J. 2021 Apr 1; 42(13): 1203–1212.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp and Dohme Corp. and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education

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Data show that GLP-1 RAs and SGLT2 inhibitors can reduce the risk of major adverse cardiovascular events (MACE) in people with type 2 diabetes with established risk factors. Given these therapies have multifactorial benefits, and that guideline advice has been shifting towards starting dual therapy earlier for many presentations, should we consider these agents for people who are not high risk? Prof. Steve Bain answers your questions

This series will feature episodes aiming to address areas with unanswered clinical questions; first up we will be speaking to Prof. Stephen Bain about offering cardioprotective agents in type 2 diabetes. Send any questions to contact@knowledgeinpractice.eu or message us on Twitter/LinkedIn.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • DECLARE-TIMI 58: Wiviott S, et al. N Engl J Med. 2019 Jan 24;380(4):347-357.
  • REWIND: Gerstein H, et al. Lancet. 2019 Jul 13;394(10193):121-130.v
  • CREDENCE: Perkovic V, et al. N Engl J Med. 2019 Jun 13;380(24):2295-2306.
  • VERIFY: Matthews D, et al. Lancet. 2019 Oct 26;394(10208):1519-1529.
  • Buse J, et al. Diabetes Care. 2020;43(2):487-493
  • Cosentino F et al. Eur Heart J. 2020 Jan 7;41(2):255-323

Disclosures:

Prof. Stephen Bain declares no relevant financial relationships

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Given that cardiovascular health is an area of major concern in diabetes, multidisciplinary care is essential to ensure that comprehensive and multifactorial management plans can be put in place. So how can diabetes specialists best work with those in cardiology?

Today we’re joined by Professor Lars Rydén, to discuss collaboration opportunities for healthcare professionals in both diabetes and cardiology. Professor Rydén is Senior Professor of Cardiology at the Karolinska Institute in Stockholm and is a past president of the European Society of Cardiology. As well as focusing much of his research on cardiovascular disease in diabetes, he also chaired the Task Forces of the 2007 and 2013 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases.

Do you have a question for our expert faculty? This series will feature episodes aiming to address areas with unanswered clinical questions; first up we will be speaking to Prof. Stephen Bain about offering cardioprotective agents in type 2 diabetes. Send any questions to contact@knowledgeinpractice.eu or message us on Twitter/LinkedIn.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

Disclosures:

Professor Lars Rydén declares no relevant financial relationships within the past 12 months.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Cardiovascular disease is the biggest cause of mortality among people with type 1 and type 2 diabetes, with chronic hyperglycaemia causing vascular damage, while in type 2 diabetes other risk factors may also present in the prediabetes phase. This episode discusses the importance of optimising control of cardiovascular risk factors such as blood pressure, lipids and smoking status, with Prof. Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow.

Do you have a question for our expert faculty? This series will feature episodes aiming to address areas with unanswered clinical questions; first up we will be speaking to Prof. Stephen Bain about offering cardioprotective agents in type 2 diabetes. Send any questions to contact@knowledgeinpractice.eu or message us on Twitter/LinkedIn.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • Welsh C et al. Diabetes Care. 2019 Dec;43(2):44-445
  • McAllister D et al. Circulation. 2018 Dec 11;138(24):2774-2786
  • Thomas M. Adv Chronic Kidney Dis. 2014 May;21(3):311-7
  • Buse J et al. Diabetes Care. 2020 Feb;43(2):487-493
  • Cosentino F et al. Eur Heart J. 2020 Jan 7;41(2):255-323
  • American Diabetes Association. Diabetes Care 2021 Jan; 44(Supplement 1)

Disclosures:

Professor Naveed Sattar declares the following:

Advisory board: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Sanofi

Speaker honoraria: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Sanofi

Institutional research grant: Boehringer Ingelheim

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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As part of the patient-centred care model described by the ADA & EASD in their 2018 consensus report, glycaemic targets should be individualised and set collaboratively with the patient. But how should we approach these consultations, and what happens if the target is not met? Join us for a discussion of this topic with Professor Peter Rossing, Head of Complications Research at Steno Diabetes Center Copenhagen, Professor of Endocrinology at the University of Copenhagen and an author of the ADA/EASD consensus report on the management of hyperglycaemia in type 2 diabetes.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • Davies, at al. Diabetologia. 2018;61(12):2461-2498
  • American Diabetes Association. Diabetes Care. 2021;44(Supplement 1)
  • Reinhardt Varming, et al. Patient Prefer Adherence. 2015; 9: 1243–1253.

Disclosures:

Professor Rossing reports advisor fees (fee to institution) and research grants from AstraZeneca and Novo Nordisk, advisor fees (fee to institution) from Astellas, Bayer, Gilead, Vifor, Boehringer Ingelheim, Eli Lilly and Sanofi.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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The Covid-19 pandemic has brought new risks and challenges for diabetes patients in all aspects of their daily lives, including accessing care and maintaining glycaemic control. So how can clinicians adapt to these challenges and continue to provide optimal care for their patients? To discuss this today we welcome Professor Chantal Mathieu, Professor of Medicine at the KU Leuven and Chair of Endocrinology at the University Hospital Leuven, Belgium.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References:

  • Diabetes UK position statement on support to manage risk for adults living with diabetes from COVID-19. Available at: https://www.diabetes.org.uk/professionals/position-statements-reports/coronavirus-position (last accessed December 2020).
  • Role of technology in diabetes control during COVID-19. Available at: https://www.easd.org/virtualmeeting/home.html#!resources/role-of-technology-in-diabetes-control-during-covid-19 (last accessed December 2020).
  • Garg, et al. Diabetes Technol Ther. 2020(6):431-439
  • Using the NHS and other health services during coronavirus. Available at: https://www.nhs.uk/conditions/coronavirus-covid-19/social-distancing/using-the-nhs-and-other-health-services/ (last accessed December 2020).

Disclosures:

Professor Chantal Mathieu has no relevant financial relationships to disclose.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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The first appointment following a diabetes diagnosis is an important opportunity to begin an optimal management plan. Through a patient-centred approach, this should include discussion of the patient’s personal goals and circumstances, and education on the importance of glycaemic control. To help us put this into practice we are joined by Dr John Buse, Professor of Medicine at the University of North Carolina School of Medicine, and author of the ADA and EASD consensus report on the management of hyperglycaemia in type 2 diabetes.

For more free education, visit the DKIP website, follow us on Twitter (@dkipractice) or connect on LinkedIn.

References

  • Khunti, et al. Prim Care Diabetes. 2017;11(1):3-12

  • Paul, et al. Cardiovasc Diabetol. 2015;14:100

  • Davies, at al. Diabetologia. 2018;61(12):2461-2498

  • Buse, et al. Diabetes Care. 2020;43(2):487-493

  • Matthews, et al. Lancet. 2019;394(10208):1519-1529

Disclosures:

Dr John Buse declares consulting fees and travel support (paid to the University of North Carolina) from Adocia, AstraZeneca, Dance Biopharm, Eli Lilly, Fortress Biotech, MannKind, NovaTarg, Novo Nordisk, Sanofi, Senseonics, vTv Therapeutics, and Zafgen; consulting fees from Cirius Therapeutics Inc, CSL Behring, Fortress Biotech, Mellitus Health, Moderna, Neurimmune AG, Pendulum Therapeutics, Stability Health and Zealand Pharma; stock options in Mellitus Health, Pendulum Therapeutics, PhaseBio, and Stability Health; grant support from NovaTarg, Novo Nordisk, Sanofi, Tolerion and vTv Therapeutics.

Funding statement:

This independent educational activity is supported by an educational grant from Eli Lilly, Merck Sharp & Dohme Corp and Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; the financial supporters have had no influence on the content of this education.

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Summarising our recent topic of patients with comorbidities, we are joined this week by Dr Kevin Fernando for a discussion of three complex cases, exploring the presentation of diabetes alongside at least two other conditions, including: obesity and NASH, heart failure and CKD, and obesity and ASCVD.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education

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We continue to examine comorbidities in diabetes; this week we discuss chronic kidney disease (CKD), affecting an estimated 50% of people with type 2 diabetes. Considering its high morbidity, mortality, and association with other adverse outcomes, this is clearly an important issue to consider. We are joined by Dr David Cherney for a discussion of management strategies in primary and secondary care, as well as data from the CREDENCE and DAPA-CKD trials on the use of SGLT2 inhibitors to help in risk reduction.

References:

This independent educational activity is supported by an educational grant from Merck Sharp & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Merck Sharp & Dohme Corp has had no influence on the content of this education.

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Heart failure is a common comorbidity of diabetes, particularly in patients with a long duration of diabetes. This week we examine guidelines and data on managing HFrEF and HFpEF, including data from VICTORIA, DAPA-HF and EMPEROR- reduced. Join us to hear Dr Darren McGuire provide his expert opinion on how best to help people with these comorbidities manage both conditions through an optimal treatment pathway.

References:

  • Armstrong PW, et al. N Engl J Med. 2020 May 14;382(20):1883-1893.

  • Buse JB, et al. Diabetes Care. 2020 Feb;43(2):487-493.

  • Gazewood JD, Turner PL. 2017 Nov 1;96(9):582-588. PMID: 29094875.

  • McMurray JJV, et al. N Engl J Med. 2019 Nov 21;381(21):1995-2008.

  • Murphy SP, Ibrahim NE, Januzzi JL Jr. JAMA. 2020 Aug 4;324(5):488-504.

  • Packer M, et al. N Engl J Med. 2020 Oct 8;383(15):1413-1424.

  • Ponikowski P, et al. Eur Heart J. 2016 Jul 14;37(27):2129-2200.

  • Schefold JC, Filippatos G, Hasenfuss G, Anker SD, von Haehling S. Nat Rev Nephrol. 2016 Oct;12(10):610-23.

  • Wallner M, Eaton DM, von Lewinski D, Sourij H. Curr Diab Rep. 2018 Oct 20;18(12):134.

This independent educational activity is supported by an educational grant from Merck Sharp & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Merck Sharp & Dohme Corp has had no influence on the content of this education.

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Non-alcoholic steatohepatitis (NASH) is a growing concern for all patients with metabolic disease. This liver disease is an advanced form of fatty liver disease, recently renamed to metabolic-associated fatty liver disease (MAFLD), which is present in up to 90% of people with obesity, type 2 diabetes or metabolic syndrome. As 20% of people with MAFLD will progress to NASH, this is an important subset of patients, and a common comorbidity to consider.

Join Professor William Alazawi for a summary of how to identify and manage NASH among people with diabetes.

References:

  • Anstee QM, et al. Nat Rev Gastroenterol Hepatol. 10(6):330-44.
  • Ciardullo S, et al. Open Diabetes Research and Care. 2020;8:e000904.
  • EASL-EASD-EASO. J Hepatol. 2016; 64(6):1388-1402
  • Eslam M, et al. J Hepatol. 73(1):202-209.
  • Jennison E, et al. Postgraduate Medical Journal 2019;95:314-322.
  • Perumpail BJ, et al. World J Gastroenterol. 21;23(47):8263-8276.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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As metabolic diseases, obesity and diabetes commonly present alongside one another. However, how should these conditions be managed alongside one another? What treatments are available and recommended for obesity, and how should these be considered alongside type 2 diabetes?

Joining us this week to answer this very question is Professor Carel le Roux, of University College Dublin.

References:

  • Behary P, et al. Diabetes Care 2019, 42 (8) 1446-1453

  • Daousi C, et al. Postgrad Med J. 2006 82(966):280-4.

  • le Roux CW, et al. Obes Surg. 2020 Aug 26.

  • Ling C, Rönn T, Cell Metab. 2019;29(5):1028-1044.

  • Malone JI, Hansen B. Pediatr Diabetes. 2019 20(1):5-9.

  • Nowakowska M, et al. BMC Med. 2019;17(1):145.

  • Yumuk V, et al. Obes Facts. 2015;8:402-424

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Following the new data and developments presented at recent congresses, we thought it would be a good idea to recap on developmental therapeutics and their predicted role in type 2 diabetes management. This episode focuses on the once-weekly basal insulin icodec, the GIP/GLP-1 agonist tirzepatide and the novel oral antihyperglycaemic agent imeglimin.

Joining us this week to discuss these novel developments is Dr Athena Philis-Tsimikas, Corporate Vice President of the Scripps Whittier Diabetes Institute at Scripps Health and the Director of Community Engagement at Scripps Research Translational Institute in San Diego, California.

References:

  • Bajaj H, et al. Efficacy and safety of switching to insulin icodec, a once-weekly basal insulin, vs insulin glargine U100 in patients with type 2 diabetes inadequately controlled on OADs and basal insulin. Poster 657, presented at: EASD 2020

  • Hövelmann U, et al. Insulin icodec: an insulin analogue suited for once-weekly dosing in type 2 diabetes. Poster 656, presented at: EASD 2020

  • Lingvay I, et al. Effect of three different titration algorithms of insulin icodec vs insulin glargine U100 on time in range in patients with type 2 diabetes inadequately controlled on OADs. Poster 658, presented at: EASD 2020

  • Dubourg J, et al. Efficacy and safety of imeglimin in combination with insulin in Japanese patients with type 2 diabetes: results of TIMES 3 trial. Poster 637, presented at: EASD 2020

  • Pirro V, et al. Effects of tirzepatide, a novel dual GIP and GLP-1 receptor agonist, on metabolic profile in patients with type 2 diabetes. Oral Presentation 146, presented at: EASD 2020

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The recent EASD annual meeting provided the opportunity for a lot of new data to be presented - however, what were the key highlights, and how might these impact practice? We joined three leading experts in diabetes to hear their thoughts on a number of topics, including: 

  • Professor Chantal Mathieu, for a discussion of the DAPA-CKD and EMPEROR-Reduced trials

  • Dr Tim Heise, for a discussion of once-weekly basal insulin

  • Professor Carel le Roux, for a discussion of the STEP trials and MAFLD in diabetes

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Join us for a roundup of the 2020 ESC congress, discussing all the latest data related to diabetes and how it should impact practice. 

Featuring interviews with:

  • Professor Lars Ryden, discussing a subgroup analysis of REWIND

  • Dr Naveed Sattar, discussing pooled analysis of SUSTAIN 6 and PIONEER 6

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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There are a range of different options for patients who require treatment escalation beyond dual or triple therapy, including premixed insulin, basal insulin plus mealtime insulin, and premixed GLP-1 RA and insulin. But how can we compare these different tactics, and going further, how do individual agents compare? Join Dr Tim Heise of the Profil Institute for an in-depth discussion of available trial data surrounding injectable therapies in type 2 diabetes.

References

  • Swinnen SG, et al. Cochrane Database Syst Rev. 2011; 2011(7):CD006383
  • Philis-Tsimikas A, et al. Diabetologia. 2020; 63(4):698-710
  • Bowering K, et al. Diabetes Care. 2017; 40(7):951-957
  • Klaff L, et al. Presented at ADA 2019; June 7-11, San Francisco, CA.
  • Billings LK, et al. Diabetes Care. 2018; 41(5):1009-1016
  • Tabak AG, et al. Diabetes Ther. 2020;11(1):305-318.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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International guidelines recommend patient self-directed titration of insulin where initiating a basal regimen. However, these same guidelines do not appear to provide any clear direction of which algorithm should be used, other than it be “evidence-based”. With this in mind, how should we select between algorithms to offer our patients?

Join us for a quick summary of three example algorithms before discussing optimal approaches with Dr Ronald Goldenberg from LMC Diabetes & Endocrinology in Thornhill, Canada.

References:

Davies MJ,e t al. Diabetes Care. 2018; 41(12): 2669-2701

ADA. Diabetes Care 2020; 43(Suppl 1): S1-S2

Davies M, et al. Diabetes Care. 2005; 28(6):1282-1288

Meneghini L, et al. Diabetes Obes Metab. 2007; 9(6):902-13

Yale JF, et al. Poster presented at: ATTD 2017, 15-18 February, Paris France.

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As discussed in our previous episode, it is vital to monitor blood glucose when receiving insulin-based therapy due to the risk of hypoglycaemia. However, given the relative crudeness of insulin-based treatment, SMBG testing is not an infallible way of preventing hypogycaemia. What are the other risks, and how can we address these?

Join Professor Simon Heller of the University of Sheffield for a detailed discussion of risk factors, management strategies, and how to empower patients to minimise their risk of hypoglycaemia

References

  • Davies MJ, D'Alessio DA, Fradkin J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701.
  • Iqbal A, Heller SR. The role of structured education in the management of hypoglycaemia. Diabetologia. 2018;61(4):751-760.
  • Philis-Tsimikas, A., Klonoff, D.C., Khunti, K. et al. Risk of hypoglycaemia with insulin degludec versus insulin glargine U300 in insulin-treated patients with type 2 diabetes: the randomised, head-to-head CONCLUDE trial. Diabetologia 63, 698–710 (2020).
  • Silbert R, Salcido-Montenegro A, Rodriguez-Gutierrez R, Katabi A, McCoy RG. Hypoglycemia Among Patients with Type 2 Diabetes: Epidemiology, Risk Factors, and Prevention Strategies. Curr Diab Rep. 2018;18(8):53. Published 2018 Jun 21.
  • Yorke E, Atiase Y. Impact of structured education on glucose control and hypoglycaemia in Type-2 diabetes: a systematic review of randomized controlled trials. Ghana Med J. 2018;52(1):41-60.

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A vital aspect of insulin-based treatment is glucose monitoring, typically using on-the-spot finger prick blood tests. While this is essential to monitor treatment effectiveness and prevent hypoglycaemia, it can be difficult for patients to adapt to a new routine. What can we do to support people in adapting to regular glucose monitoring?

Join Professor Richard Holt from the University of Southampton for a detailed discussion of monitoring approaches and introducing these to your patients.

References:

American Diabetes Association. 15. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S193-S202.

Danne T, Nimri R, Battelino T, et al. International Consensus on Use of Continuous Glucose Monitoring. Diabetes Care. 2017;40(12):1631-1640.

Davies MJ, D'Alessio DA, Fradkin J, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Having explored the earlier segments of the patient pathway, our next set of episodes will focus on injectable therapies, and how and when to advance to these. Join Dr Vanita Aroda for an overview of initial choices in injectable therapy, including basal insulin and fixed ratio combiantions of GLP-1 RA and insulin.

References

  • Buse JB,e t al. Diabetes Care 2019 Dec; dci190066.
  • American Diabetes Association. Diabetes Care. 2020; 43(S1)

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The recent results of VERTIS-CV have provided new insights into the individual and class effects of SGLT2 inhibitors, prompting further considerations of the multifactorial effects of these medications. But what made this trial so thought-provoking?

This week, join us for a retrospective review of outcomes trials for SGLT2 inhibitors and a detailed discussion of the VERTIS-CV trial with Dr Chris Cannon, cardiologist at Brigham and Women’s Hospital, professor of medicine at Harvard Medical School and principal investigator for the VERTIS-CV trial.

References

  • Zinman B, et al. N Engl J Med 2015; 373:2117-2128
  • Reiger EE, et al. Clin Diabetes. 2016; 34(4): 173–180.
  • Perkovic V, et al. N Engl J Med 2019; 380:2295-2306
  • McMurray JJV, et al. N Engl J Med 2019; 381:1995-2008
  • Buse JB,e t al. Diabetes Care 2019 Dec; dci190066.
  • Cannon CP, et al. Results of the eValuation of ERTugliflozin EffIcacy and Safety CardioVascular Outcomes Trial (VERTIS CV). Presented at: 80th ADA Scientific Sessions; June 16, 2020. Symposium.

This independent educational activity is supported by an educational grant from Merck Sharp & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Merck Sharp & Dohme Corp has had no influence on the content of this education.

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A series of expert interviews conducted at ADA 2020. This includes:

Professor Tina Vilsboll

Dr Ronald Goldenberg

Dr Chris Cannon

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Over the first half of the year, we've taken an in-depth look at guideline algorithms, best practice recommendations and expert advice on optimising outcomes in the earlier stages of type 2 diabetes. 

To help summarise all this guidance and put it into perspective, join Professor Peter Rossing of the Steno Diabetes Centre Copenhagen for a discussion of three model patient cases.

This independent educational activity is supported by an educational grant from Merck Sharp & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Merck Sharp & Dohme Corp has had no influence on the content of this education.

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Guidelines recommend normalisation of body weight, but how are we able to assist people with diabetes in achieving this? Join Professor Carel le Roux for a detailed discussion of optimal approaches in obesity management.

References

  • Lean MEJ. Lancet Diabetes Endocrinol. 2019;7(5):344-355
  • American Diabetes Association. Diabetes Care. 2019. 42(Suppl 1),.S182-S183.
  • Gardner CD, et al. JAMA, 319(7): 667-679
  • Look AHEAD Research Group. N Engl J Med 2013; 369:145-154.
  • Kelly S, et al. PLOS ONE. 2016; 11(1):e0145074.
  • Davies M, et al. Diabetes Care,2018; 41(12):.2669-2701.
  • Pories WJ, et al. Ann Surg. 1995; 222(3):339-50; discussion 350-2.
  • Batterham RL, Cummings DE. Diabetes Care. 2016; 39(6):893-901.
  • Behary P, et al. Diabetes Care. 2019; 42(8):1446-1453.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Join Professor Steve Bain for a discussion of common side effects across commonly-used antihyperglycaemic agents, including metformin, SGLT2 inhibitors, DPP-4 inhibitors and GLP-1 receptor agonists.

References

  • Lalau JD. Drug Saf. 2010 Sep 1;33(9):727-40
  • Gajjar K, Luthra P. Cureus. 2019 Apr; 11(4): e4384.
  • Napp Pharmaceuticals Limited. Summary of product characteristics. Invokana. 2020.
  • Pinto LC, et al. Sci Rep. 2018; 8: 782.
  • Kim YG, et al. J Diabetes Res. 2018 Apr 10;2018:5246976
  • Sun F, et al. Diabetes Technol Ther. 2015; 17(1): 35–42.
  • Marso P, et al. N Engl J Med 2016; 375:1834-1844
  • Davies MJ, et al. Diabetes Care. 2018; 41(12)

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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At the start of 2020, new guidelines were published by the EASD and ADA providing new recommendations on treatment escalation. But how should we implement these into practice?

Join Dr Ronald Goldenberg from LMC Diabetes & Endocrinology in Thornhill, Canada for a summary of guideline advice and how it applies in daily practice

References

Consentino, et al. Eur Heart J 2020; 2(7):255-323

Buse JB, et al. Diabetes Care. 2020 Feb;43(2):487-493.

American Diabetes Association. Diabetes Care 2020; 42(suppl1)

This independent educational activity is supported by an educational grant from Merck Sharp & Dohme Corp. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Merck Sharp & Dohme Corp has had no influence on the content of this education.

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A mountain of data exist for each antihyperglycaemic agent, from metformin through to the most recently approved agent. Considering all these data, what are the most significant observations to date?

Join Professor Jens Juul Holst from the University of Copenhagen for a summary of data on DPP-4 inhibitors, SGLT2 inhibitors and GLP-1 receptor agonists, including a particular focus on within-class differences and whether oral vs injectable formulations have different effects

References

  • Pinto LC, et al. Diabetol Metab Syndr. 2015; 7(Suppl 1): A58

  • Craddy P, et al. Diabetes Ther. 2014;5(1):1-41.

- Uccellatore A, et al. Diabetes Ther. 2015;6(3):239-56

  • Nauck MA, et al. Diabetologia. 2016; 59(2):266-74.

- Aroda VR, et al. Diabetes Obes Metab. 2020; 22(3):303-314

  • Ahrén B. Front Endocrinol (Lausanne). 2019;10:376

  • Rosenstock J, et al. JAMA. 2019 Sep 19. [Epub ahead of print]

  • Kristensen SL. Lancet Diabetes Endocrinol. 2019; 7(10):776-785

- Romera I, et al. Diabetes Therapy 2019; 10:5-19

- McMurray JJV, et al. N Engl J Med 2019; 381:1995-2008

- Perkovic V, et al. N Engl J Med 2019; 380:2295-2306

- Fitchett D, et al. Diabetes Obes Metab. 2019;21 Suppl 2:34-42.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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While it’s all very well and good to discuss optimal treatment approaches in diabetes, it is imperative to involve patients themselves in treatment decisions and management approaches in diabetes. Join patient advocate Mr Ken Tait for a discussion of how to empower people with diabetes to optimise their self-care, and approaches to involving them in treatment decisions.

References

  • Davies MJ, et al. Diabetes Care. 2018; 41(12):2669-2701
  • Consentino F, et al. Eur Heart J. 2020; 41(2):255-323
  • Deakin T, et al. Cochrane Database Syst Rev. 2005; (2):CD003417
  • Steinsbekk A, et al. BMC Health Serv Res. 2012; 12:213
  • Duncan I, et al. Diabetes Educ. 2011; 37(5):638-57
  • Lasalvia P, et al. J Diabetes Sci Technol. 2016; 10(4):959-66

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Join Dr Kevin Fernando for a detailed discussion of how to implement recent guideline recommendations into daily clinical practice, including 2019 ESC recommendations and the 2020 EASD/ADA update.

References

  • Buse JB, et al. Diabetologia. 2020; 63(2):221-228.
  • Davies MJ, et al. Diabetes Care. 2018; 41(12):2669-2701
  • Consentino F, et al. Eur Heart J. 2020; 41(2):255–323

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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All guidelines advocate for lifestyle interventions in the management of diabetes, including exercise, healthy eating and weight normalisation. But how can we actually help patients achieve this? Join us this week for a discussion of practical tips to achieve a healthy lifestyle, with expert advice from Professor Naveed Sattar.

References

  • Davies MJ, et al. Diabetes Care. 2018; 41(12):2669-2701
  • Galaviz KI, et al. Diabetes Care. 2018; 41(7):1526-1534
  • Dutton GR, et al. Prog Cardiovasc Dis. 2015; 58(1):69-75
  • Lean M, et al. Lancet. 2018; 391(10120):541-551
  • Consentino F, et al. Eur Heart J. 2020; 41(2):255–323
  • Salas-Salvadó J, et al. Diabetes Care. 2011; 34(1):14-9
  • Huo R, et al. Eur J Clin Nutr. 2015; 69(11):1200-8
  • Sluik D, et al. Arch Intern Med. 2012; 172(17):1285-95
  • Hansen E, et al. J Strength Cond Res. 2012; 26(2):327-34

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Featuring an interview with Professor Tina Vilsboll.

Rapid achievement of glycaemic targets has been a key goal of treatment in diabetes, but does it matter how quickly we achieve this? Based on guidelines, trial evidence and real-world studies, the answer is a resounding "yes". Tune in to this episode to learn outcome improvements associated with early, intensive therapy, and how to achieve this in your clinic.

References

  • Davies MJ, et al. Diabetes Care 2018; 41(12):2669-2701
  • Buse JB, et al. Diabetologia. 2020; 63(2):221-228.
  • Thomas MC. Adv Chronic Kidney Dis. 2014; 21(3):311-7
  • Laiteerapong N, et al. Diabetes Care. 2019; 42(3):416-426
  • Paul SK, et al. Cardiovasc Diabetol. 2015;14:100.
  • Reaven PD, et al. N Engl J Med 2019; 380:2215-2224
  • Khunti K, Millar-Jones D. Prim Care Diabetes. 2017;11(1):3-12.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an interview with Professor David Matthews, President of the EASD.

How should we consider individual factors when setting multifactorial targets - and once these are set, how should we prioritise achieving them? Catch up on the latest guideline recommendations across glycaemic, lipid and blood pressure targets and how these should be met in clinical practice.

References

  • Consentino F, et al. Eur Heart J, 2020; 41(2): 255–323
  • Buse JB, et al. Diabetes Care 2019 Dec; dci190066.
  • ADA. Diabetes Care 2020; 43(Suppl 1): S1-S2

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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An announcement about the upcoming season 2, running through February to November 2020

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Rounding off our first season of the podcast, we join Dr Vanita Aroda of Brigham and Women's Hospital for a discussion of future trends in diabetes management. Take a quick walk down memory lane of how practice has changed, and the direction the next decade could head.

References

  • Davies MJ, et al. Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018; 41(12):2669-2701.
  • Rowley WR, et al. Diabetes 2030: Insights from Yesterday, Today, and Future Trends. Popul Health Manag. 2017;20(1):6–12.
  • Kerr D, et al. Diabetes and technology in 2030: a utopian or dystopian future? Diabet Med. 2018; 35(4):498-503.
  • ESC. New apps for atrial fibrillation. Available online.
  • Kebede MM, Pischke CR. Popular Diabetes Apps and the Impact of Diabetes App Use on Self-Care Behaviour: A Survey Among the Digital Community of Persons With Diabetes on Social Media [published correction appears in Front Endocrinol (Lausanne). 2019 Apr 05;10:220]. Front Endocrinol (Lausanne). 2019;10:135.
  • Coskun T, et al. LY3298176, a novel dual GIP and GLP-1 receptor agonist for the treatment of type 2 diabetes mellitus: From discovery to clinical proof of concept. Mol Metab. 2018; 18:3-14.
  • Vuylsteke V, et al. Imeglimin: A Potential New Multi-Target Drug for Type 2 Diabetes. Drugs R D. 2015;15(3):227–232.

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Featuring an interview with Professor Rudy Bilous.

Pregnancy presents a number of considerations for people with diabetes. In addition, a population of pregnant people can develop a transient state of hyperglycaemia called gestational diabetes mellitus, or GDM. In this session, we explore how to diagnose GDM, and why glucose control is so important for both mother and child.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring and interview with EASD President, Professor David Matthews.

Join us for an end-of-year review of the biggest trials of 2019, plus a detailed interview with Professor Matthews about key data, what the future may entail, and the debate surrounding the ESC 2019 guidelines.

References

  • CARMELINA: Rosenstock J, et al. JAMA 2019; 321(1):69-79
  • CAROLINA: Rosenstock J, et al. JAMA 2019; 322(12):1155-1166
  • CREDENCE: Perkovic V, et al. N Engl J Med 2019; 380:2295-2306
  • DAPA-HF: McMurray JV, et al. N Engl J Med 2019; 381:1995-2008
  • PIONEER 6: Husain M, et al. N Engl J Med 2019; 381:841-851
  • REWIND: Gerstein HC, et al. Lancet. 2019; 394(10193):121-130
  • ESC guidelines: Consentino F, et al. Eur Heart J, 2019; ehz486

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Featuring an interview with Dr Alexander Miras of Imperial college London.

This episode takes a closer look at clinical inertia, and how even a 1 year delay in treatment intensification can lead to significantly increased risk of poor patient outcomes.

References

  • Khunti S, et al. Therapeutic inertia in type 2 diabetes: prevalence, causes, consequences and methods to overcome inertia. Ther Adv Endocrinol Metab. 2019;10:2042018819844694.
  • Lin J, et al. Real-world medication persistence and outcomes associated with basal insulin and glucagon-like peptide 1 receptor agonist free-dose combination therapy in patients with type 2 diabetes in the US. Clinicoecon Outcomes Res. 2016;9:19–29.
  • Khunti K, Millar-Jones D. Clinical inertia to insulin initiation and intensification in the UK: A focused literature review. Prim Care Diabetes. 2017 Feb;11(1):3-12.
  • Khunti K, Wolden ML, Thorsted BL, Andersen M, Davies MJ. Clinical inertia in people with type 2 diabetes: a retrospective cohort study of more than 80,000 people. Diabetes Care. 2013;36(11):3411–3417.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an expert interview with Professor Richard Holt.

Over recent years, mental health has gained attention as an important factor for both quality of life, and success for management of chronic conditions such as diabetes. Research is increasingly demonstrating a relationship between mental health disorders and diabetes, with bidirectional causal relationships suspected across the spectrum of care. Join us for a discussion of stressors in diabetes, and how you can help patients recognise and manage their mental health.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an interview with Dr Philip Burgess, this session focuses on the importance of maintaining eye health in people with diabetes. Retinopathy-induced loss of vision is a common and preventable comorbidity of diabetes, and can be caught and treated early through annual checkups. Learn how to work together with ophtalmology services to help patients maintain their vision.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an interview with Mr Graham Bowen, clinical lead for podiatry in Southampton.

Diabetic foot disease is a combination of various arterial and/or neurological syndromes that leads to poor circulation and sensation in the lower extremities. As a result, minor foot problems (such as cuts and bruises) can develop into severe infected ulcerations and, ultimately, amputation. In this episode, we explore data surrounding the pathogenesis of poor outcomes, and practical techniques to minimise risk among people with diabetes.

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Featuring an interview with Prof Alberico Catapano.

Dyslipidaemia commonly co-occurs with type 2 diabetes, and is a major risk factor for cardiovascular disease. To prevent this condition, all recent guidelines recommend reducing LDL cholesterol concentrations in the blood to near-normal levels, particularly in those with elevated cardiovascular risk. This episode provides a quick overview of dyslipdaemia in diabetes before Prof Alberico Catapano provides his top tips for helping patients bring lipids under control.

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A series of expert interviews conducted at EASD 2019. This includes:

  • Professor Steve Bain, discussing the PIONEER trials of oral semaglutide
  • Professor Dr Thomas Danne, discussing approaches to type 1 diabetes management
  • Professor Jens Juul Holst, discussing gastric peptides as actionable targets
  • Professor Didac Maruicio, discussing the CONCLUDE trial

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an expert interview with Professor Steve Bain. This episode summarises the major diabetes-related announcement at the 2019 ESC Congress in Paris. This includes the DAPA-HF trial, the new ESC guidelines (developed in collaboration with the EASD) and special population studies.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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With the ESC 2019 Congress and EASD Annual Meeting taking place over this month, we are slightly changing the release schedule. Our team will be attending both meetings to produce special episodes summarising key highlights, which will be released ~1 week after each conference.

Stay tuned for more information

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an interview with Dr William Alazawi.

Non-alcoholic fatty liver disease (NAFLD) is of increasing concern among people with type 2 diabetes. This condition, where an abnormal amount of fat is stored in liver cells, is associated with non-alcohol steathepatitis (NASH), which in turn can progress to fibrosis, cirrhosis and liver cancer. This episode provides a quick overview of NASH in diabetes before Dr William Alazawi, clinical lead for NASH for the Bart's Health NHS trust, provides his recommendations for patients with abnormal liver function.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an interview with Professor Ronald Goldenberg.

An overview of the co-occurrence of obesity and diabetes. This includes the effects of bariatric surgery, the underlying genetic factors of obesity, and recommended treatment approaches. Professor Goldenberg discusses practical advice for working together with patients to achieve normalisation of body weight and blood glucose

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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Featuring an interview with Professor Carel le Roux

An overview of  recent data regarding the renal effects of SGLT2 inhibitors, GLP-1 RAs and DPP-4s. After a 5 minute data summary, Professor Le Roux provides his insight in helping patients achieve multifactorial treatment targets.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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An overview of new and recent data presented during ADA 2019. This includes:

  • REWIND - the CVOT for dulaglutide
  • CARMELINA - the CVOT for linagliptin
  • CAROLINA - an active comparison CVOT studying linagliptin vs glimepiride
  • PIONEER 6 - the CVOT for oral semaglutide
  • DECLARE-TIMI 58 - the CVOT for dapagliflozin

Featuring an interview with Professor Steve Bain.

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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A highlight of PIONEER trial results, released during ADA 2019. This includes:

  • PIONEER 2 - Oral semaglutide vs empagliflozin
  • PIONEER 3 - Oral semaglutide vs sitagliptin
  • PIONEER 4 - Oral semaglutide vs liraglutide
  • PIONEER 5 - Oral semaglutide in patients with established kidney disease
  • PIONEER 6 - The CVOT for oral semaglutide

Featuring an interview with Professor Steve Bain

This independent educational activity is supported by an educational grant from Novo Nordisk A/S. The educational content has been developed by Liberum IME in conjunction with an independent steering committee; Novo Nordisk A/S has had no influence on the content of this education.

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An introduction to the podcast - who we are, and why we're doing this