Diabetes and endocrinology – GPnotebook Podcast: Recent Episodes
GPnotebook
The GPnotebook Podcast is a bite-sized, regular chat for all healthcare professionals working in primary care. Episodes cover clinical tips and “hacks” as well as hot topics.
The experts break down Dexcom Clarity and explain what it can provide and which key reports you should be focussing on. They discuss strategies that can be implemented to ensure optimal data use to improve care, and explain how you should use data ownership to help empower those living with diabetes.
Here, the experts examine the role that specialist dietitians play in the management of diabetes in primary care. They explore the role that rtCGM has in helping with food choices and motivation, and discuss the insights rtCGM can bring to people who live with diabetes and their HCP team.
Listen to the experts explore some of the potential barriers faced by people living with diabetes and consider ideas on how to tackle these. They also go on to discuss the initiation of people on diabetes technologies and highlight the simple and easy onboarding process for the Dexcom ONE real-time continuous glucose monitoring (rtCGM) system.
Join the diabetes experts as they discuss the important role that clinical pharmacists play in the management of diabetes care. Listen in as they delve into ways to identify those patients that would benefit most from rtCGM and explore the role that primary care has to play in getting patients started on devices like Dexcom ONE.
Two diabetes experts share how glucose monitoring has evolved into the real-time continuous glucose monitoring (rtCGM) of today, and why HCPs should stay up-to-date with the latest in rtCGM with our podcast series. Hear them review the mechanism of rtCGM and the clinical evidence that led to rtCGM being recommended in the latest NICE guidelines for both T1D and T2D.
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In this podcast, Dr Amar Puttana, Kathy Davies and Sarah Gregory will discuss some of the challenges when caring for the older person with diabetes and Sanofi’s role in supporting the care of older people with diabetes, particularly those in care homes.
In this episode, Dr Amar Puttana, Dr Patrick Holmes and Dr Shafie Kamaruddin will discuss the evolving role of biosimilar insulin in the management of diabetes, how to assess biosimilar treatment options and incorporate their use into practice.
In this episode, Professor Pratik Choudhary summarises the findings from the InRange study, the first randomised, Phase 4 study to use Time in Range as the primary endpoint to compare second-generation basal insulin analogues, Toujeo (insulin glargine 300 U/mL) and insulin degludec 100 U/mL, in people with type 1 diabetes.¹
In this episode, Professor Partha Kar looks into the ongoing inequalities in uptake and awareness of continuous glucose monitoring (CGM). Despite recent advances in access to CGM through the NHS for people with type 1 diabetes, there exist both racial and socioeconomic disparities in use of this technology.1
In this episode, Dr Kevin Fernando and Alia Gilani talk about the evidence for SGLT2 inhibitors in providing long-term outcomes for people living with type 2 diabetes.
In this episode, Dr Yassir Javaid and Dr Janaka Karalliedde discuss the broad benefits of SGLT2 inhibitors from a cardio, renal and metabolic perspective and their impact on people living with type 2 diabetes.
In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Steve Holmes (GP, Shepton Mallet and Clinical Respiratory Lead, NHS England South West and NHS Somerset) and Dr Sarah Davies (GPwSI in Diabetes, Cardiff) discuss non-alcoholic fatty liver disease (NAFLD) in the context of diabetes. How is NAFLD best detected, diagnosed and managed in high-risk populations? How can primary care professionals identify those who are at risk of fibrosis?
In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) and Dr Patrick Holmes (GP, Darlington) examine the latest developments in renal medicine, with a focus on assessing and managing chronic kidney disease (CKD). What role do sodium–glucose cotransporter 2 inhibitors have in the management of the condition, both in people with diabetes and those without diabetes?
In this episode, which has been recorded for Chronic Conditions Month 2022, Dr Sarah Davies (GPwSI in Diabetes, Cardiff) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) discuss the interplay between mental health and conditions such as diabetes, dementia and heart disease. What role do lifestyle factors such as diet and physical activity have in modulating such relationships? Most importantly, what can we do to help patients who may be stuck in a vicious cycle whereby physical ailments adversely impact mental health, which can, in turn, make positive lifestyle changes more difficult to achieve.
In this episode, Dr Kevin Fernando discusses diagnostic and management tips – as well as pitfalls to avoid – related to subclinical hyperthyroidism. Fatima is a 71-year-old woman who presents in primary care with non-specific malaise and a past medical history of atrial fibrillation, ischaemic heart disease and osteoporosis. On examination, there is no evidence of thyroid swelling. Her blood tests reveal a suppressed thyroid-stimulating hormone (TSH), but normal free thyroxine (FT4) and free triiodothyronine (FT3). Given Fatima's comorbidities, what should we do next?
In this episode, Kate discusses gynaecomastia and its investigation and management in primary care. She talks us through an infographic produced by The Association of Breast Surgery called Guidance on Gynaecomastia and considers the following important questions: “who do I need to be worried about?”, “what investigations should I consider?” and “when should I make a referral?”.
In this episode, Kevin discusses the case of Louise, a 19-year-old who has been living with type 1 diabetes for the last 12 years and hypothyroidism for the last 8 years. She presents to us in primary care with a history of recurring unexplained hypoglycaemic episodes despite proactive adjustments to her insulin regimen. In addition to her insulin, she is taking levothyroxine 150 μg/day. She has not recently made significant changes to her diet or daily physical activity. Louise has also been experiencing light-headedness when rising from a sitting position. She has a BMI of 19 kg/m2, and a recent HbA1c value was 63 mmol/mol (7.9%). You record her sitting blood pressure as 119/67 mmHg and her standing value as 99/72 mmHg. You notice some patches of vitiligo on her face. What should we do next?
In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Yassir Javaid (Cardiovascular and Diabetes Clinical Lead, Nene CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the detection of chronic kidney disease in primary care. What do the different tests tell us? What are the most up-to-date guidelines on investigations for CKD, and what do they recommend we do? How often should we be conducting tests for renal function and albuminuria?
In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the interplay between diabetes and severe mental illness (SMI). What exactly is meant by SMI? How prevalent is mental illness in people with diabetes? What is the role of the gut–brain axis? What signs should clinicians be looking out for in spotting depression?
Steroids are prescribed for a range of health conditions. In this podcast, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the factors that primary care clinicians need to be aware of when prescribing these drugs. What are the most common side effects with steroid use? What do clinicians need to do to minimise the risk of adrenal crisis when withdrawing steroids? What should sick-day guidance look like for people on long-term steroid treatment? How vigilant do clinicians need to be for steroid-induced diabetes?
Kevin is joined by Drs Patrick Holmes, Amrit Lamba and Amar Puttanna to discuss the key take-home points from last week’s American Diabetes Association Virtual Scientific Sessions congress.
Kevin discusses the findings of NHS research on COVID-19 in people with diabetes with study author Professor Partha Kar, National Specialty Advisor – Diabetes with NHS England.
Kevin discusses what to do with each of the commonly used classes of diabetes drugs during intercurrent illness – a topic of particular relevance during the COVID-19 pandemic. Are these medications safe to continue? If so, is dose titration required? Which of these drugs be temporarily be stopped?
Kevin discusses some helpful and important clinical guidance on the prevention of adrenal crisis during the pandemic. Notably, this includes not only those patients with primary adrenal insufficiency but also all of those patients on long-term steroid treatment.
Dr Kevin Fernando provides a practical overview of the utility of sodium–glucose cotransporter 2 inhibitors, focusing on dosing, cardiovascular and renal safety and the management of adverse events, including dehydration and genital infections.
Dr Kevin Fernando takes us through brief case scenarios to illustrate diagnostic tips and pitfalls in primary care.