Episodes
Thursday Jun 24, 2021
Raised From The Grave: A Second Life for Sotagliflozin?
Thursday Jun 24, 2021
Thursday Jun 24, 2021
The prevalence of heart failure in patients with diabetes is four times higher than in the general population. Likewise, chronic kidney disease (CKD) and diabetes are common morbidities. As new drug classes emerge in the management of diabetes and heart failure and CKD, it is important to thoroughly evaluate available literature and identify opportunities to reduce complications and costs. Sotagliflozin is a first-in-class dual SGLT-1 and 2 inhibitor approved in Europe. Does it improve outcomes in patients with heart failure or CKD?
Guest Authors: Maren Richards Brinton, PharmD and Jonathan C. Hughes, PharmD, BCPS, BCACP
Music by Good Talk
Friday Mar 19, 2021
Metformin During Pregnancy: Are the Results MiTy Enough to Change Practice?
Friday Mar 19, 2021
Friday Mar 19, 2021
The American Diabetes Association (ADA) currently recommends insulin as the preferred agent for the management of type 2 diabetes mellitus during pregnancy. However, metformin is routinely used as it has several advantages over insulin including the lower cost, less maternal weight gain, and less maternal hypoglycemia. The MiTy study explores the benefits and risks of a combination of metformin plus insulin.
Guest Authors: Hugh Quinn, PharmD and Mallory Telese, PharmD
Guest Panelists: Erin Raney, PharmD, BCPS, BC-ADM and Rebecca Stone, PharmD, BCPS, BCACP
Music by Good Talk
Friday Jan 15, 2021
Closing the Loop for Children with Type 1 Diabetes
Friday Jan 15, 2021
Friday Jan 15, 2021
Insulin pumps and continuous glucose monitors (CGM) have changed the standard of care for managing Type 1 Diabetes. A closed-loop system (also described as an artificial pancreas or automated insulin delivery system) consists of a CGM, an insulin pump, and a control algorithm that automatically calculates basal insulin delivery based on real-time glucose levels. Closed-loop insulin pumps may offer an opportunity to improve glycemic management while reducing some of the associated stress. However, there are limited data evaluating the safety and efficacy of this technology in children less than 14 years old.
Guest Authors: Mary K Culp, PharmD and Diana Isaacs, PharmD, BCPS, BCACP, BC-ADM, CDCES
Music by Good Talk
Friday Dec 11, 2020
Canagliflozin Comeback? New Data on the Risk of Amputation
Friday Dec 11, 2020
Friday Dec 11, 2020
Patients with diabetes are 10 times more likely to experience lower limb amputations than the general population and amputations have very significant morbidity, mortality, and financial implications. While common risk factors for amputation in patients with diabetes include poor glycemic control, diabetic peripheral neuropathy, or peripheral arterial disease, canagliflozin use was implicated in the CANVAS and CANVAS-R trials. However, the CANVAS Program trials were not specifically designed to evaluate the risk of lower-extremity amputations. Clearly, we need more information about the magnitude of risk when canagliflozin is used widely in a general population and who is at most risk.
Guest Authors: Julie Dally, PharmD, BCPS, BCACP and Amanda Schartel, PharmD, BCACP
Music by Good Talk
Friday Dec 13, 2019
Is Dapagliflozin aDAPtAble to Treating HFrEF in Patients Without Diabetes?
Friday Dec 13, 2019
Friday Dec 13, 2019
Heart failure with reduced ejection fraction (HFrEF) is associated with significant morbidity and mortality. Current guidelines recommend a renin-angiotensin inhibitor, beta-blocker, and aldosterone antagonist to reduce morbidity and mortality in these patients. Despite the use of multiple drug classes, 5-year mortality rates hover near 50% in patients with heart failure (HF). Despite the numerous medications available, mortality and the risk of HF hospitalizations remains high. Sodium-glucose cotransporter-2 inhibitors (SGLT2-I) have been shown to reduce HF hospitalizations in patients with diabetes. Could this medication class be useful for HF treatment even in patients without diabetes?
Guest Authors: John Andraos, PharmD; Alexa Zeiger, PharmD; and Michael S. Kelly, PharmD, BCACP
Music by Good Talk
Thursday Oct 24, 2019
Will Oral Semaglutide PIONEER the Way to Lower Cardiovascular Risk?
Thursday Oct 24, 2019
Thursday Oct 24, 2019
Until recently, glucagon-like-peptide-1 (GLP-1) receptor agonists were only available as injectable products. Some clinicians and patients are reluctant to use injectable agents because they require additional patient education and can be intimidating. If a GLP-1 receptor agonist were available in an oral dose form, it would be welcomed treatment option. But would the cardiovascular safety and benefits of oral GLP-1 receptor agonists be better, similar, or worse than their injectable siblings?
Guest Authors: Sally Earl, PharmD, BCPS and Megan Supple, PharmD, BCACP
Music by Good Talk
Friday Sep 21, 2018
Maybe Old is Gold? Newer Insulins Might Not Be Better – Just More Expensive
Friday Sep 21, 2018
Friday Sep 21, 2018
Fredrick Banting, the Canadian scientist who discovered insulin in 1921 and sold the patent for just $1 to the University of Toronto and made it available to pharmaceutical companies royalty-free, would be disappointed to know that the high cost of insulin is now a major barrier to treatment. The average price of insulin has nearly tripled, from $4.34/ml in 2002 to $12.92/ml in 2013. Insulin’s high cost affects everyone: (1) uninsured patients, (2) insured patients with high co-payments and deductibles, (3) Medicare beneficiaries with coverage gaps and fixed income, and (4) everyone else paying higher premiums to offset the insurers’ expenditures. Are the newer insulins really worth the extra cost? A new study by investigators at Kaiser Permanente Northern California suggests that most patients can safely use NPH insulin instead of more expensive insulin analogs.
Download the podcast patient case: NPH vs Insulin Analogs
Guest Authors: Jaini Patel, PharmD, BCACP and Regina Arellano, PharmD, BCPS
Music by Good Talk
Friday Apr 13, 2018
Friday Apr 13, 2018
Patients with type 1 diabetes often have sub-optimal glycemic control. The gold standard of treatment is basal-bolus insulin or continuous subcutaneous insulin infusion via an insulin pump. However, only a third of patients with type 1 diabetes achieve the American Diabetes Association A1C goal <7%. There has been particular interest in using SGLT-2 inhibitors in patients with type 1 diabetes due to their ability to decrease body weight and blood pressure as well as improve glycemic control and perhaps cardiovascular outcomes. InTandem3 was a phase III, multicenter, randomized, double-blind, placebo-controlled trial evaluating the safety and efficacy of sotagliflozin, a novel dual SGLT 1 and 2 inhibitor, in patients with Type 1 diabetes.
Guest Author: Diana Isaacs, Pharm.D., BCPS, BD-ADM, CDE
Music by Good Talk
Friday Feb 02, 2018
SPRINTing towards lower BP goals : A re-analysis of the ACCORD-BP trial
Friday Feb 02, 2018
Friday Feb 02, 2018
The new 2017 ACC/AHA guidelines recommend a BP goal of <130/80 mmHg for everyone – including patients with diabetes. The 2018 ADA guidelines also recommend a goal of <130/80 mmHg, but only in patients at high risk of cardiovascular disease and only when it can be achieved without undue treatment burden. This change in recommendations is largely driven by results of the Systolic Blood Pressure Intervention Trial (SPRINT), which demonstrated a 25% reduction in the primary composite outcome of CV events with intensive BP control (SBP target <120 mmHg). However, extrapolating these findings to patients with T2DM has been challenging as patients with diabetes were excluded from SPRINT. A recent re-analysis of the ACCORD-BP study shed some new light.
Guest Authors: Kevin Cowart, Pharm.D. and Karen Sando, Pharm.D.
Music by Good Talk
Friday Dec 15, 2017
Friday Dec 15, 2017
We interview Eric MacLaughlin, Joseph Saseen, and Kristin Rieser about the ACC/AHA Guidelines for the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in Adults released in November 2017. Dr. MacLaughin, a member of the Guideline Writing Committee, gives a insiders view of the guidelines development process and explains the rationale for lower blood pressure goals. Drs. Saseen and Rieser talk about some of the practical considerations that we all must consider as we move forward to making these recommendations a reality.
Guests: Kristin Rieser, Pharm.D., Joseph Saseen, Pharm.D, and Eric MacLaughlin, Pharm.D.
Music by Good Talk