Natalie Bellini, DNP, FNP-BC, BC-ADM, CDCE

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives!

Diabetes Dialogue: Exploring New Horizons in Incretin Therapy for Diabetes and Weight Loss

Diabetes Dialogue: Technology, Therapeutics, & Real-World Perspectives

, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, explore recent advancements in incretin-based therapies, highlighting their transformative potential for 

The episode opens with a detailed discussion on Amgen’s maridebart cafraglutide (MariTide; AMG-133), an investigational antibody peptide conjugate offering remarkable efficacy for obesity and overweight in Phase 2 trial data. At 52 weeks, participants without type 2 diabetes (T2D) experienced an average weight loss of ~20% with MariTide treatment without a weight loss plateau, while those with T2D achieved up to a ~17% average reduction without a plateau. The hosts underscored the potential impact of this type of therapy, particularly in addressing adherence challenges posed by the more frequent dosing schedules of current options. Hosts cited the potential safety concerns, but noted that AMG-133 could represent a significant step forward in managing obesity and related metabolic disorders.

The conversation then shifted to a head-to-head comparison of two leading incretin therapies for obesity: tirzepatide (Zepbound) and semaglutide (Wegovy). Tirzepatide emerged as a frontrunner in the SURMOUNT-5 trial, contributing to a mean body weight reduction of 20.2% versus 13.7% achieved with semaglutide. Isaacs and Bellini discuss how these findings might influence clinical decision-making, emphasizing the importance of tailoring treatment plans to individual patient needs. They also touch on the practical implications of these therapies in both obesity and diabetes care, given the growing prevalence of these conditions.

In the final segment, Isaacs and Bellini addressed a critical safety issue: the proliferation of non-FDA-approved compounded glucgaon-like peptide-1 (GLP-1) receptor agonists. The American Diabetes Association (ADA) released a statement warning against these unregulated formulations due to concerns over safety, quality control, and potential adverse effects. Despite the growing popularity of compounded versions as a lower-cost alternative, the hosts stressed the importance of prioritizing patient safety. They advised clinicians to steer patients toward evidence-based, FDA-approved therapies that have undergone rigorous testing and demonstrated consistent efficacy and safety profiles.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.

Videos

In this episode, hosts discuss the efficacy of MariTide for obesity, a head-to-head comparison of semaglutide vs. tirzepatide, and concerns about GLP-1 agonist compounding.

Diabetes Dialogue: Celebrating 2024 - The Year of the Continuous Glucose Monitor

Diabetes Dialogue: Technology, Therapeutics, and Real-World Perspectives

, hosted by Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center.

, this episode recaps headlines and practice updates related to continuous glucose monitoring (CGM) from the past year, with a focus on regulatory news from Medtronic, Dexcom, Abbott, and Senseonics. In recognition of the 25th anniversary of the first US Food and Drug Administration (FDA) approval of a CGM device in 1999, hosts also provide historic context for each company spotlighted during the episode.

To begin the episode, hosts start where the journey began: the FDA approval of the MiniMed in June 1999. In the 25 years since, MiniMed was acquired by Medtronic but has continued to remain among the leaders in CGM technology. During their conversation, hosts spend time discussing early experiences with CGM as well as newer advances from Medtronic, including the 2024 approval of the Simplera CGM.

Conversation around Dexcom ranges from the company’s STS sensor in 2006 to the current G7 model as well as integration with pumps like the OmniPod 5, T:slim X2, and the Islet. When discussing news from 2024 from Dexcom, hosts call attention to the partnership with the Oura Ring and the launch of Stelo, the first FDA-approved over-the-counter CGM.

Next, hosts dive into advancements from Abbott—starting with the Navigator and advancing to the Libre, including the Libre 3 plus, which features real-time data and 15-day wear. The hosts also celebrate Abbott’s collaborations with Tidepool and major insulin pump manufacturers as well as the FDA clearance of the Lingo and Libre Rio.

The episode concludes with a discussion of Senseonics’ Eversense CGM, the only FDA-approved implantable CGM. As the hosts highlight, Eversense has progressed over the years from a 90-day sensor to the groundbreaking 365-day wear system, which received approval in 2024. The hosts also highlight the potential of future developments, such as eliminating the external transmitter for a fully implantable design.

Podcasts

In this episode, hosts reflect on the advancement in CGM that reshaped care for diabetes and overall health during 2024.

Diabetes Dialogue: Celebrating 25 Years of CGM, with Irl Hirsch, MD

25:32 - Emerging Metrics and Biomarkers Beyond A1C

31:01 - Future Directions in Glucose Monitoring

In celebration of the podcast surpassing 100 episodes, hosts Diana Isaacs, PharmD, an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, sit down for a special edition episode with Irl Hirsch, MD, professor of medicine at the University of Washington.

Discussion within the episode reflects on continuous glucose monitoring (CGM) and its revolutionary impact on diabetes care as well as its transformative history, beginning with its introduction by MiniMed in 1999.

Hirsch recounts his first CGM experience and how it fundamentally changed his approach to managing hypoglycemia and diabetes complications. The conversation transitions to pivotal milestones, such as the JDRF CGM study and the push for Medicare coverage, which advanced CGM accessibility and integrated it into diabetes care standards. Hirsch also highlights the evolution of CGM technology, including the adoption of factory calibration, non-invasive sensors, and over-the-counter options, while addressing challenges like patient misconceptions about device accuracy.

The trio also explore CGM’s potential beyond glucose monitoring, including ketone detection, that could revolutionize diabetes management and broader healthcare applications.

Relevant disclosures for Isaacs include Eli Lilly and Company, Novo Nordisk, Sanofi, Abbott Diabetes Care, Dexcom, Medtronic, and others. Relevant disclosures for Bellini include Abbott Diabetes Care, MannKind, Provention Bio, and others.Relevant disclosures for Hirsch include Abbott Diabetes Care, Roche, Hagar, Tandem, and Mannkind. 

The podcast episode celebrates its 100th milestone by featuring a discussion with Dr. Irl Hirsch on the transformative impact of continuous glucose monitoring (CGM) in diabetes care. The conversation covers the history of CGM, starting with its introduction by MiniMed in 1999, and highlights key developments such as the JDRF CGM study and Medicare coverage. The evolution of CGM technology, including factory calibration and non-invasive sensors, is discussed, along with potential future applications like ketone detection, which could further revolutionize diabetes management and healthcare.

To celebrate surpassing 100 episodes, Diabetes Dialogue sits down with Irl Hirsch, MD, to discuss the 25-year anniversary of continuous glucose monitoring in 2024. 

Diabetes Dialogue: Diabetes Tech Updates from November 2024 

, hosts an endocrine clinical pharmacist, director of Education and Training in Diabetes Technology, and codirector of Endocrine Disorders in Pregnancy at the Cleveland Clinic, and Natalie Bellini, DNP, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center discuss exciting updates in diabetes technology from November 2024. 

First, they highlighted the newly announced collaboration between Dexcom and the Oura Ring, which promises to integrate glucose monitoring with insights from the wearable's advanced sleep and activity tracking. This partnership could provide actionable data for patients and clinicians, offering deeper insights into how factors like exercise, sleep, and stress affect glucose trends. While the integration is not yet live, both hosts express enthusiasm for its potential, especially for tools like the over-the-counter Dexcom Stelo CGM.

Next, they discuss the expanded compatibility of the OmniPod 5 system with Abbott's FreeStyle Libre 2 sensors, now available in the U.S. for use with the OmniPod's controller. This change introduces greater choice for users and enhances affordability by accommodating insurance-preferred sensors. They also address the rollout of OmniPod 5’s iPhone app for Dexcom G6, new preset bolus options for meals, and updated simulator tools, all designed to streamline workflows and improve patient outcomes. However, the hosts emphasize the need for careful coordination between pod types and CGM models during this transitional period.

Lastly, Isaacs and Bellini explore Medtronic’s new integration of the Simplera CGM with its InPen smart pen. This innovation provides trend-based correction dose recommendations, mirroring features of automated insulin delivery systems. With easier-to-use CGMs and connected pen options, this development could benefit patients preferring multiple daily injections or seeking breaks from pump therapy. The hosts underline how these advancements offer more personalized, flexible diabetes management solutions.

The latest updates in diabetes technology include a collaboration between Dexcom and Oura Ring, promising integrated glucose monitoring with sleep and activity insights. The OmniPod 5 system now supports Abbott's FreeStyle Libre 2 sensors, enhancing user choice and affordability. Additionally, Medtronic's Simplera CGM integrates with the InPen smart pen, offering trend-based correction dose recommendations. These advancements aim to provide more personalized and flexible diabetes management solutions. The hosts emphasize the importance of careful coordination between devices during these transitions to optimize patient outcomes.

In this episode, hosts discuss the collaboration between Dexcom and Oura Ring, expanded compatibility of Omnipod 5 with Freestyle Libre 2, and Simplera CGM integration with the InPen.

Natalie Bellini, DNP, FNP-BC, BC-ADM, CDCE

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