CCO Medical Specialties Podcast

Link to CME: Claim Credit - https://bit.ly/3dQPQwT .

Continuous glucose monitoring (CGM) is a great tool that improves clinical outcomes for people with diabetes; these individuals are often happy to get this new technology.

However, there can be some initial barriers that both people with diabetes and clinicians need to overcome.

BARRIER 1: Wearing something on the body so other people know the person has diabetes.

SOLUTION 1: Let the person see the size of different devices through demonstrations and show possible discreet places on the body where they can be worn.

• Consider starting with a professional CGM, owned by the clinic and borrowed by the individual for up to 14 days, so that he or she can get a feel for what it is like.
• Consider a CGM that can be integrated with a smart pen instead of an insulin pump, so the individual has only 1 device to wear.

BARRIER 2: Cost of the CGM.

SOLUTION 2: Find out insurance requirements to see if the CGM can be covered and what is required for coverage.

• A disposable sensor is a lower cost option. There are coupons available and some pharmacies sell for lower costs.
• Professional CGM is an underused insurance benefit that is often covered multiple times per year if used on a short- term basis.

BARRIER 3: Too much information from CGM can be overwhelming for the individual.

SOLUTION 3: Make sure alarms and alerts are set appropriately to avoid alarm fatigue—have the alerts go off when it matters most, like during hypoglycemia. Look at the device at key times only, like before meals, before bedtime, and before activities like exercising and driving, and utilize CGM to determine glycemic trends.

BARRIER 4: Clinicians are hesitant to embrace CGM technology.

SOLUTION 4: There are various resources available to help clinicians understand CGM technology and to assist in integrating CGM into their practice settings.

• Online tutorials, industry representatives, and diabetes care and education specialists can help clinicians understand how to start people with diabetes on CGM and how to interpret the data.
• CPT codes are now available to help support the cost of additional staff to train the individual on the devices and cover the cost of review and interpretation.

Presenters:
Carla Cox PhD, RD, FAADE
Certified Diabetes Educator and Clinical Dietitian
Mountain Vista Medicine
South Jordan, Utah

Diana Isaacs PharmD, BCPS, BCACP, BC-ADM, CDE
Clinical Pharmacy Specialist/CGM Program Coordinator
Department of Endocrinology, Diabetes, and Metabolism
Cleveland Clinic Diabetes Center
Cleveland, Ohio

Provided by the Endocrine Society in collaboration with the ADCES.
Supported by an educational grant from Lilly.

How do you decide when to move from first-line to second-line treatment for primary biliary cholangitis (PBC)? In this podcast, listen as experts Alan Bonder, MD, AGAF, and Aparna Goel, MD, discuss this question and more, including:

• How and when to measure treatment response
• Evidence-based goals of therapy
• Considerations for second-line treatment
• New agents for second-line treatment: PPAR agonists

Presenters:

Alan Bonder, MD, AGAF
Associate Professor of Medicine
Medical Director of Liver Transplant
Department of Gastroenterology
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, Massachusetts

Aparna Goel, MD
Associate Clinical Professor of Medicine
Division of Gastroenterology and Hepatology
Stanford University
Palo Alto, California

Content based on an online CME program supported by independent educational grants from Gilead Sciences, Inc., and Ipsen Biopharmaceuticals, Inc​.

To learn more about PBC management, check out our program,
Curbside Consults: Expert Insights on Challenges in PBC Management.

Supported by educational grants from Gilead Sciences, Inc. and Ipsen Biopharmaceuticals, Inc

In this podcast, expert faculty, Dr Stuart Gordon and Dr Nancy Reau, use an illustrative patient case to explore the roles of ALP and other biochemical markers in PBC management, and explain what to expect from treatment. Topics covered include:

• How baseline ALP can affect ALP normalization after second-line treatment with elafibranor and seladelpar
• Potential outcomes if ALP normalization cannot be achieved
• The importance of managing fatigue, pruritus, and sleep disturbances independently of the biochemical response

Presenters:

Stuart C. Gordon, MD
Professor of Medicine
Wayne State University School of Medicine
Director, Division of Hepatology
Henry Ford Health
Detroit, Michigan

Nancy Reau, MD
Professor of Medicine
Richard B. Capps Chair of Hepatology
Chief, Section of Hepatology
Associate Director, Solid Organ Transplantation
Rush University Medical Center
Chicago, Illinois

To learn more about PBC management, check out our program, Curbside Consults: Expert Insights on Challenges in PBC Management.

Clinical gaps in the treatment of pruritus in primary biliary cholangitis (PBC) remain. In this episode, taken from a recent symposium, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with PBC, discuss emerging therapies currently in clinical trials for the management of this disease that can dramatically affect patients’ quality of life.

Listen as they discuss:

• Gaps in current management
• Patient perspectives: why we should not dismiss itching as an underlying psychologic problem
• PPAR agonists and how they affect pruritus
• BEZURSO and FITCH
• ELATIVE
• ENHANCE and RESPONSE
• IBATs (inhibitors of bile acid transport)
• GLIMMER
• Common questions

Presenters:

Marlyn J. Mayo, MD
Professor of Internal Medicine
Division of Digestive & Liver Diseases
UT Southwestern Medical Center
Dallas, Texas

Stuart C. Gordon, MD
Professor of Medicine
Wayne State University School of Medicine
Director, Division of Hepatology
Henry Ford Health
Detroit, Michigan

Pam Rivard, RN
Person living with PBC

Link to full program:
https://bit.ly/3Dnfb2E

In this episode, Marlyn J. Mayo, MD; Stuart C. Gordon, MD; and Pam Rivard, RN, a person living with primary biliary cholangitis (PBC), discuss the burden of pruritus in PBC and the impact it has on quality of life, including both physical and mental health, from a patient’s perspective.

Presenters:

Marlyn J. Mayo, MD
Professor of Internal Medicine
Division of Digestive & Liver Diseases
UT Southwestern Medical Center
Dallas, Texas

Stuart C. Gordon, MD
Professor of Medicine
Wayne State University School of Medicine
Director, Division of Hepatology
Henry Ford Health
Detroit, Michigan

Pam Rivard, RN
Person living with PBC

Link to full program:
https://bit.ly/4gDGDaB