Special Edition - Compounded Medication in Diabetes Care Perspectives from Patients, Physicians and Pharmacists– February 2025

In this special episode on Treatment of Heart Failure with Preserved Ejection Fraction (HFpEF) our host, Dr. Neil Skolnik will lead a case-based discussion on HFpEF, presenting challenges and integration of emerging evidence into clinical practice. This special episode is supported by an independent educational grant from Roche. 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 Susan Kuchera, M.D. - Clinical Assistant 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. Muthu Vaduganathan M.D. - Cardiologist and Co-Director, Center for Cardiometabolic Implementation Science at Brigham and Women’s Hospital and Harvard Medical School; Associate Editor of the Journal of the American College of Cardiology.   Selected references referred to the in the Podcast: Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association.  Diabetes Care 2022  2023 American College of Cardiology Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction (HFpEF). Journal of the American College of Cardiology 2023 Time to Clinical Benefit of Dapagliflozin in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction. JAMA Cardiology 2022;7(12):1259-1263    

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.     Dapagliflozin plus calorie restriction for remission of type 2 diabetes 2.     Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity 3.     Effectiveness of Empagliflozin vs Dapagliflozin for Kidney Outcomes in Type 2 Diabetes 4.     Tirzepatide Associated With Reduced Albuminuria in Participants With Type 2 Diabetes 5.     Use of SGLT2i Versus DPP-4i as an Add-On Therapy and the Risk of PAD-Related Surgical Events (Amputation, Stent Placement, or Vascular Surgery)   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 edition of Diabetes Core Update, host Neil Skolnik, MD, explores the timely and critical topic of compounded medications in diabetes care. In this episode Dr. Skolnik moderates a discussion between a family doctor, a patient, and a pharmacist about practical decision making around the topic of compounded medication for the treatment of overweight and obesity. This special edition of Diabetes Core Update is supported by Lilly. Presented by: Neil Skolnik, MD – Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington–Jefferson Health John Hertig, PharmD, MS, CPPS – Associate Professor, Butler University College of Pharmacy and Health Sciences Susan Kuchera, MD - Clinical Assistant 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. Lisa Kessler MS, CCC-SLP - Infant-toddler Homebased Pediatric Speech-Language Pathologist Compounded GLP 1 and Dual GIP/GLP 1 Receptor Agonists: A Statement from the American Diabetes Association. Diabetes Care December 2, 2024;  dci240091 https://doi.org/10.2337/dci24-0091 PubMed: 39620926 FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss.  US FDA Website ( current as of 12/18/2024)

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.     Large Language Model GPT-4 Compared to Endocrinologist Responses on Initial Choice of Antidiabetic Medication   2.     Long term health outcomes in people with diabetes 12 months after hospitalization with COVID-19 in the UK: a prospective cohort study 3.     Risk of nephrolithiasis associated with SGLT2 inhibitors versus DPP4 inhibitors among patients with type 2 diabetes: a target trial emulation study 4.     Early Screening for Latent Autoimmune Diabetes in Adults to Improve Care—Beyond the Routine 5.     Project ECHO Diabetes Trial Improves Outcomes for Medically Underserved People   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

This is the second episode in a special three-part series of the Diabetes Core Update podcast, focusing on heart failure with preserved ejection fraction (HFpEF) in people with diabetes. Sponsored by Roche, this series provides primary care clinicians and healthcare professionals with actionable insights into screening, diagnosis, and treatment of HFpEF, a major complication in cardiometabolic care. In this episode, host Dr. Neil Skolnik discusses treatment strategies for HFpEF with expert guest Dr. James Jannuzzi, a cardiologist and professor at Harvard Medical School. Building on the first episode’s discussion of screening and diagnosis, this installment highlights evidence-based treatments and their integration into diabetes care. Presented by: ·       Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health ·       James Jannuzzi, MD, Professor of Medicine at Harvard Medical School, Staff Cardiologist at Massachusetts General Hospital, and Senior Cardiometabolic Faculty at Baim Institute for Clinical Research. Selected references: ·       Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association. Diabetes Care 2022 ·       2023 American College of Cardiology Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction. Journal of the American College of Cardiology 2023 Tune in to the third and final episode, where the series will explore clinical decision-making and case-based applications of HFpEF treatments. This special edition of Diabetes Core Update is sponsored by Roche.  

Welcome to this special edition of Diabetes Core Update, where host Dr. Neil Skolnik takes a deep dive into the transformative role of continuous glucose monitoring (CGM) in diabetes care. Through engaging conversations with two leading experts, Dr. Skolnik explores the latest advancements in CGM technology, its clinical benefits, and its growing accessibility. Packed with valuable insights, this episode is an essential listen for healthcare professionals navigating the evolving landscape of diabetes management. This episode is sponsored by Dexcom, the #1 HCP-recommended CGM brand* and creators of Dexcom G7. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Eden Miller, DO, Founder of Diabetes Nation, a nonprofit organization, and CEO of Diabetes and Obesity Care, Bend, Oregon Eugene Wright, MD, Medical Director of Performance Improvement, Charlotte Area Health Education Center, Charlotte, North Carolina; Consulting Associate, Department of Medicine, Duke University Medical Center, Durham, North Carolina Select resources and studies mentioned in the podcast: https://pro.diabeteswise.org/en/resources https://www.aafp.org/pubs/fpm/issues/2024/0100/continuous-glucose-monitoring.pdf https://www.adces.org/danatech/glucose-monitoring/continuous-glucose-monitors-(cgm)/cgm-insurance-coverage-look-up Miller E, Chuang JS, Roberts GJ, Nabutovsky Y, Virdi N, Wright Jr. EE: Association of changes in A1C following continuous glucose monitoring acquisition in people with sub‐optimally treated type 2 diabetes taking GLP‐1 RA therapy. Diabetes Therapy 2024;15:2027-2038 https://doi.org/10.1007/s13300-024-01619-1 This special episode of Diabetes Core Update is sponsored by Dexcom, the #1 HCP-recommended CGM brand* and creators of Dexcom G7 (1). Dexcom G7 is a continuous glucose monitoring system, designed for patients with all types of diabetes (2). The American Diabetes Association recommends the use of CGM in people with diabetes, as CGM is clinically proven to lower A1C, reduce hyper- and hypoglycemia, and increase time in range (3). Getting started with Dexcom G7 is easy, with only one prescription needed. Visit https://Dexcom.com/ADA for prescribing information and to sample Dexcom G7 for free. *Based on a comparison in NPS scores across major CGM brands. References 1. Seagrove Partners, LLC. Seagrove Partners HCP Perspectives. 2022 2. Dexcom. Dexcom G7 User Guide. 2023 3. American Diabetes Association Professional Practice Committee. Standards of Care in Diabetes—2025. Diabetes Care 2025;48(Suppl. 1):S1–S352

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.     Results from a Randomized Trial of Intensive Glucose Management Using CGM Versus Usual Care in Hospitalized Adults with Type 2 Diabetes: the “TIGHT” Study 2.     Tirzepatide for Obesity Treatment and Diabetes Prevention  3.     Intensive Blood-Pressure Control in Patients with Type 2 Diabetes 4.     Association of Insulin Resistance With Radiographic Lung Abnormalities and Incident Lung Disease 5.     Association Life-course Associations between Ambient Fine Particulate Matter and the Prevalence of Prediabetes and Diabetes 6.     Semaglutide in Persons with Obesity and Knee Osteoarthritis   For more information about each of ADA’s science and medical journals, please visit www.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 edition of Diabetes Core Update, host Neil Skolnik, MD, explores the timely and critical topic of compounded medications in diabetes care. Dr. Skolnik is joined by John Hertig, PharmD, MS, CPPS, Associate Professor at the Butler University College of Pharmacy and Health Sciences, and Ed Hernandez, Executive Vice President and President of Manufacturing Operations at Eli Lilly & Company. Together, they discuss the role of compounded medications, the benefits and risks associated with their use, and the importance of ensuring quality and safety standards in the compounding process. This episode offers valuable insights for clinicians navigating the complexities of compounded therapies and provides practical considerations for patient care. This podcast is the first of a four-part series, “Compounding Concerns: Diabetes and Obesity Medications” in Diabetes Core Update’s 12-episode “Elevating Diabetes Care: Advanced Clinical Insights” program. This 3-episode series and the “Elevating Diabetes Care: Advanced Clinical Insights Program” are supported by Lilly.    The views, thoughts, and opinions expressed in this podcast belong solely to the individual speakers and do not necessarily reflect the views or opinions of Eli Lilly and Company or any of its affiliates. Presented by: Neil Skolnik, MD – Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington–Jefferson Health John Hertig, PharmD, MS, CPPS – Associate Professor, Butler University College of Pharmacy and Health Sciences Ed Hernandez – Executive Vice President, Eli Lilly & Company; President of Manufacturing Operations at Lilly Selected References: Compounded GLP 1 and Dual GIP/GLP 1 Receptor Agonists: A Statement from the American Diabetes Association. Diabetes Care December 2, 2024;  dci240091 https://doi.org/10.2337/dci24-0091 PubMed: 39620926 FDA’s Concerns with Unapproved GLP-1 Drugs Used for Weight Loss.  US FDA Website ( current as of 12/18/2024)

In this special episode of Diabetes Core Update, our host, Dr. Neil Skolnik, discusses with two expert guests the recommendations for respiratory vaccinations in people with diabetes, the rise in vaccine hesitancy and some of the possible reasons for this hesitancy, and several ways to address vaccine hesitancy in the office. This special edition is sponsored by Sanofi.  Presented by: Neil Skolnik, MD, 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, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair, Department of Family Medicine, Abington–Jefferson Health Aaron Sutton, LCSW, BCD, CAADC, Behavioral Health Faculty at the Family Medicine Residency Program at Abington–Jefferson Health; Chief Wellness Officer for Graduate Medical Education at Abington–Jefferson Health Select references mentioned in the podcast: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2024–25 Influenza Season. MMWR Recomm Rep 2024;73:1–25. DOI: 10.15585/mmwr.rr7305a1 Recombinant or Standard-Dose Influenza Vaccine in Adults Under 65 Years of Age. N Engl J Med 2023;389:2245–2255. DOI: 10.1056/NEJMoa2302099 Influenza Vaccine as a Coronary Intervention for Prevention of Myocardial Infarction. Heart 2016;102:1953–1956. DOI: 10.1136/heartjnl-2016-309983

Welcome to the first episode in a special three-part series of the Diabetes Core Update podcast, focused on heart screening in people with diabetes. Sponsored by Roche, this series explores "heart failure with preserved ejection fraction" (HFpEF), providing primary care clinicians and healthcare professionals with essential insights into screening, diagnosis, and management of this increasingly recognized condition. Episode Summary In this episode, host Dr. Neil Skolnik introduces the growing importance of HFpEF in diabetes care and is joined by two esteemed experts: Rodica Busui, MD, PhD, professor and chief of the division of endocrinology at the Oregon Health and Science University and past president of the American Diabetes Association for Medicine and Science. James Jannuzzi, MD, professor of medicine at Harvard Medical School, staff cardiologist at Massachusetts General Hospital, and senior cardiometabolic faculty at Baim Institute for Clinical Research. The discussion explores: HFpEF Basics: Definition, prevalence, and how it differs from heart failure with reduced ejection fraction (HFrEF). Pathophysiology: The multifactorial causes of HFpEF, including aging, obesity, diabetes, and more. Diabetes and HFpEF: Why HFpEF should be considered a major complication of diabetes alongside atherosclerotic and microvascular diseases. Screening Recommendations: Insights from the 2022 ADA/ACC Consensus Report, emphasizing early detection through biomarkers like NT-proBNP and annual testing for at-risk patients. Key Takeaways Epidemiology: HFpEF affects at least half of heart failure patients and is increasingly prevalent due to aging, obesity, and diabetes. Screening Guidelines: Every person with diabetes, especially those with chronic kidney disease, hypertension, or obesity, should be considered for HFpEF screening. Biomarkers: NT-proBNP thresholds are key tools for early diagnosis, with tailored considerations for obesity and other conditions. Prevention and Collaboration: Effective risk factor management and team-based care can prevent HFpEF progression and improve outcomes. Thank you for joining us on this first of a multipart series on early detection and treatment of heart failure with preserved ejection fraction. In the first part of this series, we focused on basics—epidemiology, pathophysiology, and staging—as well as the critically important new recommendations around screening people with diabetes for heart failure. In the second part of the series, we’ll explore treatment strategies for HFpEF. This special edition of Diabetes Core Update is sponsored by Roche.