The Huddle: Conversations with the Diabetes Care Team

Maria Bustamante and Megan Martinez are involved in the diabetes care and prevention programs at the National Center for Farmworker Health (NCFH) and join us today to share some of the work they’re doing to improve health outcomes for the vital workforce of agricultural workers. While the topic may sound niche at first, you are likely to recognize the challenges faced by agricultural workers in your own patent populations, especially if you are working within immigrant communities, in rural, agricultural settings, or with men with physically demanding jobs. You’ll hear how Megan and Maria’s teams developed resources to meet people with prediabetes or diabetes where they are—and we’ll tell you how you can access these tools for your own practice!

Resources

• Diabetes & U.S. Agricultural Workers Data: http://www.ncfh.org/diabetes-fact-sheet.html
• Ag worker access campaign: http://www.ncfh.org/ag-worker-access.html
• NCFH Diabetes Resource Hub: http://www.ncfh.org/diabetesresourcehub.html
• Jeopardy game: http://www.ncfh.org/uploads/3/8/6/8/38685499/jeopardy_guide-final_eng.pdf
• NCFH Diabetes Webinar Archive: http://www.ncfh.org/archived-webinars.html#diabetes_webinars
• NCFH Health Information and Referral Hotline: http://www.ncfh.org/callforhealth.html
• Telehealth readiness worksheet: http://www.ncfh.org/uploads/3/8/6/8/38685499/final_patient_telehealth_readiness_tool_.pdf
• Resource for being active for men who are already physically active: https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/aade7/adces-men-health-being-active-v1.pdf
• Resource for reducing risks: https://www.diabeteseducator.org/docs/default-source/living-with-diabetes/tip-sheets/aade7/adces-reducing-risk-english-final.pdf?sfvrsn=84c39758_2

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Amy Hess Fischl MS, RD, LDN, BC-ADM, CDE joins the Huddle to share her expertise and experiences providing support to patients with type 2 diabetes as they are experiencing weight reduction while on injectable, non-insulin therapies. We will cover topics like patient experiences with changes in appetite and food intake, nutritional counseling for people experiencing weight reduction and emphasizing the importance of exercise as well.

Disclosures: Speaker for Abbott Diabetes Care, Insulet, Xeris Pharmaceuticals

This podcast was developed in partnership with Eli Lilly and Company.

Resources:

Download a patient-focused tipsheet that complements the topics covered in this Huddle podcast. 59-23_tipsheet-losingweight-7.pdf (adces.org)

1. El Sayed et al., Diabetes Care. 2023;46:S128
2. Galgani & Ravussin Int J Obesity. 2008;32:S109
3. Morselli et al., Best Practice & Research Clinical Endocrinology & Metabolism. 2010;24:687
4. Garber. DOM. 2012;14:399
5. Hall & Kahan. Med Clin North Am. 2018;102(1):183
6. El Sayed et al., Diabetes Care. 2023;46:S68
7. El Sayed et al., Diabetes Care. 2023;46:S140
8. https://pi.lilly.com/us/trulicity-uspi.pdf
9. https://www.bydureon.com/bydureon-bcise.html
10. https://www.novo-pi.com/victoza.pdf
11. https://www.novo-pi.com/ozempic.pdf
12. https://www.novo-pi.com/rybelsus.pdf
13. https://pi.lilly.com/us/mounjaro-uspi.pdf?s=pi
14. Heise et al., Diabetes Care. 2023;46(5):998
15. ten Kulve et al., Diabetes Care. 2016;39:214
16. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Diabetes-related foot conditions like ulcers and amputations can be very serious, but these complications are preventable when comprehensive foot exams are prioritized. Podiatrist Dr. Mark Hinkes joined The Huddle to talk about the importance of foot health and comprehensive foot exams for people with diabetes, and how we can use data collected from these foot exams to predict potential future risk.

Learn more about the International Working Group on the Diabetic Foot here: Home - IWGDF Guidelines

View Mark's book "Healthy Feet for People with Diabetes" here: Healthy Feet for People With Diabetes: Hinkes DPM, Dr. Mark: 9780985628604: Books - Amazon.ca

Learn more about diabetes-related foot complications:

• Foot Complications | ADA
• Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer | Journal of Foot and Ankle Research | Full Text

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

This week on The Huddle, we're resharing an episode with Miguel Johns, Co-Founder & CEO of mmnt and creator of Milton. Miguel discussed how the use of artificial intelligence (AI) can benefit health care professionals across the diabetes space and how this technology is growing and changing. Topics include addressing some of the current opportunities and challenges associated with AI in health care, how AI can provide improved clinical decision support, and where this technology may be headed in the future.

Explore danatech here: Diabetes technology for healthcare professionals | Danatech (adces.org)

For more information on Miguel or mmnt, visit Milton | Powered by MMNT (getmilton.com)

View a recorded annual conference session on AI and more by registering for ADCES24 On Demand: ADCES24: Diabetes Care, Education and Technology (mcievents.com)

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.

Eileen Egan, DNP, FNP-C, BC-ADM, CDCES, FADCES joins The Huddle to share her expertise about the interplay between weight and glycemic management in people with Type 2 diabetes, the importance of meeting glycemic and weight goals early after a Type 2 diabetes diagnosis, as well as best practices for helping people stay motivated and engaged. This episode was made possible with support from Lilly, A Medicine Company.

Learn more about this topic in this accompanying patient/client handout (support for the development of this handout was provided by Lilly, A Medicine Company): adces_tipsheet_early_control2.pdf

References:

American Diabetes Association. Obesity and weight management for the prevention and treatment of type 2 diabetes: standards of care in diabetes- 2024. Diabetes Care, 47(1): S145-S157.

Center for Disease Control and Prevention. Adult overweight and obesity. https://www.cdc.gov/obesity/basics/adult-defining.html

DCCT/EDIC study research group. Intensive Diabetes Treatment and Cardiovascular Outcomes in Type 1 Diabetes: The DCCT/EDIC Study 30-Year Follow-up. Diabetes Care. 2016;39(5):686-693.

Gregg E, Jakicic J, Blackburn G, et al. Association of the magnitude of weight loss and changes in physical fitness with long-term cardiovascular disease outcomes in overweight or obese people with type 2 diabetes: a post hoc analysis of the Look AHEAD randomized clinical trial. Lancet Diabetes Endocrinol. 2016; 4(11): 913-921.

Gutiérrez-Cuevas J, Santos A, Armendariz-Borunda J. Pathophysiological Molecular Mechanisms of Obesity: A Link between MAFLD and NASH with Cardiovascular Diseases. Int J Mol Sci. 2021. 27;22(21):11629.

Howard BV, Ruotolo G, Robbins DC. Obesity and dyslipidemia. Endocrinol Metab Clin North Am. 2003;32(4):855-867.

Jin X, et al. Pathophysiology of obesity and its associated diseases. Acta Pharm Sin B. 2023;13(6):2403-2424.

Laiteerapong N, Ham SA, Gao Y, et al. The legacy effect in type 2 diabetes: impact of early glycemic control on future complications (The Diabetes & Aging Study). Diabetes Care. 2019;42(3):416-426.

Lean MEJ, Leslie WS, Barnes AC, et al. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial.Lancet Diabetes Endocrinol. 2019;7(5):344-355.

Lingvay I, Sumithran P, Cohen RV, le Roux CW. Obesity management as a primary treatment goal for type 2 diabetes: time to reframe the conversation. Lancet. 2022 Jan 22;399(10322):394-405. doi: 10.1016/S0140-6736(21)01919-X. Epub 2021 Sep 30. Erratum in: Lancet. 2022 Jan 22;399(10322):358. PMID: 34600604

Rachel G. Miller, Trevor J. Orchard; Understanding Metabolic Memory: A Tale of Two Studies. Diabetes 1 March 2020; 69 (3): 291–299. https://doi.org/10.2337/db19-0514

Ross, R., Neeland, I.J., Yamashita, S. et al. Waist circumference as a vital sign in clinical practice: a Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity. Nat Rev Endocrinol16, 177–189 (2020). https://doi.org/10.1038/s41574-019-0310-7

Thom G, McIntosh A, Messow CM, et al. Weight loss-induced increase in fasting ghrelin concentration is a predictor of weight regain: Evidence from the Diabetes Remission Clinical Trial (DiRECT). Diabetes Obes Metab. 2021;(23):711-719.

Tsai AG, Bessesen DH. Obesity. Ann Intern Med. 2019;170(5):ITC33-ITC48.

Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145-154.

World Health Organization. Obesity. https://www.who.int/health-topics/obesity#tab=tab_1

Listen to more episodes of The Huddle at adces.org/perspectives/the-huddle-podcast.

Learn more about ADCES and the many benefits of membership at adces.org/join.