#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns from The Curbsiders Internal Medicine Podcast

#433 CGMs, Insulin, and How to Adjust Diabetes Meds to Glucose Patterns

1 hour 13 minutes Posted Apr 1, 2024 at 7:00 am.

Introduction and Diabetes Puns

Introduction of Guest and Topic

Qualifications and Eligibility for CGMs

Types of CGMs and Sensor Placement

Interpreting CGM Data and Alarms

Troubleshooting Patterns and Adjustments

Understanding Hypoglycemia and Counter Regulatory Hormone Responses

The Rule of 15 and Addressing Hypoglycemia

Reducing Basal Insulin to Address Nocturnal Hypoglycemia

Addressing Postprandial Highs with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin

Managing Exercise-Induced Hypoglycemia

Preventing Exercise-Induced Hypoglycemia with Snacks

Managing Nocturnal Hypoglycemia with Sulfonylureas

Addressing Postprandial Hyperglycemia with GLP-1, SGLT-2 Inhibitors, or Prandial Insulin

Adjusting Basal Insulin to Address Morning Hyperglycemia

Troubleshooting High Blood Sugars with Basal Insulin and Mealtime Insulin

Managing High Blood Sugars with Basal Insulin and Mealtime Insulin

Addressing Adherence and Medication Barriers

Using Continuous Glucose Monitors (CGMs) for Diabetes Management

Using Sulfonylureas and Basal Insulin Combination as a Stopgap

Considering Patient Adherence and Barriers to Treatment

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Show notes

Step up your diabetes game! Learn the ins and outs of continuous glucose monitors (CGM) including key features, what and how to order, interpreting CGM data (time in range, time above range, etc.), and how to make adjustments to a patient’s insulin regimen, aka “insulin pattern matching”. We discuss common scenarios including overnight hypoglycemia, exercise-induced hypoglycemia, post-prandial hyperglycemia, what to do when the patient runs high all the time, and how to incorporate GLP1 agonists and SGLT2 inhibitors into a patient's regimen. Returning guest and Paul’s favorite frenemy, Dr. Jeff Colburn (VCU Health) returns!

Claim CME for this episode at curbsiders.vcuhealth.org!

Show Segments

Credits

Writer and Producer: Matthew Watto MD, FACP

Show Notes: Matthew Watto MD, FACP

Cover Art and Infographic: Matthew Watto MD, FACP

Hosts: Matthew Watto MD, FACP; Paul Williams MD, FACP

Reviewer: Emi Okamoto MD

Showrunners: Matthew Watto MD, FACP; Paul Williams MD, FACP

Technical Production: PodPaste

Guest: Jeff Colburn MD

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