Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!
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Show Segments
00:00 Introduction and Diabetes Puns01:00 Introduction of Guest and Topic09:12 Qualifications and Eligibility for CGMs11:32 Types of CGMs and Sensor Placement24:47 Interpreting CGM Data and Alarms34:30 Troubleshooting Patterns and Adjustments35:23 Understanding Hypoglycemia and Counter Regulatory Hormone Responses36:15 The Rule of 15 and Addressing Hypoglycemia37:10 Reducing Basal Insulin to Address Nocturnal Hypoglycemia38:29 Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin39:51 Managing Exercise-Induced Hypoglycemia41:43 Preventing Exercise-Induced Hypoglycemia with Snacks43:42 Managing Nocturnal Hypoglycemia with Sulfonylureas45:31 Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin46:54 Adjusting Basal Insulin to Address Morning Hyperglycemia51:18 Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin56:49 Managing High Blood Sugars with Basal Insulin and Mealtime Insulin57:44 Addressing Adherence and Medication Barriers59:39 Using Continuous Glucose Monitors (CGMs) for Diabetes Management01:02:30 Using Sulfonylureas and Basal Insulin Combination as a Stopgap01:05:49 Considering Patient Adherence and Barriers to Treatment
Credits
Writer and Producer: Matthew Watto MD, FACPShow Notes: Matthew Watto MD, FACPCover Art and Infographic: Matthew Watto MD, FACPHosts: Matthew Watto MD, FACP; Paul Williams MD, FACP Reviewer: Emi Okamoto MDShowrunners: Matthew Watto MD, FACP; Paul Williams MD, FACPTechnical Production: PodPasteGuest: Jeff Colburn MD
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