These five 3-minute videos summarise the role of primary care services in helping people with diabetes achieve multifactorial health. This includes foot care, kidney health, eye care, mental health and diet
In type 2 diabetes, there is often the perception that poor outcomes only happen later on in the disease, and people can gradually get their blood sugar under control. However, the truth is far more severe: delaying treatment intensification by just 1 year is linked to a 62% higher lifetime risk of cardiovascular outcomes such as heart attack and stroke.
This 5-minute video, steered by Tina Vilsbøll of the Steno Diabetes Center in Copenhagen, describes the pathophysiology that leads to this higher lifetime risk, the importance of early intensive therapy, and how you can work in partnership with your patient to implement this vital regimen.
While lifestyle interventions are the cornerstone of type 2 diabetes management, antihyperglycaemic medications remain an important part of disease management. However, given the wide range of available agents, how can we select between the available options?
This 5-minute video, steered by Dr Kevin Fernando of the North Berwick Health Centre UK, guides you though a simplified version of the EASD/ADA algorithm, most recently updated in December 2019.
Moving through the algorithm, it includes clear discussion of when to initiate dual therapy, key information on the importance of cardiorenal status, and guidance on how to match specific drug classes to individual patients based on their profile.
GLP-1 RAs are associated with a number of multifactorial effects, including reduction in weight, protection against cardiovascular events, and improvements in HbA1c. Given their indications in type 2 diabetes, this class of agents can be particularly suited to helping specific patient presentations. But how do they work?
This 5-minute video, steered by Carel le Roux, examines the mechanism of action of GLP-1 RAs, including their effects on glucose, cardiovascular disease, and the neurohormonal system. It also discusses injectable and oral formations and strategies for discussing the therapeutic class with your patients to help them overcome fears and understand the benefits of this treatment.
Though generally the American Diabetes Association and European Association for the Study of Diabetes (ADA EASD) guidance on management of hyperglycaemia statement has been updated every three years, 2019 was a year packed full of very important studies that resulted in two key overarching changes to guidelines.
The committee felt that, though the 2018 document was still relatively new, an update was required.
In this brief video, lead author Dr John Buse explains the important new recommendations on cardiorenal protective agents, when to offer dual therapy, and how to select between GLP-1 RAs and SGLT2is in patients with established cardiovascular disease.
Cardiovascular disease and diabetes often co-occur in patients, presenting a challenge for both diabetologists and cardiologists: given numerous targets (from blood sugar to blood lipids), how can both conditions be managed concurrently?
This video, designed for cardiologists, succinctly summarises relevant guideline recommendations surrounding cardiovascular disease and diabetes, including appropriate blood pressure targets, individualised lipid targets, and how to select antihyperglycaemic agents that offer additional cardioprotective effects. By using these recommendations, you will be able to tailor treatment to an individual patient's personal presentation, which will help to optimise their cardiovascular outcomes.
HbA1c has been the main target used to assess success or failure of treatment in diabetes. However, this metric has its own limitations - for example, while it is useful in assessing a 3-month average of glucose exposure, it cannot provide any specific information on day-to-day variability or within-day hyper- or hypoglycaemia.
With this in mind, technologies such as continuous glucose monitors and flash glucose monitors have allowed for the development of new metrics in diabetes: time in range and glycaemic variability.
This video summarises the role of these new metrics, and their role in setting new targets in patients receiving insulin.