In the second episode of our type II diabetes series, our patient Tabby joins us for a discussion on non-insulin therapies.

Share your reactions and questions with us at Speak Pipe . We might feature you on a future episode!

=== Outline ===

1. Introduction
2. Chapter 5 - Patient Centered Approach
3. Chapter 6 - Medication
4. Chapter 7 - Comorbidities
5. Chapter 8 - Barriers to medication
6. Conclusion

=== Learning Points ===

1. There are several non-insulin medications for diabetes that can be differentiated by their mechanisms and all have different indications on when to use them
2. A patient’s comorbidities may guide your choice for starting a non-insulin therapy. 
3. Explaining the side effects of a medication in the context of its mechanism of action may go a long way in helping the patient manage expectations around new medications. 
4. Addressing mental health comorbidities such as depression and anxiety can be key to initiating and maintaining the management of diabetes.
5. Create adestigmatizing environment when asking patients about their medication consistency

=== Our Expert(s) ===

Dr. Tracy Rabin is an Internist and Pediatrician who joined the Yale faculty in 2011 as a member of the Section of General Internal Medicine (YSM Department of Internal Medicine), and currently serves as the Associate Program Director for Global and Community Health in the Yale Primary Care Internal Medicine Residency Program (YPC). She attends and teaches on the medical wards at the St. Raphael's Campus (SRC) of Yale-New Haven Hospital; directs care and precepts residents in the SRC Adult Primary Care Diabetes Clinic

=== References ===

1. [American Diabetes Association] Standards of Medical Care in Diabetes—2022 Abridged for Primary Care Providers: https://diabetesjournals.org/clinical/article/40/1/10/139035/Standards-of-Medical-Care-in-Diabetes-2022  
2. Figure depicting patient and disease factors that may be used to determine optimal HbA1C targets: Inzucchi, S.E., Bergenstal, R.M., Buse, J.B. et al. Management of hyperglycaemia in type 2 diabetes, 2015. Diabetologia 58, 429–442 (2015). https://doi.org/10.1007/s00125-014-3460-0 
3. Herkert D, Vijayakumar P, Luo J, Schwartz JI, Rabin TL, DeFilippo E, Lipska KJ. Cost-Related Insulin Underuse Among Patients With Diabetes. JAMA Intern Med. 2019 Jan 1;179(1):112-114. doi: 10.1001/jamainternmed.2018.5008. PMID: 30508012; PMCID: PMC6583414.

=== Recommended Reading ===

1. American Diabetes Association; 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2021. Diabetes Care 1 January 2021; 44 (Supplement_1): S111–S124. https://doi.org/10.2337/dc21-S009

=== About Us ===

The Primary Care Pearls (PCP) Podcast is created in collaboration with faculty, residents, and students from the Department of Internal Medicine at the Yale School of Medicine where give patients the autonomy to participate as experts of the lived experience of their condition.

Hosts: Katie Gielissen, Maisie Orsillo
Post-Production Assistant: Christina Liu, Helen Cai
Logo and name: Eva Zimmerman
Theme music and Editing: Josh Onyango
Other background music: Mini Vandals, Kevin MacLeod, Patrick Patrikios, Dan Bodan, Nate Blaze

Instagram: @pcpearls
Twitter: @PCarePearls
Listen on most podcast platforms: linktr.ee/pcpearls