164 - Breaking Down the Updates: Key Changes and Implications of the 2023 American Diabetes Association Guidelines

HelixTalk - Rosalind Franklin University's College of Pharmacy Podcast

Sean P. Kane, PharmD, BCPS

Health & Fitness, Medications, Rosalindfranklin, Rfums, Pharmacy, Pharmd, Pharmacist, Medicine, Drugs

5 • 644 Ratings

🗓️ 25 April 2023

⏱️ 42 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode, we will discuss the most important updates from the American Diabetes Association’s 2023 Standards of Care in Diabetes.

Key Concepts

The first-line therapy for type II diabetes is based on whether the primary goal of therapy is cardiorenal benefit (reduced risk of ASCVD, heart failure, or CKD) or glycemic and weight goals.
For cardiorenal benefit, GLP1 receptor agonists and SGLT2 inhibitors are heavily emphasized. For glycemic control and weight gain, GLP1 receptor agonists (or GLP1/GIP in the case of tirzepatide) have a very favorable effect on weight loss and glycemic control. While metformin is still mentioned, it is no longer the sole, first-line therapy for type II diabetes.
For patients with diabetes and a high risk of ASCVD (20% or higher), high-intensity statins, ezetimibe, and/or PCSK9 inhibitors are recommended to achieve an LDL less than 70 mg/dL. In patients with a history of ASCVD events, these same therapies are used to achieve a recommended LDL goal of less than 55 mg/dL.
Among selected patients with diabetes and CKD with albuminuria, finerenone (a new mineralocorticoid receptor antagonist) is recommended to improve renal and cardiovascular outcomes.
A variety of different therapies are now recommended for neuropathic pain, including gabapentinoids, SNRIs, TCAs, and several antiseizure medications (lamotrigine, lacosamide, oxcarbazepine, and valproic acid).
A wide variety of other new recommendations are discussed in the episode, including NASH/NAFLD, obesity and weight management, special populations, diabetes technology, and health behavior changes.

References

American Diabetes Association. Standards of Care in Diabetes-2023. Diabetes Care. 2023; 46(1): S1-S292. https://diabetesjournals.org/care/issue/46/Supplement_1

Transcript

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0:00.0	Welcome to Helix Talk, an educational podcast for healthcare students and providers covering real-life clinical pearls, professional pharmacy topics, and drug therapy discussions.
0:11.0	This podcast is provided by pharmacists and faculty members at Rosal Franklin University College of Pharmacy.
0:17.0	This podcast contains general information for educational purposes only. This is not professional
0:22.4	advice and should not be used in lieu of obtaining advice from a qualified health care provider.
0:27.2	And now on to the show. Welcome to Helix Talk episode 164. I'm your co-host Dr. Kane.
0:36.0	And I am Dr. Patel. And today we have Dr. Sneha Shavashtla
0:40.9	back with us to discuss all the updates in diabetes. Thank you for joining us again today, Dr.
0:47.6	Shavasel. Thanks for having me. It's always wonderful to be on this podcast. Yeah. So with that diabetes expert joining us, of course,
0:56.9	we are going to talk about updates and diabetes. The title of our episode is breaking down the
1:01.9	updates, key changes and implications of the 2023 American Diabetes Association Guidelines.
1:08.2	So here we are kind of talking through some of the important things that
1:12.5	are changed as part of this annually changing guidelines. I'll tell you, Dr. Kane and Dr. Shravastava,
1:18.4	I've had people personally reaching to me and asking me to do this episode. So let's see. This is
1:24.5	the most debated episode of the year. And Dr. Patel, before we get into it, I just want to highlight again how awesome it is
1:30.8	that we have annual updates on a guideline from ADA.
1:34.2	So kudos to them.
1:35.8	And actually, for the listeners, I was actually fairly surprised at some of the recommendations
1:39.6	that have come out in terms of this 2023 update.
1:42.4	So stay tuned.
1:43.4	You're going to see some things that I found
1:44.6	somewhat surprising or I wouldn't say game changing necessarily, but maybe a little bit game
1:49.2	changing in terms of what I learned in school is really falling out of favor in terms of
	...

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