Medscape InDiscussion: Type 2 Diabetes

Drs Carol H. Wysham and Grazia Aleppo discuss how and when to use CGM in clinical type 2 diabetes practice, navigating patient resistance, and benefits in gestational diabetes.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002050. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Standards of Care in Diabetes—2025 https://diabetesjournals.org/care/issue/48/Supplement_1

7. Diabetes Technology: Standards of Care in Diabetes-2024 https://pubmed.ncbi.nlm.nih.gov/38078575/

Hyperglycemia and Adverse Pregnancy Outcomes https://pubmed.ncbi.nlm.nih.gov/18463375/

Diabetes Requires a Village: Northwestern Medicine's Diabetes Tune-up Pathway Program https://breakthroughsforphysicians.nm.org/diabetes-requires-a-village-diabetes-tune-up-pathway-program.html

Testing the Real-World Accuracy of the Dexcom G6 Pro CGM During the Insulin-Only Bionic Pancreas Pivotal Trial https://pubmed.ncbi.nlm.nih.gov/37668666/

Continuous Glucose Monitoring for Prediabetes: What Are the Best Metrics? https://pubmed.ncbi.nlm.nih.gov/38629784/

Defining Continuous Glucose Monitor Time in Range in a Large Community-based Cohort Without Diabetes https://pubmed.ncbi.nlm.nih.gov/39257191/

Drs Carol H. Wysham and Liana K. Billings discuss how to incorporate SGLT2 inhibitors and GLP-1 receptor agonists into the management of patients with type 2 diabetes and chronic kidney disease.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002049. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Type 2 Diabetes Mellitus https://emedicine.medscape.com/article/117853-overview

Chronic Kidney Disease (CKD) https://emedicine.medscape.com/article/238798-overview

Global, Regional, and National Burden of Chronic Kidney Disease Due to Diabetes Mellitus Type 2 From 1990 to 2021, With Projections to 2036: A Systematic Analysis for the Global Burden of Disease Study 2021 https://pubmed.ncbi.nlm.nih.gov/40034386/

Advantages, Limitations, and Clinical Considerations in Using Cystatin C to Estimate GFR https://pubmed.ncbi.nlm.nih.gov/36514729/

New Creatinine- and Cystatin C-Based Equations to Estimate GFR Without Race https://pubmed.ncbi.nlm.nih.gov/34554658/

Effects of Semaglutide on Chronic Kidney Disease in Patients With Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/38785209/

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy https://pubmed.ncbi.nlm.nih.gov/30990260/

Dapagliflozin in Patients With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/32970396/

Empagliflozin in Patients With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/36331190/

Chronic Kidney Disease and Risk Management: Standards of Care in Diabetes—2025 https://pubmed.ncbi.nlm.nih.gov/39651975/

CKD Early Identification & Intervention Toolkit https://kdigo.org/wp-content/uploads/2019/01/ISN_KDIGO_EarlyScreeningBooklet_WEB_updatedOct11.pdf

Combination Therapy as a New Standard of Care in Diabetic and Non-Diabetic Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/39907542/

Living With Chronic Kidney Disease and Type 2 Diabetes Mellitus: The Patient and Clinician Perspective https://pubmed.ncbi.nlm.nih.gov/36282450/

Drs Carol H. Wysham and Christopher M. Kramer discuss heart failure and type 2 diabetes, and the role of incretin therapies in the management of HFpEF.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002048. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

The Incidence of Congestive Heart Failure in Type 2 Diabetes: An Update https://pubmed.ncbi.nlm.nih.gov/15277411/

Hypertension in Diabetes: An Update of Basic Mechanisms and Clinical Disease https://pubmed.ncbi.nlm.nih.gov/34601960/

Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This statement does not represent an update of the 2017 ACC/AHA/HFSA heart failure guideline update https://pubmed.ncbi.nlm.nih.gov/31167558/

Insulin Resistance and Hyperinsulinaemia in Diabetic Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/26678809/

Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2024 https://pubmed.ncbi.nlm.nih.gov/38078592/

The Paradox of Low BNP Levels in Obesity https://pubmed.ncbi.nlm.nih.gov/21523383

Tirzepatide for Heart Failure With Preserved Ejection Fraction and Obesity https://pubmed.ncbi.nlm.nih.gov/39555826/

Cardiovascular Effects of Incretin-Based Therapies: Integrating Mechanisms With Cardiovascular Outcome Trials https://pubmed.ncbi.nlm.nih.gov/35050311/

Beyond Weight Loss: the Emerging Role of Incretin-Based Treatments in Cardiometabolic HFpEF https://pubmed.ncbi.nlm.nih.gov/38294187/

Heart Failure With Preserved Ejection Fraction: Mechanisms and Treatment Strategies https://pubmed.ncbi.nlm.nih.gov/34379445/

Obesity and Heart Failure With Preserved Ejection Fraction: New Insights and Pathophysiological Targets https://pubmed.ncbi.nlm.nih.gov/35880317/

Epidemiology of Heart Failure in Diabetes: A Disease in Disguise https://pubmed.ncbi.nlm.nih.gov/38334818/

Semaglutide in Patients With Heart Failure With Preserved Ejection Fraction and Obesity https://pubmed.ncbi.nlm.nih.gov/37622681/

Mechanisms of Benefits of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/37674356/

Finerenone in Heart Failure With Mildly Reduced or Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/39225278/

Effects of Tirzepatide on Circulatory Overload and End-Organ Damage in Heart Failure With Preserved Ejection Fraction and Obesity: A Secondary Analysis of the SUMMIT Trial https://pubmed.ncbi.nlm.nih.gov/39551891/

Effects of Tirzepatide on the Clinical Trajectory of Patients With Heart Failure, a Preserved Ejection Fraction, and Obesity https://pubmed.ncbi.nlm.nih.gov/39556714/

Tirzepatide Reduces LV Mass and Paracardiac Adipose Tissue in Obesity-Related Heart Failure: SUMMIT CMR Substudy https://pubmed.ncbi.nlm.nih.gov/39566869/6

Spironolactone for Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/24716680/

Drs Carol H. Wysham and Rozalina G. McCoy discuss the 2025 updates of the American Diabetes Association, including comorbidities, dental care, sexual dysfunction, and CGM use.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002047. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Standards of Care in Diabetes-2025 https://diabetesjournals.org/care/issue/48/Supplement_1

4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2025 https://pubmed.ncbi.nlm.nih.gov/39651988/

8. Obesity and Weight Management for the Prevention and Treatment of Type 2 Diabetes: Standards of Care in Diabetes-2025 https://pubmed.ncbi.nlm.nih.gov/39651976/

The Simplified Nutritional Appetite Questionnaire (SNAQ) as a Screening Tool for Risk of Malnutrition: Optimal Cutoff, Factor Structure, and Validation in Healthy Community-Dwelling Older Adults https://pubmed.ncbi.nlm.nih.gov/32967354/

Weight Regain and Cardiometabolic Effects After Withdrawal of Semaglutide: The STEP 1 Trial Extension https://pubmed.ncbi.nlm.nih.gov/35441470/

9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025 https://pubmed.ncbi.nlm.nih.gov/39651989/

1. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes-2025 https://pubmed.ncbi.nlm.nih.gov/39651974/

Drs Carol H. Wysham and Medha Munshi discuss type 2 diabetes in older adults, understanding geriatric syndromes and how they impact care, and when to de-escalate treatment.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002046. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Worldwide Trends in Diabetes Prevalence and Treatment From 1990 to 2022: A Pooled Analysis of 1108 Population-Representative Studies With 141 Million Participants https://pubmed.ncbi.nlm.nih.gov/39549716/

National Diabetes Statistics Report https://www.cdc.gov/diabetes/php/data-research/index.html

Home Modifications for Older Adults: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/36655622/

Geriatric Syndromes in Older Adults With Diabetes https://pubmed.ncbi.nlm.nih.gov/36948783/

The Relationship Between CGM-Derived Metrics, A1C, and Risk of Hypoglycemia in Older Adults With Type 1 Diabetes https://pubmed.ncbi.nlm.nih.gov/32461211/

Glycemic Control and Hypoglycemia in Patients Treated With Insulin Pump Therapy: An Observational Study https://pubmed.ncbi.nlm.nih.gov/32832557/

Drs Carol H. Wysham and Scott Isaacs discuss incorporating the screening and management of metabolic dysfunction–associated steatotic liver disease in endocrine practice.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/1002045. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Type 2 Diabetes Mellitus https://emedicine.medscape.com/article/117853-overview

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A State-of-the-Art Review https://pubmed.ncbi.nlm.nih.gov/37700494/

Fibrosis-4 (FIB-4) Calculator https://www.hepatitisc.uw.edu/page/clinical-calculators/fib-4

Liver Fibrosis Assessment: MR and US Elastography https://pubmed.ncbi.nlm.nih.gov/34687329/

Using the FIB-4, Automatically Calculated, Followed by the ELF Test in Second Line to Screen Primary Care Patients for Liver Disease https://pubmed.ncbi.nlm.nih.gov/38806580/

American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD) https://pubmed.ncbi.nlm.nih.gov/35569886/

Mediterranean Diet and Nonalcoholic Fatty Liver Disease https://pubmed.ncbi.nlm.nih.gov/29785077/

Drug Treatment for Metabolic Dysfunction-Associated Steatotic Liver Disease: Progress and Direction https://pubmed.ncbi.nlm.nih.gov/39470028/

Current Status of Glucagon-Like Peptide-1 Receptor Agonists in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Clinical Perspective https://pubmed.ncbi.nlm.nih.gov/39801787/

Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors https://www.ncbi.nlm.nih.gov/books/NBK576405/

Update on the Applications and Limitations of Alpha-Fetoprotein for Hepatocellular Carcinoma https://pubmed.ncbi.nlm.nih.gov/35110946/

Join Drs Carol Wysham and Silvio Inzucchi as they discuss how type 2 diabetes management has evolved over the years, and the most promising developments on the horizon.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982419). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Continuous Glucose Monitoring in Persons With Type 2 Diabetes Not Using Insulin https://pubmed.ncbi.nlm.nih.gov/34633261/

Macrovascular Complications of Type 2 Diabetes Mellitus https://pubmed.ncbi.nlm.nih.gov/30961498/

Rate of Decline in Kidney Function and Known Age-of-Onset or Duration of Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/34282181/

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/26378978/

Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/27299675/

Tirzepatide Prescribing Information https://uspl.lilly.com/mounjaro/mounjaro.html#pi

Glycemic Targets: Standards of Care in Diabetes-2023 https://pubmed.ncbi.nlm.nih.gov/36507646/

2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines https://pubmed.ncbi.nlm.nih.gov/30879355/

American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update https://pubmed.ncbi.nlm.nih.gov/35963508/

2018 ESC/ESH Guidelines for the Management of Arterial Hypertension https://pubmed.ncbi.nlm.nih.gov/30165516/

The Role of BNP Testing in Heart Failure https://pubmed.ncbi.nlm.nih.gov/17168346/

Semaglutide Effects on Cardiovascular Outcomes in People With Overweight or Obesity (SELECT) Rationale and Design https://pubmed.ncbi.nlm.nih.gov/32916609/

A Heart Disease Study of Semaglutide in Patients With Type 2 Diabetes (SOUL) https://clinicaltrials.gov/ct2/show/NCT03914326

GLP-1 Receptor Agonists and Kidney Protection https://pubmed.ncbi.nlm.nih.gov/31159279/

Glucagon-like Peptide 1 Receptor Agonists, Diabetic Retinopathy and Angiogenesis: The AngioSafe Type 2 Diabetes Study https://pubmed.ncbi.nlm.nih.gov/31589290/

A Study of Tirzepatide (LY3298176) Versus Insulin Lispro (U100) in Participants With Type 2 Diabetes Inadequately Controlled on Insulin Glargine (U100) With or Without Metformin (SURPASS-6) https://clinicaltrials.gov/ct2/show/NCT04537923

The Emerging Role of Glucagon-like Peptide-1 Receptor Agonists for the Management of NAFLD https://pubmed.ncbi.nlm.nih.gov/34406410/

Comparison of Noninvasive Markers of Fibrosis in Patients With Nonalcoholic Fatty Liver Disease https://pubmed.ncbi.nlm.nih.gov/19523535/

Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus https://pubmed.ncbi.nlm.nih.gov/30090738/

Join Drs Carol Wysham and Carel le Roux for practical, actionable strategies when targeting weight management as a key goal in type 2 diabetes prevention and treatment.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982418). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

UK Prospective Diabetes Study https://www.dtu.ox.ac.uk/ukpds/

National Diabetes Prevention Program https://www.cdc.gov/diabetes/prevention/index.html

The Finnish Diabetes Prevention Study (DPS): Lifestyle Intervention and 3-Year Results on Diet and Physical Activity https://pubmed.ncbi.nlm.nih.gov/14633807/

The Look AHEAD Study: A Description of the Lifestyle Intervention and the Evidence Supporting It https://pubmed.ncbi.nlm.nih.gov/16855180/

Antidiabetics, Glucagon-like Peptide-1 Agonists https://reference.medscape.com/drugs/antidiabetics-glucagon-like-peptide-1-agonists

Semaglutide (Rx) https://reference.medscape.com/drug/ozempic-rybelsus-wegovy-semaglutide-1000174

Weight Management: Obesity to Diabetes https://pubmed.ncbi.nlm.nih.gov/28848305/

Efficacy and Safety of Tirzepatide in Type 2 Diabetes and Obesity Management https://pubmed.ncbi.nlm.nih.gov/36750526/

Tirzepatide Once Weekly for the Treatment of Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

Opportunities abound to upgrade your technology in type 2 diabetes patient care. Join Dr Carol Wysham and nurse practitioner Davida F. Kruger in a discussion on the latest wearables and devices.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982417). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

SGLT2 Inhibitors and GLP-1 Receptor Agonists: Established and Emerging Indications https://pubmed.ncbi.nlm.nih.gov/34216571/

How May GIP Enhance the Therapeutic Efficacy of GLP-1? https://pubmed.ncbi.nlm.nih.gov/32396843/

Continuous Glucose Monitoring in Primary Care – Are We There? https://pubmed.ncbi.nlm.nih.gov/34845158/

Finger-Stick Glucose Monitoring: Issues of Accuracy and Specificity https://pubmed.ncbi.nlm.nih.gov/20351231/

FreeStyle Libre 3: "Almost Like Wearing Nothing" https://www.medscape.com/viewarticle/979580

FDA Okays Dexcom G7 Continuous Glucose Monitoring System https://www.medscape.com/viewarticle/985274

InPen https://www.medtronicdiabetes.com/products/inpen-smart-insulin-pen-system

Patch Pumps for Insulin https://pubmed.ncbi.nlm.nih.gov/30070604/

Join Dr Carol Wysham and Dr Katherine Tuttle as they discuss advances in kidney disease management in patients living with type 2 diabetes.

Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/982416). The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

National Kidney Foundation Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification https://pubmed.ncbi.nlm.nih.gov/12859163/

KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/32998798/

Prevalence of Non-diabetic Kidney Disease and Inability of Clinical Predictors to Differentiate It From Diabetic Kidney Disease: Results From a Prospectively Performed Renal Biopsy Study https://pubmed.ncbi.nlm.nih.gov/36517108/

Diabetes Control and Complications Trial / Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) https://repository.niddk.nih.gov/studies/edic/

UK Prospective Diabetes Study https://www.dtu.ox.ac.uk/ukpds/

Kidney Disease and Obesity: Epidemiology, Mechanisms and Treatment https://pubmed.ncbi.nlm.nih.gov/28090083/

Diet and Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/31728497/

SGLT2 Inhibitors and the Diabetic Kidney https://pubmed.ncbi.nlm.nih.gov/27440829/

GLP-1 Receptor Agonists in Diabetic Kidney Disease: From Clinical Outcomes to Mechanisms https://pubmed.ncbi.nlm.nih.gov/32694999/

Cardiovascular Outcomes Trials: A Paradigm Shift in the Current Management of Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/35927730/

Effects of Long-term Antihypertensive Treatment on Kidney Function in Diabetic Nephropathy https://pubmed.ncbi.nlm.nih.gov/4077229/

A Randomized Trial of Intensive Versus Standard Blood-Pressure Control https://pubmed.ncbi.nlm.nih.gov/26551272/

Effects of Intensive Blood-Pressure Control in Type 2 Diabetes Mellitus https://pubmed.ncbi.nlm.nih.gov/20228401/

Effects of a Fixed Combination of Perindopril and Indapamide on Macrovascular and Microvascular Outcomes in Patients With Type 2 Diabetes Mellitus (the ADVANCE Trial): A Randomised Controlled Trial https://pubmed.ncbi.nlm.nih.gov/17765963/

Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) https://pubmed.ncbi.nlm.nih.gov/36202661/

Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/27299675/

Empagliflozin in Heart Failure With a Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/34449189/

Cardiovascular and Renal Outcomes With Empagliflozin in Heart Failure https://pubmed.ncbi.nlm.nih.gov/32865377/