Special Edition: Focus on Geriatrics - Part 1 – August 2023

In this special series on The Cardiovascular Outcome Trials our host, Dr. Neil Skolnik will discuss the history and importance of the Cardiovascular Outcome Trials for diabetes medications. In Part 1 we discussed an historical perspective with Dr. Steven Nissen. Today we discuss with Dr. Darren McGuire the incredible evolution of the CVOTs since that time, and the most recent CVOT using new methodology, the SURPASS CVOT This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Darren McGuire, M.D,  Distinguished Teaching Professor, Jere H. Mitchell, M.D. Distinguished Chair in Cardiovascular Science, University of Texas Southwestern Medical Center and Parkland Health System

In this special episode on a Beta Cell Update Dr. Neil Skolnik discusses this emerging area with Dr. Melena Bellin. This special episode is supported by an independent educational grant from Sanofi. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Melena Bellin.  Professor, Pediatric Endocrinology, and Surgery, Co-Director, Total Pancreatectomy and Islet Autotransplant Program and the Albert D. and Eva J. Corniea Chair, University of Minnesota/ Masonic Children's Hospital      Selected References: Consensus guidance for monitoring individuals with islet autoantibody-positive pre-stage 3 type 1 diabetes. Diabetes Care 2024;47(8):1276–1298 An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med 2019;381:603-613 Management of Latent Autoimmune Diabetes in Adults: A Consensus Statement . Diabetes 2020;69(10):2037–2047 Resources for Auto-antibody Testing: Type 1 Diabetes TrialNet Centers of Excellence Locations Type 1 Risk test         Trialnet  

This issue will review: 1.     Effects of Semaglutide With or Without Concomitant Mineralocorticoid Receptor Antagonist Use in Participants With Type 2 Diabetes and Chronic Kidney Disease: A FLOW Trial Prespecified Secondary Analysis  - Diabetes Care 2.     Orforglipron, an Oral Small-Molecule GLP-1Receptor Agonist, in Early Type 2 Diabetes – NEJM 3.     Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment – NEJM 4.     Dementia Risk in People With Type 1 Diabetes and Associated Risk Factors – Diabetes Care 5.     Impact of baseline GLP-1 Receptor Agonist Use on Albuminuria Reduction and Safety With Simultaneous Initiation of Finerenone and Empagliflozin in Type 2 Diabetes and CKD – Diabetes Care 6.     Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity -  NEJM    Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

In this special series on The Cardiovascular Outcome Trials our host, Dr. Neil Skolnik will discuss the history and importance of the Cardiovascular Outcome Trials for diabetes medications . In Part 1 we discuss an historical perspective with Dr. Steven Nissen and how this has lead to the CVOTs that change the way we practice from EMPA-REG in 2015 to SURPASS-CVOT in 2025. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Steven Nissen, M.D., Chief Academic Officer of the Heart and Vascular Institute at the Cleveland Clinic and Professor of Medicine at the Clevland Clinic Lerner College of Medicine. Selected references: Nissen SE, Wolski K, Topol EJ. Effect of Muraglitazar on Death and Major Adverse Cardiovascular Events in Patients With Type 2 Diabetes Mellitus. JAMA. 2005;294:2581-2586 Kahn SE, Haffner SM, Heise MA, et al. Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy (ADOPT). N Engl J Med 2006;355:2427­43. DREAM trial investigators. Effect of rosiglitazone on the frequency of diabetes in patients with impaired glucose tolerance or impaired fasting glucose: a randomised controlled trial. Lancet 2006;368:1096 Nissen SE, Wolski K. Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes. N Engl J Med 2007;356:2457-2471.

In this special series on Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-associated steatohepatitis (MASH) our host, Dr. Neil Skolnik will discuss Epidemiology, Importance, Screening and treatment of MASH. This special episode is supported by an independent educational grant from Boehringer Ingelheim. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Jay Shubrook, D.O., Professor and Diabetologist in the Department of Clinical Sciences and Community Health At Touro University California College of Osteopathic Medicine Selected references: Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association. Diabetes Care 2025;48(7):1057–1082  

This issue will review: 1.     Once-weekly Ultra-processed Foods and Diet Quality in Association With Long-term Weight Change and Progression to Type 2 Diabetes Among Individuals With a History of Gestational Diabetes Mellitus—A Prospective Study 2.     Plant-Based Dietary Patterns Associated With Reduced Risk of All-Cause Mortality in Diabetes Subgroups 3.     Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes- NEJM   4.     Risk of Phimosis Associated With SGLT2i Versus GLP-1RA: A Danish Cohort Study 5.     GLP-1 Receptor Agonists and Sight-Threatening Ophthalmic Complications in Patients With Type 2 Diabetes Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss treatment of OSA. In Part 1 we discussed an overview of OSA, in Part 2 we discussed making the diagnosis, Part 3 was treatment, and in Part 4 we bring it all together with a case to explore clinical decision making for OSA. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Susan Kuchera, M.D. - Clinical Associate Professor of Family and Community Medicine at the Sidney Kimmel Medical College of Thomas Jefferson University and Program Director of the Family Medicine Residency at Jefferson Health Abington. Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med 2024;391:1193-1205  

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals. Intended for practicing physicians and health care professionals, Diabetes Core Update   discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review:   1.     Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity  - NEJM   2.     Once-weekly IcoSema versus multiple daily insulin injections in type 2 diabetes management (COMBINE 3)– Lancet Diabetes Endocrinology    3.     Nutritional priorities to support GLP-1 therapy for Obesity – A Joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society - American Journal of Clinical Nutrition 4.     Gradual Titration of Semaglutide Results in Better Treatment Adherence and Fewer Adverse Events – Diab Care 5.     Tirzepatide as Compared with Semaglutide for the Treatment of Obesity – NEJM For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org. Hosts: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

In this special episode on Strategies for Staying Full and Satisfied, our host, Dr. Neil Skolnik will moderate a discussion with Lily Correa, registered dietitian about communicating strategies for staying full and satisfied. This special edition of Diabetes Core Update is sponsored by Avocados - Love One Today ®.    For more information, as well as diabetes-friendly mean plans and a free downloadable toolkit just go to:http://loveonetoday.com/SatisfiedEating Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Lilian (Lily) M. Correa, Lily Correa is a registered dietitian and diplomate of the American College of Lifestyle Medicine   Resources and References:   Henning, Susanne M. et al. Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current Developments in Nutrition 2019, Volume 3, Issue 8, ISSN 2475-2991. https://doi.org/10.1093/cdn/nzz068.   Khan, Naiman A. et al. Avocado Consumption, Abdominal Adiposity, and Oral Glucose Tolerance Among Persons with Overweight and Obesity. The Journal of Nutrition 2021, Volume 151, Issue 9p2513-2521. https://doi.org/10.1093/jn/nxab187.   Lichtenstein, Alice H. et al. Effect of Incorporating 1 Avocado Per Day Versus Habitual Diet on Visceral Adiposity: A Randomized Trial. Journal of the American Heart Association 2022, Volume 11, Number 14. https://doi.org/10.1161/JAHA.122.02565.   Pacheco, Lorena S. et al. Effects of Different Allotments of Avocados on the Nutritional Status of Families: A Cluster Randomized Controlled Trial. Nutrients 2021, 13(11), 4021. https://doi.org/10.3390/nu13114021.   Senn, MacKenzie K. et al. Associations between avocado intake and measures of glucose and insulin homeostasis in Hispanic individuals with and without type 2 diabetes: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Nutrition, Metabolism and Cardiovascular Diseases 2023, Volume 33, Issue 12, 2428 – 2439. https://doi.org/10.1016/j.numecd.2023.08.002.   Wood, Alexis C. et al. Associations between Metabolomic Biomarkers of Avocado Intake and Glycemia in the Multi-Ethnic Study of Atherosclerosis. The Journal of Nutrition 2023, Volume 153, Issue 10, 2797 – 2807. https://doi.org/10.1016/j.tjnut.2023.07.013.   For more resources, research and recipes visit LoveOneToday.com/healthprofessionals.

In this special episode on Obstructive Sleep Apnea our host, Dr. Neil Skolnik will discuss treatment of OSA. In Part 1 we discussed and overview of OSA, in Part 2 we discussed making the diagnosis will, and Part 4 will look at cases. This special episode is supported by an independent educational grant from Lilly. Presented by: Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Sanjay Patel, M.D, Professor of Medicine, Epidemiology, & Clinical and Translational Science, and Director of the Center for Sleep and Cardiovascular Outcomes Research; Medical Director of the Comprehensive Sleep Disorders Program, University of Pittsburgh Medical Center Selected references: Diagnosis and Management of Obstructive Sleep Apnea - A Review. JAMA. 2020;323(14):1389-1400 Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity. N Engl J Med 2024;391:1193-1205