Can Metformin Use Cut Wet AMD Risk?

Guest: Kumar Sharma, MD, FAHA, FASN What if we could identify diabetic kidney disease (DKD) before traditional markers reveal kidney damage? Dr. Kumar Sharma joins us to explore how emerging blood and urine biomarkers may help identify these underlying changes, improve disease staging, and guide future therapeutic strategies that build on the kidney-protective benefits of SGLT2 inhibitors. He's the Chief of the Division of Nephrology and Vice Chair for Research in the Department of Medicine at UT Health San Antonio.

Guest: Kumar Sharma, MD, FAHA, FASN Metabolic changes in the diabetic kidney can set off a cascade of cellular dysfunction, inflammation, and fibrosis that contributes to kidney damage. Join Dr. Kumar Sharma, Chief of the Division of Nephrology and Vice Chair for Research in the Department of Medicine at UT Health San Antonio, as he explains how metabolic rewiring, mitochondrial dysfunction, and excess adenine production contribute to the progression of diabetic kidney disease (DKD).

Guest: Emily Wan, MD, MPH Mucus plugging is increasingly recognized as an important radiographic biomarker in patients with COPD, but what does its presence mean for clinical outcomes? Joining us to share insights from her presentation at the 2026 GOLD International COPD Conference is Dr. Emily Wan. She discusses the high prevalence of CT-detected mucus plugs, their distinction from symptomatic chronic bronchitis, and their associations with lung function decline, acute exacerbations, and increased all-cause mortality. Dr. Wan is the Section Chief of Pulmonary and Critical Care at the Minneapolis VA Health Care System and an Associate Professor of Medicine at the University of Minnesota.

Guest: Kumar Sharma, MD, FAHA, FASN How does altered glucose metabolism contribute to kidney damage in patients with diabetes? Join Dr. Kumar Sharma, Chief of the Division of Nephrology and Vice Chair for Research in the Department of Medicine at UT Health San Antonio, as he explores the metabolic shift from fatty acid oxidation to glycolysis in proximal tubular cells, examining how excess glucose drives lactate production and disrupts mitochondrial function. Learn how emerging findings from patient kidney biopsies are advancing our understanding of metabolic dysfunction in diabetic kidney disease (DKD).

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Ted Kyle Effective obesity care starts with recognizing the complexity of the condition and the impacts of weight bias and stigma on patient care. Joining Dr. Peter Buch to discuss the evolving role of GLP-1–based therapies and explore how shared decision-making can help clinicians engage patients as active partners in long-term obesity care is Ted Kyle. He's the Founder of ConscienHealth, Policy and Advocacy Advisor to the Obesity Society, and Past Chair of the Obesity Action Coalition.

Guest: Javier Morales, MD, FACP, FACE The role of triple agonist therapies in obesity and type 2 diabetes management is evolving. Hear from Dr. Javier Morales as he explains how these therapies work and what these advances may mean for individualized treatment strategies. Dr. Morales is an Associate Clinical Professor of Medicine at the Barbara and Donald Zucker School of Medicine at Hofstra University and Northwell.

Host: Vaidehi S. Dedania, MD Guest: Yewlin E. Chee, MD Guest: Joshua H. Uhr, MD Does phacovitrectomy improve outcomes over conventional PPV for rhegmatogenous retinal detachment repair in a phakic eyes? Or does it introduce unnecessary complexity? Vaidehi Dedania, MD; Yewlin Chee, MD; and Joshua Uhr, MD, review results from a multicenter cohort study published in Ophthalmology Retina and discuss whether the study's findings have any bearing on real-world decision-making, parse generational differences regarding perceived phacovitrectomy risks, and review whether changes to technology during the course of the study may have affected the findings.

Host: Brian P. McDonough, MD, FAAFP Guest: David A. Johnson, MD, FACG, FACP Individualizing colorectal cancer screening isn't just about picking the "best" test; it's about picking the one your patient will actually complete. From weighing risk and preference to anticipating barriers with follow-up care, real-world adherence patterns can help providers guide patients toward the right screening pathway. Joining Dr. Brian McDonough to discuss how clinicians can personalize colorectal cancer screening recommendations to improve long-term adherence is Dr. David Johnson, Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School at Old Dominion University.

Host: Maria Berrocal Guest: Dimitra Skondra, MD Could metformin reduce risk of wet AMD development? Maria Berrocal, MD, speaks with Dimitra Skondra, MD, PhD, about a study published in Ophthalmology Retina finding that metformin exposure was associated with up to 30% lower odds of new-onset wet AMD. They discuss what the findings mean for patients with and without diabetes, where the protective effect appears to break down, and what a prospective trial could tell us next.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: John A. Scolaro, MD MA For anticoagulated patients with orthopedic or trauma fractures, delaying surgery to reduce bleeding risk may carry its own consequences. Join Dr. Charles Turck and Dr. John Scolaro as they explore how factors like surgical approaches, anticoagulation indications, comorbidities, transfusion-related risks, and physiologic reserve inform reversal decisions and discuss why multidisciplinary communication and timely intervention are critical throughout perioperative care and rehabilitation. Dr. Scolaro is an Associate Professor, Residency Program Director, and Chief of Orthopedic Trauma in the Department of Orthopedic Surgery at the University of California, Irvine.