What are the most effective ways for a diabetes care team to tackle the complexities and challenges of insulin management for patients?

Our host, Dr. Alice Cheng, discusses practical approaches in coordinating multidisciplinary diabetes care with Dr. Michelle Long, a Primary Care Physician based in Port Hope, Ontario, with more than 30 years in clinical practice, and Ms. Susie Jin, a Pharmacist and Certified Diabetes Educator based in Cobourg, Ontario, recognized for her national leadership in diabetes.

Together, our experts explore the importance of a connected care team—including endocrinologists, general practitioners, pharmacists, and diabetes educators—in optimizing insulin use for patients with diabetes. They discuss strategies for initiating insulin conversations, dispelling misconceptions, and leveraging the expertise of the entire care team. Tune in to hear practical tips for improving communication and collaboration among healthcare providers to better support individuals living with diabetes, especially in resource-limited settings.

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The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent. 

Additional resource for healthcare providers:

‘Insulin Pen Start Checklist’

Available at: https://guidelines.diabetes.ca/reduce-complications/insulin-checklist

Declaration of conflict of interest:  

Dr. Alice Cheng:

• Direct financial relationship, including receipt of honoraria: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi, CPD Network, Canadian Collaborative Research Network, Master Clinical Alliance, Canadian Medical & Surgical Knowledge Translation Research Group, Sea Courses, Alliance of Best Practices in Health Education, Partners in Progressive Medical Education, MD Briefcase, LMC Physician Inc., Medscape, Humber River Health, Timed Right, The ACADEMY, International Atherosclerosis Society, Canadian Cardiovascular Society, Diabetes Canada, ADA. Membership on advisory boards or speaker’s bureaus: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi. Funded grants, research, or clinical trials: Applied Therapeutics, Novo Nordisk, Sanofi.

Dr. Michelle Long:

• None.

Ms. Susie Jin:

• Direct financial relationship, including receipt of honoraria: Abbott, AbbVie, Boehringer Ingelheim, Dexcom, Sol-M, Canadian Association of Pharmacy Technicians, Canadian Pharmacists Association, Diabetes Canada, Manitoba Pharmacists Association, Ontario Pharmacists Association, Sun Life, Wounds Canada. Membership on advisory boards or speaker’s bureaus: AbbVie, Dexcom, Kenvue, Eli Lilly. Funded grants, research, or clinical trials: Boehringer Ingelheim.

MAT-CA-2500670

Curious about how primary care practitioners are managing the complexities of type 2 diabetes (T2D) in their practice?

Join our host Dr. Alice Cheng as she delves into this topic with Dr. James Kim, Clinical Assistant Professor in the Department of Family Medicine at the University of Calgary, lead editor for the Primary Care section of the Canadian Journal of Diabetes, and a key contributor within Diabetes Canada.

Our experts examine the critical role that primary care plays in the early diagnosis of T2D, personalizing and implementing treatment plans, and facilitating regular screening for potential complications. They stress the importance of managing both the physical and mental health of people living with diabetes, and provide practical strategies for organizing care and for maximizing the use of community resources.

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The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Alice Cheng:

• Direct financial relationships, including receipt of honoraria: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi, CPD Network, Canadian Collaborative Research Network, Master Clinical Alliance, Canadian Medical & Surgical Knowledge Translation Research Group, Sea Courses, Alliance of Best Practices in Health Education, Partners in Progressive Medical Education, MDBriefCase, LMC Physician Inc., Medscape, Humber River Health, Timed Right, The ACADEMY, International Atherosclerosis Society, Canadian Cardiovascular Society, Diabetes Canada, American Diabetes Association. Membership on advisory boards or speakers’ bureaus: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi. Funded grants, research, or clinical trials: Applied Therapeutics, Novo Nordisk, Sanofi.

Dr. James Kim:

• Direct financial relationships, including receipt of honoraria: Abbott, AbbVie, AstraZeneca, Boehringer Ingelheim, Eisai, embecta, Eli Lilly, GSK, Janssen, Novo Nordisk, Pfizer, Sanofi, Takeda, Searchlight, Otsuka, Teva. Membership of advisory board or speakers’ bureaus: Abbott, AbbVie, ALK, AstraZeneca, Bayer, Boehringer Ingelheim, Eisai, embecta, Eli Lilly, GSK, Novo Nordisk, Sanofi, Teva, Takeda, Searchlight, Valeo. Funded grants, research, or clinical trials: Novo Nordisk. All other investments or relationships: MDBriefCase, CPD Network, Academy for Continued Advancement in Healthcare Education, EOCI, Family Physician Airway Group of Canada, Liv Agency, PPME, CCRN.

MAT-CA-2401556

How is our understanding of autoimmunity in type 1 diabetes (T1D) shifting the way it’s detected and treated?

Our host, Dr. Alice Cheng, discusses this topic and more with Dr. Bruce Perkins, Professor, Endocrinologist, Epidemiologist, and Clinician-Scientist in the Faculty of Medicine and the Institute for Health Policy Management and Evaluation at the University of Toronto.

In this episode, the stages of T1D development and the role of autoimmunity are summarized, before examining the clinical benefits and challenges of autoantibody testing for the early detection of T1D. Current practices are discussed, as well as who should be prioritized for screening. Finally, our experts explore future directions of population-wide screening initiatives with the hopes of delaying or preventing clinical onset in those at high risk of developing T1D.

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The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Alice Cheng:

• Direct financial relationship, including receipt of honoraria: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi, CPD Network, Canadian Collaborative Research Network, Master Clinical Alliance, Canadian Medical & Surgical Knowledge Translation Research Group, Sea Courses, Alliance of Best Practices in Health Education, Partners in Progressive Medical Education, MD Briefcase, LMC Physician Inc., Medscape, Humber River Health, Timed Right, The ACADEMY, International Atherosclerosis Society, Canadian Cardiovascular Society, Diabetes Canada, ADA. Membership on advisory boards or speakers’ bureaus: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi. Funded grants, research, or clinical trials: Applied Therapeutics, Novo Nordisk, Sanofi.

Dr. Bruce Perkins:

• Direct financial relationship, including receipt of honoraria or in-kind compensation: Abbott, Sanofi, Insulet, Medtronic, Novo Nordisk. Membership on advisory boards or speakers’ bureaus: Abbott, Insulet, Sanofi, Novo Nordisk, Vertex. Funded grants, research, or clinical trials: Novo Nordisk, Bank of Montreal. Patents on a drug, product, or device: Boehringer Ingelheim.

MAT-CA-2401456 Nov 2024

What do we know about the developmental stages of type 1 diabetes (T1D), and how can this understanding ultimately lead to improved patient outcomes?

Our host, Dr. Alice Cheng, explores these questions with Dr. Bruce Perkins, Professor, Endocrinologist, Epidemiologist, and Clinician-Scientist in the Faculty of Medicine and the Institute for Health Policy Management and Evaluation at the University of Toronto.

Our experts kick off the discussion by identifying the key differentiators between type 1 and type 2 diabetes, before diving into the presence and involvement of autoantibodies in the development of T1D. Dr. Perkins details the stages of T1D, and explains how identification of early stages has the potential to improve patient outcomes and prevent serious illness.

Don’t miss the conversation!

The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Alice Cheng:

• Direct financial relationship, including receipt of honoraria: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi, CPD Network, Canadian Collaborative Research Network, Master Clinical Alliance, Canadian Medical & Surgical Knowledge Translation Research Group, Sea Courses, Alliance of Best Practices in Health Education, Partners in Progressive Medical Education, MD Briefcase, LMC Physician Inc., Medscape, Humber River Health, Timed Right, The ACADEMY, International Atherosclerosis Society, Canadian Cardiovascular Society, Diabetes Canada, ADA. Membership on advisory boards or speakers’ bureaus: Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Dexcom, Eli Lilly, GSK, Insulet, HLS Therapeutics, Medtronic, Novo Nordisk, Pfizer, Sanofi. Funded grants, research, or clinical trials: Applied Therapeutics, Novo Nordisk, Sanofi.

Dr. Bruce Perkins:

• Direct financial relationship, including receipt of honoraria or in-kind compensation: Abbott, Sanofi, Insulet, Medtronic, Novo Nordisk. Membership on advisory boards or speaker’s bureaus: Abbott, Insulet, Sanofi, Novo Nordisk, Vertex. Funded grants, research, or clinical trials: Novo Nordisk, Bank of Montreal. Patents on a drug, product, or device: Boehringer Ingelheim.

MAT-CA-2401455 Nov 2024

As technology advances, what are the current and future digital innovations that can best serve patients with diabetes and improve diabetes management?

Our host, Dr. Ilana Halperin, discusses these innovations with Dr. Peter Lin, Director of Primary Care Initiatives at the Canadian Heart Research Centre, and a contributing author of the 2013 and 2018 Canadian Diabetes Guidelines.

Our experts delve into the evolving role of continued glucose monitoring and how its increased usage can lead to positive patient behaviour change. Advances in insulin delivery are also discussed, and how connected innovations can lead to decreasing the burden on patients and healthcare providers. Finally, our speakers touch on the potential role for AI in diabetes management.

Don’t miss the conversation!

The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Ilana Halperin:

• Direct financial relationship, including receipt of honoraria: Sanofi, Novo Nordisk, Dexcom, Abbott. Membership on advisory board: Sanofi, Dexcom

Dr. Peter Lin:

• Direct financial relationship, including receipt of honoraria: AstraZeneca, GlaxoSmithKline, Medexus, Moderna, Pfizer, Amgen, Novo Nordisk, Eli Lilly, Boehringer Ingelheim. Membership on advisory board or speaker’s bureaus: AstraZeneca, GlaxoSmithKline, Medexus, Moderna, Pfizer, Amgen, Novo Nordisk, Eli Lilly

MAT-CA-2400907

Why does the timely addition of basal insulin remain an important issue in practice, despite the increasing use of glucagon-like peptide-1 receptor agonists (GLP1-RA) seen in recent years?

Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Meera Luthra, an endocrinologist at St. Joseph’s Healthcare Hamilton and Clinician Educator at McMaster University.

The episode discusses clinical inertia and approaches you may use in practice for treatment intensification to improve glycemic control, particularly around initiating basal insulin, for patients with type 2 diabetes (T2D). The importance of real-world studies is discussed, namely, the RESTORE-G and DELIVER-G studies, in the context of the efficacy behind adding basal insulin to GLP1-RA therapy to optimize glycemic control.

The RESTORE-G study examined treatment intensification approaches to adding basal insulin for patients with T2D already on a GLP1-RA therapy. The DELIVER-G study looked at the impact of the addition of second-generation basal insulin, glargine U300 for patients with T2D on GLP1-RA therapy. Our experts also dive into the relevance and applicability of some practical approaches for treatment intensification to improve glycemic control in clinical practice.

Don’t miss the conversation!

The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Ronald Goldenberg:

• Direct financial relationship, including receipt of honoraria: Abbott, Amgen, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, Hamilton Academy of Medicine, HIT Global, HLS, Insulet, Janssen, LiV, LMC Physician Inc., MD Briefcase, Novartis, Novo Nordisk, Sanofi, SL Solutions, Unik, Virtual Hallway Consults Inc. Membership on advisory boards or speakers’ bureaus: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Novo Nordisk, Sanofi. Funded grants, research, or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi.

Dr. Meera Luthra:

• Direct financial relationship, including receipt of honoraria: Amgen, Bayer, Boehringer Ingelheim, Dexcom, Eisai, Pfizer, Eli Lilly, Novo Nordisk, Sanofi. Membership on advisory boards or speakers’ bureaus: Dexcom, HLS Therapeutics, Novo Nordisk, Sanofi. Funded grants, research, or clinical trials: None

MAT-CA-2400799

Hypoglycemia associated with commonly used diabetes medications can be distressing and potentially lethal. What are the latest recommendations on prevention and treatment of hypoglycemia from the Diabetes Canada Clinical Practice Guidelines (CPG)?

Our host, Dr. Alexandria Ratzki-LeeWing, takes a deeper look into this topic together with Dr. Stewart Harris, a family doctor and professor at Western University in London.

This episode discusses highlights from the 2023 CPG chapter updates on hypoglycemia in adults. Our speakers explore how guidance on hypoglycemia has evolved in these new recommendations, and its impact on diabetes care for both people living with diabetes and clinicians.

They also touch on practical strategies to reduce hypoglycemia risk, and offer their perspectives on topics that may be expanded on in future CPG iterations.

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The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Ratzki-LeeWing

• Direct financial relationship including receipt of honoraria: Eli Lilly, Novo Nordisk, American Diabetes Association. Funded grants, research, or clinical trials: Sanofi Global.

Dr. Harris:

• Direct financial relationship including receipt of honoraria or in-kind compensation: Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi Aventis. Membership on advisory boards: Abbott, AstraZeneca, Bayer Inc., Dexcom, Eli Lilly, HLS Therapeutics, Janssen, Novo Nordisk, Sanofi Aventis. Funded grants, research, or clinical trials: Abbott, Applied Therapeutics Inc., AstraZeneca, Boehringer Ingelheim, Eli Lilly, Novartis, Novo Nordisk, Sanofi Aventis.

MAT-CA-2400059

Diabetes remission is a concept that has been gaining attention as new treatments and interventions become available in the Diabetes Canada Clinical Practice Guidelines. How do we define diabetes remission, and what strategies can we employ to sustain it once it has been attained?

Our host, endocrinologist Dr. Hertzel Gerstein, professor of medicine at McMaster University and Hamilton Health Sciences, takes a deeper look into this topic with Dr. Kaberi Dasgupta, a physician scientist and professor of medicine at McGill University and the McGill University Health Centre.

This episode explores the latest updates from the Diabetes Canada Clinical Practice Guidelines on remission of type 2 diabetes (T2D) and other new approaches in development.

In their discussion, they detail the definition of remission in diabetes and what it means for the patient, before explaining the importance of early intervention in T2D. Together, they review two approaches included in the Canadian clinical practice guidelines to achieving remission: bariatric surgery and low-energy diets. They also discuss the importance of sustaining weight loss by continuing to adhere to the same healthy diet and lifestyle modifications that were implemented to attain remission.

Ongoing research efforts focused on prevention, treatment, and remission of diabetes continue to emerge, with more discoveries expected in the future.

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The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Gerstein

• Membership on advisory board or speakers’ bureaus: Sanofi, Lilly, Merck, AstraZeneca, DKSH, Zuellig, Novo Nordisk, Abbott, Pfizer, Kowa, Hanmi, Carbon Brand, Jiangsu Hanson Pharma. Funded grants, research, or clinical trials: Eli Lilly, Merck, AstraZeneca, Novo Nordisk

Dr. Dasgupta:

• Funded grants, research, or clinical trials: CIHR, The Lawson Foundation, The JR McConnell Foundation.

MAT-CA-2300840

Numerous challenges afflict patients with type 1 diabetes (T1D) throughout their disease journey. How can newer, more innovative management approaches help patients overcome these challenges?

This episode discusses the challenges that regularly burden patients with T1D, and how recent technological breakthroughs, such as automated insulin pumps and continuous glucose monitoring (CGM), have been transformative in diabetes management.

Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Bruce Perkins, Professor, Endocrinologist, Epidemiologist, and Clinician Scientist in the Faculty of Medicine and the Institute for Health Policy Management and Evaluation at the University of Toronto, and Director of Leadership at the Sinai Centre for Diabetes. Together, they provide practical advice for patients and their healthcare team in managing T1D and discuss emerging developments that have the potential to shift the treatment paradigm in diabetes care.

Don’t miss the conversation!

The views and opinions expressed in this episode are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Ronald Goldenberg:

• Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speakers’ bureaus: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. 

Dr. Bruce Perkins:

• Direct financial relationship including receipt of honoraria: Novo Nordisk, Sanofi, Abbott, Insulet, Medtronic. Membership on advisory boards: Abbott, Insulet, Novo Nordisk, Sanofi, Vertex. Funded grants, research, or clinical trials: Bank of Montreal, Novo Nordisk. Patent on a drug, product, or device: Boehringer Ingelheim.

MAT-CA-2300841

With the abundance of various glucose monitoring technologies, how can healthcare providers guide patients with type 2 diabetes (T2D) toward the most appropriate choice?

Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Ilana Halperin, Endocrinologist at Sunnybrook Health Sciences Centre and Assistant Professor at the University of Toronto.

This episode discusses the limitations of previous-generation glucose monitoring devices and highlights the advantages of continuous glucose monitoring (CGM) with an emphasis on the most important parameters, namely time-in-range (TIR), time-below-range (TBR), and coefficient of variation (CV). The importance of clinical trials is discussed, namely, the IMMEDIATE and two-part MOBILE studies in the context of CGM for T2D.

The IMMEDIATE study examined the efficacy of intermittently scanned CGM in patients with T2D using non-insulin therapies. The MOBILE Phase 1 study explored the impact of CGM discontinuation after 8 months of use in adults with T2D treated using basal insulin without bolus insulin. Similarly, the MOBILE Phase 2 study assessed the effectiveness of CGM in adults with T2D treated with both basal insulin and bolus insulin in primary care practices. Our experts also dive into the relevance and applicability of these recent study findings to clinical practice.

Don’t miss the conversation!

The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Ronald Goldenberg:

• Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speakers’ bureaus: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. 

Dr. Ilana Halperin:

• Direct financial relationship including receipt of honoraria or in-kind compensation: Abbott, Dexcom, Novo Nordisk, Sanofi. Membership on advisory boards: Dexcom, Sanofi.

MAT-CA-2300748