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Diabetes Knowledge in Practice Podcast

Diabetes Knowledge in Practice Podcast

By Diabetes Knowledge in Practice
A summary of new trial data, guideline recommendations and expert opinion across diabetes care, run by Diabetes Knowledge in Practice (www.knowledgeinpractice.eu), 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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Collaborative cardiovascular care: diabetologists and cardiologists | With Prof. Lars Rydén
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.
13:45
April 13, 2021
Managing CV risk in T2D | With Prof. Naveed Sattar
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.
19:05
March 30, 2021
Setting glycaemic targets: a patient-centred approach | With Prof. Peter Rossing
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.
15:09
March 9, 2021
Managing diabetes in the Covid-19 era | With Prof. Chantal Mathieu
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.
20:02
February 23, 2021
The pivotal first appointment | With Dr John Buse
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.
19:24
February 9, 2021
Complex case study clinic: Managing comorbidities in diabetes
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
18:17
January 5, 2021
Comorbidities in diabetes: CKD
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: - Chen TK, Knicely DH, Grams ME. JAMA. 2019 Oct 1;322(13):1294-1304. - Easd.org. 2020. Virtual Meeting | EASD. [online] Available at: [Accessed 8 December 2020]. - Heerspink HJL, et al. N Engl J Med. 2020 Oct 8;383(15):1436-1446. - Perkovic V, et al.; CREDENCE Trial Investigators.. N Engl J Med. 2019 Jun 13;380(24):2295-2306. - Thomas MC, Cooper ME, Zimmet P. Nat Rev Nephrol. 2016 Feb;12(2):73-81. - Tuegel C, Bansal N. Heart. 2017 Dec;103(23):1848-1853. - Yun HR, et al.. Am J Kidney Dis. 2018 Sep;72(3):400-410. 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.
19:24
December 22, 2020
Comorbidities in diabetes: Heart Failure
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.
17:55
December 9, 2020
Managing comorbidities in diabetes – NASH and MAFLD
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.
15:55
November 24, 2020
Managing comorbidities in diabetes: Obesity
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 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
13:16
November 10, 2020
Upcoming and developmental therapeutics in type 2 diabetes
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 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
13:40
October 27, 2020
EASD Special: once-weekly insulins, renal outcome trials & other highlights
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.
25:12
October 13, 2020
ESC Special – diabetes, cardiovascular disease, and managing both conditions through multifactorial agents
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.
15:51
September 29, 2020
Comparing injectable therapies: what can the data tell us?
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.
17:52
September 15, 2020
Self-directed titration with insulin: which algorithms are suitable?
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. 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.
13:24
September 1, 2020
Hypoglycaemia: minimising the risk among insulin-treated patients
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. 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
16:01
August 18, 2020
Introducing SMBG monitoring
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.
16:20
August 4, 2020
Advancing to combination injectable approaches
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) 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
15:35
July 21, 2020
SGLT2 inhibitors in review: latest data & their wider context
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.
14:04
July 7, 2020
ADA 2020 Special
A series of expert interviews conducted at ADA 2020. This includes: Professor Tina Vilsboll Dr Ronald Goldenberg Dr Chris Cannon 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
19:46
June 23, 2020
Case study clinic: summarising guideline advice
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.
19:17
June 9, 2020
Assisting patients in achieving weight reduction
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.
19:54
May 26, 2020
Adverse events in diabetes: common side effects and how to remedy them
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.
14:55
May 12, 2020
Selecting between therapeutics: guideline recommendations and clinical evidence
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.
17:52
April 28, 2020
Multifactorial effects across pharmacotherapies: clinical data and what they mean
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.
23:38
April 14, 2020
The patient perspective: working together to achieve targets
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.
16:46
March 31, 2020
Achieving multifactorial control
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.
14:28
March 17, 2020
Practical tactics to achieve lifestyle change
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 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.
16:30
March 3, 2020
Early, intensive treatment: A year really does make a difference
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.
16:13
February 18, 2020
Setting and individualising multifactorial targets
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.
19:45
February 5, 2020
Coming soon: Season 2!
An announcement about the upcoming season 2, running through February to November 2020
01:13
January 31, 2020
Future directions in diabetes care
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. 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.
13:53
January 21, 2020
Diabetes and pregnancy: GDM, HbA1c and considerations for planning pregnancy
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.
20:44
January 8, 2020
2019 in review: guidelines, CVOTs and what they all mean.
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 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.
22:50
December 16, 2019
Clinical inertia: the dangers of delay & tips to address it
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.
15:23
December 2, 2019
Mental health & diabetes: the importance of communication
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.
15:51
November 18, 2019
Optimising eye health in diabetes
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.
14:16
November 3, 2019
Protecting your patients' feet
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. 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.
16:28
October 22, 2019
Dyslipidaemia in diabetes
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. 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.
12:22
October 7, 2019
EASD special: conference roundup
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.
30:34
September 23, 2019
ESC special: cardioprotection in diabetes
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.
17:23
September 9, 2019
Announcement: September schedule and conference specials
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.
00:52
August 30, 2019
NASH, diabetes, and the importance of liver health
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.
16:19
August 19, 2019
DiaBesity: achieving weight loss in comorbid obesity
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.
17:32
August 4, 2019
Renal outcomes and treatment options
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.
16:28
July 21, 2019
Cardiovascular outcomes at ADA 2019
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.
16:37
July 8, 2019
The PIONEER trial programme
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.
14:05
June 27, 2019
About this podcast
An introduction to the podcast - who we are, and why we're doing this
00:46
June 26, 2019