We’re back this week with Kieran and Ashley to take another look at diabetes and sweet treats. Should current practice guidelines be taken with a grain of salt – or should I say – sugar? Listen to find out!
New drugs have popped up on the market for diabetes management, necessitating an update to practice guidelines in diabetes care. But which of the new drugs on the block are best? Ashley takes listeners through a discussion of a large observational cohort study, focusing on cardiovascular risk with a wide variety of combinations of newer and older agents for management of diabetes.
In medicine, thresholds have to be established to determine who is at risk. In pregnancy and gestational diabetes, an interesting question arises: who are these thresholds set to benefit – the mother or the baby? Kieran leads a fascinating discussion on a study examining the arbitrary thresholds for diagnosis of gestational diabetes in pregnancy, highlighting the focus on risk of fetal obesity, and not other potentially important maternal complications.
It wouldn’t be The Rounds Table without the weekly Good Stuff segment! First, Ashley shares a TED Talk on a new transgenic tobacco plant developed to produce human collagen. Next, have you heard of Louise DeLage? Kieran shares an Instagram campaign targeted at highlighting the normalization of alcohol abuse in young people.
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The Papers
1. DM: http://www.bmj.com/content/354/bmj.i3477
2. CAD & pregnancy: http://www.bmj.com/content/354/bmj.i4694
Good Stuff
1. Transgenic tobacco: https://www.ted.com/talks/oded_shoseyov_how_we_re_harnessing_nature_s_hidden_superpowers?language=en
2. Alcoholism Instagram campaign: https://www.theguardian.com/technology/2016/oct/06/shell-drink-to-that-fake-instagram-louise-delage-profile-highlights-alcoholism
Music Credits (Creative Commons)
In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart
Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music
Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music
All tracks have been modified for the purposes of this podcast.
I’m disappointed your review of diabetes drugs didn’t specifically address rosiglitizone. The data for glitizones sounded positive, but did that just include pioglitazone? It would have been helpful to highlight this in your review. Especially in light of the fact that I almost never see glitizones prescribed since rosiglitizone received it’s black-box warning!
Overall I love the show though. As you can tell I’m a few episodes behind but will catch back up. :)
Hello Chris,
Thank you for your question and for supporting our show! We really appreciate your comments regarding Hippisley-Cox et al’s publication in the BMJ on different diabetic therapies and cardiovascular disease in a primary care cohort.
The study included both pioglitazone and rosiglitazone. Unfortunately, it does not report the relative proportions of each specific drug that was used by patients. The black box warning from the FDA is definitely important when making prescribing decisions, including rosiglitazone being contraindicated in patients with NYHA class III or IV heart failure.
As I am sure you are aware, our primary objective at The Rounds Table is to help physicians and healthcare providers stay up to date on the latest medical research, and not provide a comprehensive review of any particular topic. We would love to hear your thoughts on the relative differences between the different glitazones!
Please feel free to email me at: kieran.quinn@mail.utoronto.ca