Diving Into Diabetes

Diving Into Diabetes

por Diving Into Diabetes
Salud y estado físicoCiencias de la Vida
Temporada 1

Exploring Exercise and Type 1 Diabetes

Exercising with diabetes requires extra preparation, so how can healthcare providers best guide those living with type 1 diabetes in exercising safely to maintain a healthy lifestyle? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Mike C. Riddell, a Professor at York University’s School of Kinesiology and Health Science and Muscle Health Research Centre, and a Senior Scientist at the LMC Diabetes and Manna Research in Toronto. He is a leading authority on exercise and diabetes, having published numerous peer-reviewed articles, book chapters, international guidelines, and a patient guidebook on the effects of exercise and stress on diabetes and metabolism. This episode discusses the different types of exercises recommended and the practical considerations surrounding blood glucose monitoring, carbohydrate intake, and insulin dosing adjustments when staying active for those living with diabetes. Our experts also touch on some new and exciting clinical data recently presented at the ADA 2022 Scientific Sessions related to diabetes and exercise. They discuss key findings from the Type 1 Diabetes Exercise Initiative (T1DEXI) study, which assessed the effect of exercise type on time in range by comparing continuous glucose monitoring data on active vs. sedentary days, of which Dr. Riddell was a co-author. Our experts also discuss key takeaways from the ULTRAFLEXI-1 study, which compared second-generation basal insulin analogues glargine 300 U/mL (Gla-300) and degludec 100 U/mL (IDeg-100) flexibility around spontaneous exercise sessions in adults with type 1 diabetes. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Riddell: Direct financial relationship including receipt of honoraria: Dexcom, Novo Nordisk, Sanofi, Lilly Diabetes. Membership on advisory boards or speaker’s bureau: Zucara Therapeutics, Zealand Pharma, Indigo Diabetes. Funded grants, research or clinical trials: Insulet Canada, Dexcom, Verily, Glyconet, JAEB Center for Health Research, Natural Sciences and Engineering Research Council of Canada (NSERC), Zucara Therapeutics, Mitacs Canada. Other financial relationships/investments: investments (shares) in Supersapiens and Zucara Theraputics.
T1 · E9
15 nov 2022
17:35

Managing Diabetes in Pregnancy  

How do we approach diabetes management during pregnancy? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Denice Feig, an Endocrinologist, diabetes researcher, and champion for women’s health. She is Head of the Diabetes in Pregnancy Program at Mount Sinai Hospital and an Associate Professor at the University of Toronto’s Department of Medicine. Dr. Feig’s work aims to improve the standard of care for pregnant women with pre-existing and gestational diabetes. This episode discusses the topics of glycemic targets throughout pregnancy, taking second-generation basal analogues during pregnancy, and the use of continuous glucose monitoring (CGM) to improve outcomes for pregnant women with diabetes. Our experts also discuss Dr. Feig’s research investigating whether the use of CGM in women with type 1 diabetes can improve glycemic control compared to standard capillary blood glucose monitoring. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Feig: Direct financial relationship including receipt of honoraria: Sanofi. Membership on advisory boards or speaker’s bureau: Novo Nordisc. Funded grants, research or clinical trials: CIHR, JDRF.
T1 · E8
1 nov 2022
10:46

Navigating Ramadan with Diabetes

How can healthcare providers best guide Muslims living with diabetes to safely observe fasting during Ramadan? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Ally Prebtani, a Professor of Medicine in the Department of Internal Medicine, Endocrinology & Metabolism at McMaster University. This episode discusses the month of Ramadan, where a significant number of Muslims fast from dawn until dusk. Observing the Ramadan fast is associated with challenges and risks for those in the Muslim community living with diabetes. Our experts discuss risk stratification and how healthcare providers can be proactive in preparing those who choose to fast. They discuss practical tips to help people with diabetes safely navigate fasting during this holy month and emphasize the importance of understanding each person – who they are they, what treatments they are on, and how their diabetes care can be individualized. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Prebtani: Direct financial relationship including receipt of honoraria: Eli Lilly, Astra Zeneca, BI, Abbott, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Hypertension Canada, Diabetes Canada.
T1 · E7
1 nov 2022
14:14

Exploring Diabetes and Mental Health Issues

Living with a chronic disease can take a toll on one’s mental health, so how can healthcare providers best support those living with diabetes? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Michael Vallis, a Health Psychologist and Health Behaviour Change Consultant based in Halifax, and an Associate Professor in Family Medicine at Dalhousie University. He has authored chapters in the recent 2013 and 2018 Diabetes Canada Clinical Practice Guidelines on Diabetes and Mental Health. This episode discusses the common mental health issues associated with diabetes, with a particular focus on diabetes distress, psychological insulin resistance, and the fear of hypoglycemia. Our experts expand on the topics of what drives these challenges, how to recognize them in people living with diabetes, and the recent advances in diabetes management that allow individuals to overcome these barriers. They also discuss how to address these issues in a collaborative manner for more effective diabetes care and greater overall health outcomes. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Vallis: Membership on advisory boards or speaker’s bureau: Novo Nordisk, Abbvie, Bausch, Boehringer Ingelheim, Sanofi, Abbott, Lifescan, Merck. Funded grants, research or clinical trials: Novo Nordisk, Bausch, Abbott.
T1 · E6
15 oct 2022
19:25

Examining Diabetes and Renal Impairment 

Did you know that people with type 2 diabetes having chronic kidney disease are at an increased risk of hypoglycemia? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Alice Cheng, an Endocrinologist at Credit Valley Hospital in Mississauga, and St. Michael's Hospital in Toronto. She is also an Associate Professor in the Department of Medicine at the University of Toronto and the current the Chair of the Professional Section of Diabetes Canada and Associate Editor for the Canadian Journal of Diabetes. This episode discusses best practices on how to manage type 2 diabetes in those having renal impairment. Our experts take a deeper dive into talking points when communicating with such patient groups, as well as therapeutic considerations to lower the risk of hypoglycemia when choosing an appropriate basal insulin for those having kidney disease. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Cheng: Direct financial relationship including receipt of honoraria: Abbott, Astra Zeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, Insulet, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi, Takeda, Antibody, EOCI, Six Degrees, Liv, CPD Network, Canadian Collaborative Research Network, Master Clinical Alliance, Canadian Medical & Surgical Knowledge Translation Research Group, Sea Courses, Alliance of Best Practices in Health Education, Partners in Progressive Medical Education, Agence Unik, MD Briefcase, LMC Physician Inc., Meducomm, Humber Hospital, Timed Right, The ACADEMY. Membership on advisory boards or speaker’s bureau: Abbott, Amgen, Astra Zeneca, Bayer, Bausch, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, HLS Therapeutics, Insulet, Janssen, Merck, Medtronic, Novo Nordisk, Pfizer, Sanofi, Takeda. Funded grants, research or clinical trials: Applied Therapeutics, Sanofi.
T1 · E5
15 oct 2022
10:21

Practical Tips to Interpreting Continuous Glucose Monitoring Metrics

With newer technologies being used to monitor blood glucose levels, how can we use data from continuous glucose monitoring (CGM) to inform the day-to-day management of diabetes? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Ms. Lori Berard, a Registered Nurse and Certified Diabetes Educator currently working as a Nurse Clinical Research Consultant in Winnipeg. She has authored several chapters in recent Diabetes Canada Clinical Practice Guidelines, notably the 2018 Guidelines on Monitoring Glycemic Control and the 2021 Update for Blood Glucose Monitoring in Adults and Children with Diabetes. This episode discusses the technical and practical aspects of CGM use and how these newer technologies are changing diabetes care. Our experts touch on the differences between real-time and intermittently scanned CGM, and further explore the clinical relevance of key parameters such as time-in-range (TIR), time-below-range (TBR), and coefficient of variation (CV). They provide practical tips on interpreting ambulatory glucose profiles (AGP) and discuss the benefits and positive impact CGM and metrics beyond HbA1c have had in facilitating shared care in diabetes management. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Ms. Berard: Direct financial relationship including receipt of honoraria: Quanta Dialysis Ltd. Membership on advisory boards or speaker’s bureau: Eli Lilly, Sanofi, Novo Nordisk, Abbott, BD, MontMed, Bayer, DEXCOM: Bayer, AstraZeneca, Boehringer Ingelheim, Roche, HLS Therapeutics.
T1 · E4
1 oct 2022
21:24

Recent Evidence for Fixed-Ratio Combinations of Basal Insulin and GLP-1 RA vs. Basal-Bolus Insulin in T2D: Updates from ADA 2022

Fixed-ratio combinations of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) have demonstrated maintenance of HbA1c efficacy, less hypoglycemia, and weight loss compared to basal-bolus insulin therapies in previous trials, but what is the latest evidence comparing these strategies in those with type 2 diabetes? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Jeremy Gilbert, an endocrinologist at the Sunnybrook Health Sciences Centre and Associate Professor at the University of Toronto Department of Medicine. He has authored chapters in recent Diabetes Canada Clinical Practice Guidelines and is the national lead for dissemination and implementation for the current guidelines. He is also an executive and national editor for the Canadian Journal of Diabetes, and the endocrinology section chair at the Royal College and Surgeons of Canada. This episode discusses data from several studies recently presented at the ADA 2022 Scientific Sessions comparing fixed-ratio combinations of basal insulin and GLP-1 RA vs. basal-bolus regimens in type 2 diabetes, including the SoliSimplify and SoliComplex Real-World Studies, and the IDegLira HIGH Trial. The SoliSimplify and SoliComplex Studies directly compared iGlarLixi (insulin glargine 100 U/mL and lixisenatide) vs. a basal-bolus regimen in those with type 2 diabetes advancing from basal insulin therapy, evaluating HbA1c and body weight outcomes, and treatment persistence and adherence outcomes, respectively. The IDegLira HIGH Trial compared the efficacy and safety of IDegLira (insulin degludec and liraglutide) vs. a basal-bolus regimen in those with poorly controlled type 2 diabetes and very high HbA1c. Our experts also dive into the relevance and applicability of these recent study findings to clinical practice. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Gilbert: Membership on advisory boards or speaker’s bureau: Abbott, Astra Zeneca, Amgen, Bayer, Boerhringer, Dexcom, Eli Lilly, HLS therapeutics, Janssen, Phizer, Novo Nordisk, Sanofi.
T1 · E3
1 oct 2022
14:38

Glucose Variability Results from the InRange Study

Metrics beyond HbA1c such as glucose variability are emerging as key parameters that can help guide the daily management of diabetes, but what is the clinical relevance of such measures, particularly for those with diabetes taking basal insulin? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Tadej Battelino, Professor, Head, and Chair of Pediatrics at the University of Ljubljana Faculty of Medicine, and Head of the Department of Pediatric and Adolescent Endocrinology at the UMC Ljubljana. There has been limited data on the utility of CGM as an outcome measure in clinical practice and a lack of evidence on the use of CGM to compare second-generation basal insulin analogues glargine 300 U/mL (Gla-300) and degludec 100 U/mL (IDeg-100). InRange was the first randomized controlled trial to compare Gla-300 and IDeg-100 in adults with type 1 diabetes using CGM data to assess time-in-range (TIR) as the primary endpoint. This episode discusses the within-day and between-day glucose variability data from the InRange study comparing Gla-300 and IDeg-100, of which Dr. Battelino was the primary investigator. Our experts also dive into the topics of why glucose variability should be a parameter of greater consideration, with a focus on coefficient of variation. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Battelino: Membership on advisory boards or speaker’s bureau: Novo Nordisk, Sanofi, Eli Lilly, Boehringer-Ingelheim, Medtronic, Indigo Diabetes, AstraZeneca, Sanofi, Roche. Funded grants, research or clinical trials: Abbott Diabetes Care, Medtronic, Novo Nordisk, Sanofi, Sandoz, Novartis. Other financial relationships/investments: owns stocks of DreaMed Diabetes.
T1 · E2
8 sept 2022
13:40

Prime Time for InRange: Comparison of Insulin Glargine 300 U/mL vs. Degludec 100 U/mL in Type 1 Diabetes

Continuous glucose monitoring (CGM) metrics are emerging as key parameters that can help guide the management of diabetes, but how can they be applied in clinical practice, particularly for those with diabetes taking basal insulin? Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Tadej Battelino, Professor, Head, and Chair of Pediatrics at the University of Ljubljana Faculty of Medicine, and Head of the Department of Pediatric and Adolescent Endocrinology at the UMC Ljubljana. Dr. Battelino also most notably led the 2019 International Consensus in Time in Range. There has been limited data on the utility of CGM as an outcome measure in clinical practice and a lack of evidence on the use of CGM to compare second-generation basal insulin analogues glargine 300 U/mL (Gla-300) and degludec 100 U/mL (IDeg-100). InRange was the first randomized controlled trial to compare Gla-300 and IDeg-100 in adults with type 1 diabetes using CGM data to assess time-in-range (TIR) as the primary endpoint. This episode discusses study design, key findings, and clinical implications from the InRange trial, of which Dr. Battelino was the primary investigator. Our experts also discuss the importance of CGM metrics such as TIR and coefficient of variation, and the practical relevance of using these markers to help people with diabetes establish personalized targets and proactively manage highs and lows to improve glycemic control. Don’t miss the conversation! The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent. Declaration of conflict of interest: Dr. Goldenberg: Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. Dr. Battelino: Membership on advisory boards or speaker’s bureau: Novo Nordisk, Sanofi, Eli Lilly, Boehringer-Ingelheim, Medtronic, Indigo Diabetes, AstraZeneca, Sanofi, Roche. Funded grants, research or clinical trials: Abbott Diabetes Care, Medtronic, Novo Nordisk, Sanofi, Sandoz, Novartis. Other financial relationships/investments: owns stocks of DreaMed Diabetes.
T1 · E1
8 sept 2022
16:03
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