Welcome back to Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives!

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, discuss the newly released Preexisting Diabetes in Pregnancy guidelines from The Journal of Clinical Endocrinology & Metabolism, which offer 10 key recommendations to improve outcomes in pregnant individuals with type 1 or type 2 diabetes.

00:00:00 Intro

00:01:25 Recommendations 1 and 2

00:02:27 Recommendation 3

00:07:11 Recommendation 4

00:09:58 Recommendation 5

00:14:51 Recommendations 6 and 7

00:19:05 Recommendation 8

00:23:11 Recommendation 9

00:25:11 Recommendation 10

Welcome back to Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives!

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, recapped highlights from the 2025 Endocrine Society annual meeting. They spotlighted advances, controversies, and ongoing unmet needs in type 1 diabetes care.

00:00:00 Intro

00:00:40 GLP-1 RAs in type 1 diabetes

00:05:50 Tirzepatide in type 1 diabetes

00:08:32 Cardioprotective therapies in type 1 diabetes

00:12:17 Type 1 diabetes Barbie and public education

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down with Carol Levy, MD, director of the Mount Sinai Diabetes Center and Type 1 Diabetes Clinical Research, to discuss the upcoming T1D Pregnancy and Me – or PRAM T1D – clinical study.

Enrollment for T1D Pregnancy & Me is currently open. Interested listeners can enroll at https://www.mountsinai.org/clinical-trials/t1d-pregnancy-me.

00:00:00 Introduction

00:01:43 The "why" behind the trial

00:04:24 The structure of the study

00:07:37 Will maternal outcomes be collected?

00:08:12 Can patients enroll themselves in this trial?

00:12:40 No devices will be excluded

00:15:20 Dividing data based on first versus later pregnancies

00:18:14 Will you continue to enroll after the first 500?

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, continue their recap of ADA’s 2025 Scientific Sessions, spotlighting 3 more of the top clinical trials focused on obesity and type 2 diabetes.

00:00:00 Intro

00:00:31 BELIEVE Trial

00:08:11 Phase 2 Maritide Trial

00:17:12 CATALYST-2

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, recap some of the biggest clinical trials presented at the American Diabetes Association (ADA) 2025 conference in Chicago, Illinois.

00:00 Introduction

2:04 The Vertex Trial

6:57 The T1D Trial

15:23 The Achieve 1 Trial

In this episode of Diabetes Dialogue, cohosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, recap some of the biggest clinical trials presented at the American Diabetes Association (ADA) 2025 conference in Chicago, Illinois.

00:00 Introduction

2:04 The Vertex Trial

6:57 The T1D Trial

15:23 The Achieve 1 Trial

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, recorded during the 85th Scientific Sessions of the American Diabetes Association (ADA 2025) in Chicago, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, speak with Rachael Sood, RN, MSN, APRN, NP, CDCES, founder of The Diabetes Collective, about modern approaches to diabetes care, patient engagement, and the role of social media in education and advocacy.

The discussion highlights Sood’s innovative use of social media to make diabetes education accessible and engaging. Known for creative and widely shared content—such as her wedding-themed video announcing the Dexcom G7 and Omnipod 5 integration—Sood shares how spontaneous, relatable messaging can improve awareness and patient connection. Her content spans emerging therapeutics like GLP-1 receptor agonists, type 1 diabetes staging and screening, and technology updates such as ketone monitoring and CGM integration.

Sood reflects on the emotional impact of recent ADA presentations, including advances in islet cell therapy and the evolving treatment landscape for both type 1 and type 2 diabetes. She emphasizes the importance of healthcare providers offering clear, empathetic, and tailored care, recounting a patient case where basic interventions—CGM use, education, and therapeutic escalation—had a transformative effect after years of clinical inertia.

The episode underscores the value of clinician-led care, continuity, and communication, particularly in independent practices. Sood also points to the importance of collaborative energy within the diabetes community, noting the power of partnerships among healthcare professionals, patients, and advocacy groups to drive progress.

In this episode of Diabetes Dialogue, recorded live at the 85th Scientific Sessions of the American Diabetes Association (ADA 2025), hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, welcome Jay Shubrook, DO, and Conan Tu, MD, to explore the mission and momentum of the American College of Diabetology.

The conversation centers on addressing the national shortage of diabetes specialists. Shubrook, a primary care diabetologist and founding figure in diabetology training, details the evolution of fellowship programs dating back to 2004, with the current infrastructure supporting 11 programs and plans for further expansion. Tu, an internist from New York, shares his personal journey into diabetology, emphasizing the increasing demand for diabetes-focused care in primary settings and the transformative impact of timely, expert-level interventions.

The guests outline how the American College of Diabetology is building a standardized, certified workforce through board certification, with an emphasis on team-based care. The College is also actively expanding to include pharmacists, nurse practitioners, and other healthcare professionals in its educational and certification efforts, helping to equip interdisciplinary teams to manage diabetes more effectively.

Additional discussion highlights include the importance of continuity of care—particularly during the transition from pediatric to adult diabetes services—the integration of cardiometabolic risk management, and the critical need for scalable models of care. The speakers advocate for diabetologists to serve not only as direct providers but as in-house experts, mentors, and system-level educators capable of elevating care across large networks.

In this episode of Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives, hosts Diana Isaacs, PharmD, and Natalie Bellini, DNP, speak with John Buse, MD, PhD, of the University of North Carolina School of Medicine, about the treatment phase of the CATALYST trial.

Findings from the phase 4 CATALYST trial suggest that mifepristone (Korlym), a glucocorticoid receptor antagonist, significantly improves glycemic control, reduces body weight, and lowers waist circumference in patients with hypercortisolism and difficult-to-control type 2 diabetes—offering a promising therapeutic option for a population with limited treatment success.

The two-part, multicenter study enrolled 1055 adults with type 2 diabetes and HbA1c >7.5% despite optimized therapy. In part 1, participants underwent dexamethasone suppression testing to identify hypercortisolism, defined by post-test cortisol levels >1.8 µg/dL and dexamethasone >140 ng/dL. Results revealed a 24% prevalence of hypercortisolism in this population (95% CI, 21.4–26.7%).

Part 2 randomized 136 patients with confirmed hypercortisolism in a 2:1 ratio to receive mifepristone or placebo for 24 weeks. The primary endpoint was change in HbA1c. Mifepristone treatment led to a least squares mean HbA1c reduction of 1.3 percentage points compared to placebo (95% CI, –1.81 to –0.83; P < .001).

Secondary endpoints also favored mifepristone: body weight decreased by 5.12 kg (95% CI, –8.20 to –2.03), and waist circumference dropped by 5.1 cm (95% CI, –8.23 to –1.99) relative to placebo.

Despite its efficacy, 49% of mifepristone-treated patients discontinued therapy, compared to 18% on placebo. Adverse events included hypokalemia, fatigue, nausea, vomiting, and elevated blood pressure, consistent with the drug’s known safety profile.

During the episode, which was recorded during the 85th Scientific Sessions of the American Diabetes Association (ADA 2025), Buse provides hosts with a deep dive into the background of the trial, prevalence of hypercortisolism in difficult-to-control type 2 diabetes, and the historic relevance of the CATALYST results. Buse also discusses how the trial offers insight into dosing approaches with mifepristone and advocates for broader cortisol screening in patients with complex type 2 diabetes—suggesting that ADA Standards of Care should reflect these findings.

In this special episode recorded at 85th Scientific Sessions of the American Diabetes Association (ADA 2025), hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and co-director of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, welcome Kevin Sayer, chief executive officer of Dexcom, for a candid conversation about the evolving landscape of continuous glucose monitoring (CGM). From Dexcom’s origins to the latest updates on G7 and the emerging Stelo app, the discussion traces the company's journey and innovation roadmap.

Sayer reflects on how sharing real-time glucose data transformed the diabetes management experience—making life safer not just for children but also for adults living independently, caregivers, and entire family networks. Dexcom’s emphasis on data transparency has laid the groundwork for a broader shift toward individualized care, especially for those with type 2 diabetes.

The episode dives into Dexcom’s growing footprint in type 2 diabetes management, with expanded coverage across the nation’s three largest pharmacy benefit managers. Sayer emphasizes that CGM is not just about preventing hypoglycemia in insulin users anymore—it’s a behavioral and educational tool. Patients can now “see” the impact of food choices, physical activity, and medication adherence in real time, prompting lifestyle changes that might otherwise take years of trial-and-error clinical encounters.

The hosts also explore the integration of AI-powered features like food recognition, enhancements in the Stelo app for wellness tracking, and the implications of new CGM algorithms as G7 expands to 15-day wear. Sayer addresses the unique needs of people with and without diabetes and the regulatory constraints in tailoring CGM algorithms to specific use cases.

In a lighter moment, Sayer shares his enthusiasm for Dexcom’s public-facing campaigns, including recent collaborations with Lance Bass and Nick Jonas as well as the company’s network of “Dexcom Warriors.”