Chronic kidney disease (CKD) is one of the most common complications of diabetes, but here’s the tricky part: you can have it for years without feeling any symptoms. The good news? Kidney disease can often be detected early, and with the right screening, treatments, and lifestyle changes, its progression can be dramatically slowed. 

In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus are joined by nephrologist Dr. Bethany Karl to break down what everyone with diabetes should know about kidney health. Dr. E also steps into the patient seat to share his own experience living with chronic kidney disease, from discovering it without symptoms to navigating kidney tests and newer treatments. Together, they explain the two simple tests that can uncover kidney problems, why blood pressure and cardiovascular health matter, and how today’s growing toolbox of medications is giving people with diabetic kidney disease more reasons for hope.

Key Topics:

• Why chronic kidney disease is often a “silent” complication of diabetes
• How diabetes can affect the kidneys over time
• Dr. Edelman’s personal experience with diabetic kidney disease
• The two important kidney tests: eGFR and UACR
• Why urine protein can be an important early warning sign
• How often people with diabetes should have their kidneys screened
• The connection between glucose, blood pressure, cholesterol, heart health, and kidney health
• Lifestyle considerations for protecting kidney function
• Medications that can help slow the progression of diabetic kidney disease
• Newer kidney-protective therapies and why there is more reason for optimism today

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Hot flashes, blood sugar swings, brain fog... is it menopause, diabetes, or both?

In this episode of the TCOYD Podcast, Dr. Steve Edelman is joined by renowned menopause expert Dr. Cindy Stuenkel, endocrinologist and Professor Emerita at UC San Diego, for an insightful conversation about how menopause affects women living with diabetes. Together, they explain why menopause is much more than a normal stage of aging. It's a major metabolic transition that can influence blood sugar management, insulin resistance, heart health, sleep, mood, and overall quality of life. 

The conversation explores what actually happens during perimenopause, menopause, and postmenopause, why hormonal fluctuations can make glucose management more challenging, and how continuous glucose monitoring can help distinguish hot flashes from hypoglycemia. Dr. Edelman and Dr. Stuenkel also discuss the latest evidence on hormone replacement therapy, newer non-hormonal treatment options, the importance of protecting heart health, and practical strategies to help women navigate this stage of life with greater confidence. Whether you're living with type 1 or type 2 diabetes, approaching menopause, currently experiencing it, or supporting someone who is, this episode provides practical guidance and evidence-based information to help you feel more prepared. 

Key Topics:

• What is perimenopause, menopause, and postmenopause?
• How hormonal changes affect blood sugar and insulin resistance
• Why menopause can increase glucose variability in women with diabetes
• The difference between hot flashes and hypoglycemia
• How continuous glucose monitoring can help during menopause
• Metabolic changes that occur during the menopause transition
• Why cardiovascular risk increases after menopause
• The connection between menopause, weight gain, and abdominal fat
• GLP-1 medications and menopause
• The latest recommendations on hormone replacement therapy
• New non-hormonal treatments for hot flashes
• Sleep, mood, brain fog, and quality of life during menopause
• Heart health strategies for women living with diabetes
• How partners can better support someone going through menopause
• Trusted menopause resources and when to seek medical care

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Have you or someone you know been diagnosed with type 2 diabetes, only to discover later it was actually type 1? You're not alone.

In this episode of the TCOYD Podcast, Dr. Steve Edelman is joined by Dr. Schaefer Boeder, endocrinologist, Medical Director of Paradigm Research, Associate Professor at UCSD, for an eye-opening discussion about LADA (Latent Autoimmune Diabetes in Adults)—one of the most commonly misdiagnosed conditions in diabetes. Together, they explain why so many adults are initially misdiagnosed with type 2 diabetes despite the warning signs that should raise suspicion for LADA, and why getting the correct diagnosis can dramatically change treatment and long-term outcomes.

The conversation explores how LADA differs from both classic type 1 and type 2 diabetes, why the autoimmune process develops more slowly, and when antibody testing should be considered. Dr. Edelman and Dr. Boeder also discuss the importance of preserving beta cell function, the role of continuous glucose monitoring, advances in disease-modifying therapies, and why there has never been a more exciting time for research in adults who developed type 1 diabetes later in life. Whether you've been diagnosed with LADA, care for someone who has, or simply want to better understand adult-onset autoimmune diabetes, this episode provides practical guidance and hope for more accurate diagnoses in the future.

Key Topics:

• What is LADA (Latent Autoimmune Diabetes in Adults)?
• Why LADA is so often mistaken for type 2 diabetes
• Common signs that may point to a misdiagnosis
• How LADA differs from classic type 1 and type 2 diabetes
• Why many adults don't fit the "typical" diabetes profile
• Autoantibody testing and when it should be considered
• The role of GAD antibodies and C-peptide testing
• Why preserving beta cell function matters
• Preventing diabetic ketoacidosis (DKA) through earlier diagnosis
• How continuous glucose monitoring can ease the transition to insulin
• Current treatment approaches for adults with LADA
• The latest research on disease-modifying therapies and preserving insulin production
• Screening resources, clinical trials, and where the future of LADA research is headed

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In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus are joined by Dr. Shara Bialo, Senior Medical Director of Type 1 Diabetes Immunology at Sanofi, pediatric endocrinologist, and person living with type 1 diabetes, for an in-depth discussion about what happens before type 1 diabetes is diagnosed. Together, they explore the autoimmune process that begins months or even years before symptoms appear, why early detection matters, and how screening is changing the future of type 1 diabetes care. 

Dr. Bialo shares her personal diagnosis story, discusses common misconceptions about what causes type 1 diabetes, and explains the three stages of the disease. The conversation also covers who should be screened, how diabetes autoantibody testing works, the benefits of preserving beta cell function, and why identifying people before they develop symptoms can lead to better long-term outcomes and fewer cases of diabetic ketoacidosis (DKA). Whether you have type 1 diabetes, have a family member at risk, or simply want to better understand the latest advances in prevention and early detection, this episode provides valuable insights into one of the fastest-moving areas of diabetes research.

Key Topics:

• Dr. Shara Bialo's personal journey living with type 1 diabetes
• Why type 1 diabetes is an autoimmune disease, not simply a blood sugar problem
• The role of genetics, viral infections, and the immune system
• Understanding the three stages of type 1 diabetes
• Why most people diagnosed with type 1 diabetes have no family history
• Adult-onset type 1 diabetes and why it is often mistaken for type 2 diabetes
• What diabetes autoantibodies are and how screening works
• Who should consider screening for type 1 diabetes
• Available screening options, including blood tests and home screening kits
• The emotional challenges families face when considering screening
• The importance of preventing diabetic ketoacidosis through early detection
• Why preserving beta cell function can improve long-term outcomes
• Italy's national screening program and the future of population-wide screening
• Resources available through screenfortype1.com

This content was produced with support from Sanofi and screenfortype1.com.

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In this episode of the TCOYD Podcast, Dr. Steve Edelman is joined by Raquel Baron, founder of Type One Together, to discuss the challenges, triumphs, and everyday realities of raising a child with type 1 diabetes. Diagnosed herself at age five, Raquel combines her lived experience with years of supporting families through Type One Together, an organization that provides trusted resources, educational programs, and a nationwide network of trained babysitters for children with type 1 diabetes. 

Together, Dr. Edelman and Raquel explore the emotional side of diabetes that often goes beyond blood sugars. They discuss helping children navigate school, sports, friendships, burnout, and growing independence, while giving parents practical strategies to reduce fear, build confidence, and create a healthier relationship with diabetes. The conversation also covers diabetes technology, social media, Afrezza for children, community support, and why perfection should never be the goal.

Whether you’re the parent of a newly diagnosed child or have been managing type 1 diabetes for years, this episode offers practical advice, reassurance, and reminders that children with diabetes can live full, active lives.

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In this episode of the TCOYD Podcast, Dr. Steve Edelman is joined by pediatric endocrinologist Dr. Anna Cymbaluk, along with Philip and his father Jim, to discuss the recent FDA approval of Afrezza inhaled insulin for children and adolescents living with type 1 diabetes. Dr. Cymbaluk served as an investigator on the INHALE-1 trial, while Philip participated in the study himself, providing a unique real-world perspective on what it is like to transition from injections to inhaled insulin, and Philip’s dad, Jim provided the parent perspective as well as addressed parental concerns that might have arisen.

The conversation focuses on the INHALE-1 study and the unmet challenges that continue to exist around mealtime insulin dosing in pediatric diabetes care. Dr. Cymbaluk reviews the trial design, glucose outcomes, safety data, patient satisfaction findings, and the practical realities of introducing inhaled insulin into everyday diabetes management. Philip and Jim share how Afrezza impacted school, sports, social situations, and the day-to-day burden of diabetes, particularly around pre-bolusing, corrections, and avoiding multiple injections throughout the day.
Dr. Edelman and Dr. Cymbaluk also explore how Afrezza is dosed, how inhaled insulin differs from injected insulin, who may be a good candidate, and where it may fit alongside pumps and automated insulin delivery (AID) systems. For families looking for more flexibility, fewer mealtime barriers, and another option in the diabetes toolbox, this episode provides an honest look at the benefits, limitations, and real-world experience of inhaled insulin in children and teens.

Key Topics
• The FDA approval of Afrezza for children and adolescents living with type 1 diabetes
• The design and results of the INHALE-1 pediatric clinical trial
• Patient satisfaction and quality-of-life outcomes from the study
• The challenges of pre-bolusing and mealtime insulin management in children and teens
• How inhaled insulin compares to traditional mealtime injections
• Dosing strategies, cartridge sizes, and insulin conversion considerations
• Using Afrezza for corrections, meals, and post-meal dosing
• The role of continuous glucose monitoring (CGM) when using inhaled insulin
• Safety findings, lung-function monitoring, and cough management
• Who may be a good candidate for Afrezza—and who may not be
• Benefits for active children, athletes, and those participating in sports
• Social situations, injection avoidance, and reducing the burden of diabetes management
• Using Afrezza alongside insulin pumps and automated insulin delivery (AID) systems
• The importance of having more treatment options to individualize diabetes care

Supported by an unrestricted educational grant from MannKind Corporation

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In this episode of the TCOYD Podcast, Drs. Edelman and Pettus are joined by pediatric endocrinologist Dr. Jamie Wood, medical director of pediatric diabetes at Rainbow Babies & Children's Hospital and an investigator on the INHALE-1 trial, to discuss inhaled insulin in children and its place in pediatric practice.

The conversation centers on the recent approval of Afrezza down to age six and what INHALE-1 actually demonstrated. Dr. Wood walks through the trial design, the A1C analysis, the FEV1 and pulmonary safety data, the weight and BMI findings, and the practical mechanics of dosing in a pediatric population. Rather than framing it as a replacement for injections or automated insulin delivery (AID), the discussion focuses on where this option fits, from the needle-averse newly diagnosed patient, to the teen trying to bolus discreetly during a 20-minute lunch period.

Drs. Edelman, Pettus, and Wood also get into the clinical realities that shape real-world use: the 2:1 to 3:1 conversion versus subcutaneous insulin, the set-dose cartridges and how they reframe carb counting, a refined titration approach, side effects, and how inhaled insulin can be layered alongside pumps and AID. For a population where mealtime bolusing remains one of the most stubborn unmet needs, it is a grounded look at a new tool and the patients it may help most.

Key Topics 

• The recent approval of inhaled insulin for children as young as six 
• How the INHALE-1 pediatric trial was designed 
• A1C results and what the primary endpoint analysis showed 
• Continuous glucose monitor (CGM) metrics across the two groups
• Lung-function (FEV1) monitoring and pediatric safety 
• Weight and body mass index (BMI) findings 
• Why mealtime dosing is a leading unmet need in pediatric type 1 diabetes (T1D) 
• The set-dose cartridge approach and how it reframes meal sizes 
• A real-world titration method for inhaled insulin 
• Managing cough and other practical considerations 
• Needle phobia and the kids who struggle most with injections 
• Using inhaled insulin alongside automated insulin delivery (AID) systems 
• What's coming next, including a smaller cartridge dose and a new-onset trial

This episode is supported by an unrestricted educational grant from MannKind Corporation.

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More diabetes resources:
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What diabetes technology is actually helping people right now—and how do you figure out what fits best into your life?

In this 100th episode of the TCOYD Podcast, Dr. E and Dr. P are joined by diabetes nurse practitioner and educator Rachael Sood, founder of The Diabetes Collective, to talk through the latest updates in diabetes technology and what they’re seeing in real-world diabetes care.

The conversation focuses on how much diabetes technology has changed over the past few years, from hybrid closed loop systems and CGMs to new developments in sensing and automation. Rather than focusing on one “best” device, the discussion centers around finding the right fit for each person’s lifestyle, preferences, and goals.

Dr. E, Dr. P, and Rachael also talk about where technology may be headed next, including dual glucose and ketone sensors, more compatibility between pumps and CGMs, and the possibility of systems that require less hands-on work from people living with diabetes. The takeaway is encouraging: there are more tools and options than ever before, and diabetes technology continues to move toward making daily management simpler, safer, and more flexible.

Key Topics
• Choosing the right insulin pump and CGM
• Tubed vs. tubeless pump systems
• How lifestyle and personal preference shape technology choices
• The latest updates in automated insulin delivery systems
• Dexcom G7 10-day vs. 15-day sensors
• Abbott’s dual glucose and ketone sensor technology
• Medtronic’s newest technology developments
• Real-world conversations patients have about wearing devices
• Continuous ketone monitoring and DKA prevention
• The future of fully closed loop systems
• Why compatibility between pumps and CGMs matters
• Technology options for people with type 2 diabetes
• Where diabetes technology may be headed next

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What if something was going on with your health and you didn’t feel any symptoms at all? Could it be metabolic dysfunction-associated steatohepatitis (MASH)? In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus talk about fatty liver and MASH, a condition that can develop quietly but still has a real impact over time. They’re joined by patient advocate Manuel Oliver, who shares his experience after being diagnosed and what helped him turn things around. 

They explain why fatty liver is so common, especially in people with metabolic conditions, and why it often goes unnoticed. The conversation also highlights how things can change over time, even when you feel okay, and why routine checkups matter.

Manuel shares what it was like to hear his diagnosis, how it affected him, and the steps he took to improve his health. You’ll also hear how care has evolved, including better ways to detect liver disease and more options to support treatment alongside lifestyle changes.

The message is simple: this condition can be serious, but there are ways to manage it, and taking action can make a meaningful difference.

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What does it really mean to be “gluten-free” and how do you know if it’s something you actually need?In this episode, Dr. Steve Edelman sits down with registered dietitian EA Stewart (aka The Spicy RD) to talk through the difference between celiac disease and gluten sensitivity, and why that distinction matters. They explain how celiac disease develops, why it’s often missed, and how it connects to other autoimmune conditions like type 1 diabetes.

This conversation helps make sense of a topic that can feel confusing. Dr. E and EA walk through symptoms that go beyond digestion, the importance of getting tested the right way, and what it means to truly follow a gluten-free diet.
They also talk about the day-to-day side of things—how to approach food, avoid cross-contamination, and build a way of eating that works in real life.
The main takeaway: not everyone needs to avoid gluten, but if you do, understanding the reason behind it can make it a lot more manageable

Key Topics
• What celiac disease is and how it differs from gluten sensitivity
• The role of genetics, triggers, and gluten exposure
• Why celiac disease is often undiagnosed
• Common and less obvious symptoms
• The connection between celiac disease and type 1 diabetes
• How to properly test for celiac disease
• Why you need to be eating gluten before testing
• What a gluten-free diet actually looks like
• Naturally gluten-free foods and better alternatives
• Hidden sources of gluten in everyday foods
• Cross-contamination and why it matters
• Nutrient deficiencies and when supplements may help
• Tips for eating out and traveling

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