ATTD: Advanced Technologies and Treatments for Diabetes

In this episode of ATTD Diabetes Talks, host Diana Isaacs is joined by Dr. Medha Munshi, Director of the Joslin Geriatric Diabetes Program and Professor of Medicine at Harvard Medical School. Together, they discuss the science behind weekly insulin, patient selection criteria, tailoring therapy to individual needs, and specific considerations for older or medically complex adults.

Key Takeaways:

• Criteria & Patient Characteristics for Weekly Insulin

• Managing Resistance, Comorbidities & Lifestyle

• Benefits for Older Adults & Complex Patients

• Individualizing Treatment & Best Practices

  
  

You can find more resources on the ATTD Education Portal. Register now to access exclusive content and stay ahead in the field.

This series is supported by Eli Lilly & Company.

In this episode, we explore the science behind weekly insulin, including the pharmacology of weekly insulin, its mechanism of action, how it differs from daily insulin formulations, and why it provides consistent control over a longer period.

Guest: Dr. Manasi Shah, Assistant Professor of Medicine at Eastern Virginia Medical School and Director of the Inpatient Diabetes Program at Sentara Norfolk General Hospital

Key discussion points:

• What are the key pharmacokinetic properties that enable once-weekly insulin administration?

• How does the pharmacodynamic profile differ from that of daily basal insulin formulations?

• What mechanisms allow weekly insulin to provide sustained glucose control over several days?

• How does this prolonged action translate into clinical glycemic stability?

• What are the key pharmacological considerations clinicians should be aware of when interpreting data on weekly insulin?

• What remaining scientific questions need to be addressed before broader clinical adoption?

You can find more resources on the ATTD Education Portal. Register now to access exclusive content and stay ahead in the field.

This series is supported by Eli Lilly & Company

In this inaugural episode of ATTD Diabetes Talks: The Power of Weekly Insulin, we delve into the evolution and future of basal insulin therapy. Host Diana Isaacs sits down with Dr. Rodolfo Galindo to explore the pharmacological innovations behind weekly insulin formulations and discuss how this breakthrough is reshaping modern diabetes management.

Guest: Dr. Rodolfo Galindo (Associate Professor of Medicine and Director of the Comprehensive Diabetes Center at the University of Miami Health System)

Key Topics Covered:

• The Evolution of Basal Insulin: A look back at the progression from early long-acting formulations to current weekly treatment options.

• Pharmacological Innovation: Understanding the science that makes weekly insulin formulations possible.

• Clinical Advantages: Exploring the theoretical benefits of weekly versus daily basal insulin.

• Patient Impact: Examining how shifting to a weekly regimen affects treatment burden and overall patient experience.

• Future Outlook: How weekly insulin is poised to fit into the broader landscape of diabetes care.

Resources:

• For more in-depth knowledge and exclusive content, visit the ATTD Education Portal.

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Join host Dr. David Ahn and guest Dr. Michael Haller (Professor and Chief of Pediatric Endocrinology at the University of Florida and Chair of TrialNet) as they take a comprehensive review of the evidence base and remaining gaps for inhaled insulin use in pediatric and adolescent populations

In this final episode, we dive into:

• Key Challenges in Pediatrics: Unmet needs in pediatric insulin therapy, including injection fatigue and tech-retention issues for active youth.

• The INHALE-1 Study: A deep dive into the randomized controlled trial data of 230 youth, highlighting efficacy, per-protocol non-inferiority, less weight gain, and superior treatment satisfaction among kids and parents.

• Safety Profile: Analyzing forced expiratory volume (FEV1) data showing an excellent safety signal with no differences in pulmonary function or severe hypoglycemic events.

• Practical Toolkit Use Cases: How the unique pharmacokinetic profile of inhaled insulin provides unmatched benefits for covering adrenaline-rush highs and avoiding hypoglycemia tail effects during sports and exercise.

• Dosing Guidelines: Overcoming the practical "paradigm shift" of converting injected units to inhaled units and managing dosing effectively.

• Future Horizons: Anticipating the "INHALE FIRST" study investigating early onboarding for newly diagnosed patients and introducing a new two-unit inhaled insulin cartridge.

About ATTD Diabetes Talks:

A podcast series dedicated to providing healthcare professionals with the latest knowledge and best practices in diabetes management, supported by MannKind Corporation.

Find more resources on the ATTD Education Portal: https://unlok-education.com/attd/

Subscribe to the podcast for more updates on advancing diabetes care.

#DiabetesManagement #PediatricEndocrinology #InhaledInsulin #ATTD #DiabetesCare #MedicalPodcast #Type1Diabetes

Chapters:

00:00 Intro and Unique Challenges in Pediatric Diabetes Management

02:38 The INHALE-1 Study: Efficacy, Satisfaction, and Weight Findings

06:27 Safety Signals, Pulmonary Function, and Adherence Challenges

10:18 Practical Toolkit Use Cases: Managing Sports and Exercise

12:48 Dosing Conversions and Practical Patient Selection Guidelines

15:02 Off-Label Integration with Automated Insulin Delivery (AID) Systems

20:14 Caregiver & School Nurse Roles and Managing Safety Concerns

22:00 Research Gaps, The INHALE FIRST Trial, and Wrap Up

Join host Dr. David Ahn and guest Dr. Roy Beck (Founder and Medical Director of the Jaeb Center for Health Research) as they explore the integration of inhaled insulin with automated insulin delivery (AID) systems.

In this episode, we dive into:

• The potential of combining inhaled insulin with current AID technologies.

• Theoretical advantages, including postprandial management.

• Current evidence, clinical considerations, and existing evidence gaps.

• Practical insights for clinicians on patient education and system integration.

About ATTD Diabetes Talks:

A podcast series dedicated to providing healthcare professionals with the latest knowledge and best practices in diabetes management, supported by MannKind Corporation.

Find more resources on the ATTD Education Portal: https://unlok-education.com/attd/

Subscribe to the podcast for more updates on advancing diabetes care.

#DiabetesManagement #AIDSystems #InhaledInsulin #ATTD #DiabetesCare #MedicalPodcast #Endocrinology

Chapters:

00:00 Intro

03:03 How Inhaled Insulin Works

07:30 Real World Dosing Workflow

10:24 Exercise and Safety Upside

15:45 Clinician Education Tips

17:38 Research Gaps and Trials Needed

19:32 Future Potential and Wrap Up

In this episode, we examine the concept of "therapeutic inertia" in diabetes care. Dr. David Ahn is joined by Dr. Grazia Aleppo, Professor of Medicine at the Feinberg School of Medicine, Northwestern University, to explore how inhaled insulin can help address the clinical and behavioral barriers often associated with insulin initiation.

Key discussion points:

• Defining therapeutic inertia in the context of insulin initiation.

• Common clinician and patient-related barriers that contribute to treatment delays.

• Practical strategies for introducing inhaled insulin to hesitant patients.

• System-level considerations, including workflow and reimbursement challenges.

Find more resources and exclusive content on the ATTD Education Portal: https://unlok-education.com/attd/

Make sure to subscribe to the ATTD Diabetes Talks podcast for more insights and updates. Let’s advance diabetes care together.

#DiabetesCare #Endocrinology #InhaledInsulin #ATTD #MedicalPodcast

Chapters:

00:00 Why Inhaled Insulin Matters

00:34 Show Intro and Guest

01:22 Defining Therapeutic Inertia

02:19 Clinician Barriers to Insulin

03:49 Patient Fears and Hesitation

05:28 How Inhaled Insulin Helps

07:00 Best Fit Patient Scenarios

08:22 Talking to Hesitant Patients

10:39 Workflow and Coverage Hurdles

13:35 PFT Testing and Side Effects

14:47 Future Role and Wrap Up

In our new series, The Role of Inhaled Insulin, host Dr David Ahn looks at the practical implementation of inhaled insulin in clinical practice. He is joined by Dr Irl Hirsch.

They discuss:

• Where inhaled insulin fits today within the overall insulin therapy landscape

• The best candidates for inhaled insulin in routine clinical practice

• Key clinical factors to guide decision-making

• Practical first steps to initiating inhaled insulin

• Approaches to titration

• Monitoring strategies, particularly regarding pulmonary safety and glycemic outcomes

• Shared decision-making and engaging patients

Dr Irl Hirsch is Professor of Medicine, in the Division of Metabolism, Endocrinology and Nutrition at the University of Washington School of Medicine. 

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In today’s episode, Dr Bob Gabbay is joined by Dr Elena Toschi to address the most common questions clinicians have when it comes to insulin therapy.

They discuss:

• The most common mistakes or misconceptions in basal insulin initiation and management

• Intensification strategies such as titration, adding prandial insulin, or using fixed-ratio combinations

• Leveraging technologies to improve insulin adherence and outcomes

• Managing hypoglycemia concerns and achieving glycemic targets

• Addressing psychological and behavioral barriers to insulin use in everyday clinical practice

Dr Elena Toschi is Assistant Professor of Medicine at Harvard Medical School. She’s also Director of the Young Adult Program and a member of the Diabetes Technology Program at the Joslin Diabetes Center.

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Make sure you’re subscribed to the ATTD Podcast feed today. Leave us a review and share with a colleague.

In today’s episode, Dr Bob Gabbay is joined by Dr Anne Peters to discuss personalized insulin approaches for complex populations.

They discuss:

• Why personalization is particularly important in insulin therapy

• The patient groups most in need of a tailored approach

• How comorbidities or frailty influence insulin decision-making

• Guidelines, flexibility, and local solutions

Dr Peters is a Professor of Medicine at the Keck School of Medicine of USC, and Director of the USC Clinical Diabetes Programs.

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In this episode, host Bob Gabbay and his guest, Diana Isaacs PharmD, break down common barriers to insulin adherence; from the common reasons people may struggle with insulin, to behaviour change approaches that can help clinicians support their patients.

They discuss:

• The barriers most misunderstood by clinicians

• Communication and motivational interviewing with patients

• Emotional burden and fear of hypoglycemia

• Practical strategies clinicians can use to support patients more effectively

• The role of the wider diabetes healthcare team

Diana Isaacs is an Endocrine Clinical Pharmacist and Director of Education and Training in Diabetes Technology at the Cleveland Clinic.

Explore more on the ATTD Education Portal. Register now to access exclusive content and stay ahead in the field!

Make sure you’re subscribed to the ATTD Podcast feed today. Leave us a review and share with a colleague.