2024 Diabetes Standards

The American Diabetes Association has released the 2024 Standards of Care for people with Type 1 and Type 2 Diabetes. Join us as we talk with one of our favorite diabetes experts, Dr. Sue Cornell, about the major shifts in diabetes care that are omnipresent in this year's guideline updates.
 
The GameChanger
Diabetes treatment is shifting to prevention and delay. After a long period of time without many advances, we are now on the brink of changing the game in diabetes care and prevention with new drugs and technologies.
 
Host
Geoff Wall, PharmD, BCPS, FCCP, BCGP
Professor of Pharmacy Practice, Drake University
Internal Medicine/Critical Care, UnityPoint Health

Susan Cornell, PharmD, CDCES, FAPhA, FADCES
Diabetes Care & Education Specialist
Midwestern University College of Pharmacy
 
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CPE Information
 
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Discuss highlights of the 2024 American Diabetes Association Standards of Care Update
2. Describe the landscape of diabetes care as it shifts to prevention and delay

0.05 CEU/0.5 Hr
UAN: 0107-0000-24-050-H01-P
Initial release date: 2/5/2024
Expiration date: 2/5/2025
Additional CPE details can be found here.

Join us Tuesday, February 13th from 7-9pm for our next live course:
From A1C to Z: A Sweet Update on Diabetes Guidelines
This course will review the latest revisions to the American Diabetes Association (ADA) Standards of Care specifically highlighting the rising rates of obesity-related to diabetes, a pressing health concern affecting millions worldwide and often referred to as "diabesity". Learners will gain insights into nuances related to medication management and therapeutic decision-making for patients with diabetes. Content will provide guidance for reviewing and crafting patient-centered treatment strategies that holistically address glucose management while fostering improvements in cardio-metabolic, kidney, liver, and cognitive health for individuals grappling with diabetes and related comorbidities. 

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Transcript

Speaker 1: 0:08

Welcome to the Game Changers podcast, where we have clinical conversations that impact your pharmacy practice. Let's listen in as our team discusses this week's clinical practice. Game changer hey, ce plan members from CE Impact. This is Game Changers. I'm Jen Moulton and this week we're talking about one of our most popular topics diabetes. Every year, the American Diabetes Association updates their standards of care for people with type 1 and type 2 diabetes, and this year is no exception. We're fortunate today to have with us one of our favorite diabetes experts, sue Cornell. Dr Cornell, thank you so much for joining us today.

Speaker 2: 0:46

Happy to be here, jen, and it's just everything that you said just means I'm the old person in the room. Not at all, not at all.

Speaker 1: 0:55

A lot of our listeners do know you because you were on the podcast last year at this time and are kind of our reigning expert for our annual diabetes update, and I'll talk a little bit more about that later. But for those of you who may not know you, could you give us a little glimpse into your practice and maybe how you've developed expertise in diabetes over your career?

Speaker 2: 1:17

Yes. So again, thanks for having me, and this will definitely show how old I really am and how long I've been practicing. But let's start with the beginning. How do you get involved in diabetes? And I'll tell you. Graduated pharmacy school a very long time ago, went to work in community pharmacy because back in the day that was the thing to do. You had hospital and community. We did not have all the options that many of the young graduates have today as they're getting out into the field. So went to work to practice in community and started my career and life and all of that. And suddenly, several years into practice, my mom developed diabetes, type two diabetes. And now we are really going back because the guidelines back then were nothing like they are today. And I'll just give you a hint Diagnostic for diabetes back then was 180 milligrams per deciliter.

Speaker 2: 2:13

Oh wow, how far that goes, because back then it was urine test strips, not even post meters. So with that, of course, as any good daughter, I was concerned about mom, and mom we've got to take care of you, and so that sparked my interest and over time I became very interested in learning more and more about managing diabetes and diabetes care. We didn't have the drugs that we have today. We had sulfonereas we didn't even have metformin back then and sulfonereas and insulin, and at that point it was all about lifestyle. So we, you know, working with mom. Well, as a community pharmacist, you start to realize there's a lot of people like mom coming into my pharmacy. It's not just mom who's being poorly managed, it's all of these people. And so over time I wanted to help them as much as I wanted to help my family. And that's where I sparked my interest. And you know, years later, here I am and still thriving. I strongly believe to this day that my mom lived as long as she did with diabetes because she had good quality care and, you know, I think that is really what makes a difference. So hopefully that empowers people to you know, pharmacists especially to better help their patients, because it really does make a difference.

Speaker 2: 3:39

As a community pharmacist, because of the fact that I did become a certified diabetes educator, which was the term used back then, now it's certified diabetes care and education specialist it was very unique for a pharmacist to have a CDE, you know, to have this credentialing, because mostly it was nurses, dietitians, physicians, nurse practitioners, etc.

Speaker 2: 4:02

So for a pharmacist to have it. It was unique, which opened a lot of doors for me and with that I built, you know, connections and a network which again we tout very much to our students today, to the young pharmacists. It's important to have that network and within a short amount of time I was recruited to a different community pharmacy to develop their diabetes education program, and so we were the first and again dating myself here was Dominic's pharmacy, which unfortunately no longer is an existence, but they were part of the Safeway Company, you know, many years ago, and we were the second community pharmacy in the nation to actually have an ADA recognized diabetes program which allowed us to bill Medicare for diabetes education services. So again, opportunities for a community pharmacist to actually thrive in the diabetes world and to bill and get reimbursed beyond just a product. This is truly a service. So that's kind of where I started and life happens when you make plans, and now I work in a community clinic, so it just life keeps going.

Speaker 1: 5:18

Yeah, oh, I love that. I'm so glad I asked you that question because I didn't know any of that background and I think it's so. You hear from so many people that their passions lead into their expertise and you had a personal situation that guided that, and so it's obvious you've been in this practice for so long and it's because you feel passionate about it and you saw the impact of that. So what a great story. I love that, and it's fitting because this month we're actually talking about developing expertise as part of our pharmacist by design, so I didn't even plan for that to fit in there, but that's exactly right. Like we see something where we can make a difference and that we're passionate about it and we pour our heart and soul into it and it becomes a living, which is amazing when you can do something that you love and feel like you have an impact on patients in your community. So that's so great. Now I know why we align so well. I love that.

Speaker 1: 6:12

I was gonna say you do the You're sharing it. You do the same too. Yeah, well, absolutely, I mean you just yeah, you kind of and I think for people out there who are still kind of finding their niche. I think that's a great way to approach it. What's important to you, what is impactful whether it's for your family or your friends or the community and what do you see? Where is there a need and how can you fill it? And then how can you just continue to have other people rally around that and do the things that are important? You got paid for the services that you provided and led the way for pharmacists to be in that CDE space, so that's really cool. So, as it relates to these new guidelines which come out in December of every year the way I understand it because I just did kind of a high level and I know you're gonna dig into it but the new guidelines include recommendations around GLP-1s, screening, cgms and the use of tepolizumide. I knew I was gonna botch that. Say it for me. Yeah, tepolizumide.

Speaker 2: 7:12

Tepolizumide.

Speaker 1: 7:15

No, I trust me, I know it's like they just keep getting more and more complicated, don't they? I knew I was gonna do that being on camera, I had it down pat, but, among other things, obviously there's other things in those guidelines too, but so I think we'll talk briefly about each of these and maybe high level. But first, would you tell me, is there one thing in these standards that you anticipate to have the most impact in your practice? Like, when you look at them, is there one thing that stands out that you're like, yeah, this is gonna kind of be a game changer.

Speaker 2: 7:47

Yeah, so I will fully admit I mostly deal with type two diabetes. That's the case. I'm in just because it is a free clinic. However, we do have some type one, but in a free clinic it's a whole different ball game when I see this being a game changer. The guidelines being a game changer is in the type one space, so with the new monoclonal antibodies and there's more in the pipeline. So changing one word in the guidelines this year has made such a huge impact and previously it was to prevent or delay type two diabetes. Now it's to prevent or delay diabetes. So they took out type two, because now we're talking pre-diabetes for type one. And again, I think this is a great opportunity for community pharmacists to start to work with their patients and if they recognize something's not right, they can intervene and make a difference.

Speaker 2: 8:54

One of the biggest challenges in today's world of diabetes is it being diagnosed correctly, and that's what we're gonna be talking about during the webinar. Is this correct diagnosis and not to give everything away, but at least you know, maybe entice people. You know there are more people being diagnosed with type one and there are younger people being diagnosed with type two, and so if we can prevent type? Well, we can't prevent type one yet, and I say that very carefully, but we can delay it. And can we prevent type two? Yes, so again, that's where a lot of this is, and I know before we started talking today, you know you and I were talking about how prevention is the best and going back to, you know, the lifestyle piece of this which gets missed by so many people. You know, everything is drugs, drugs, drugs. Right, we really need to focus on the lifestyle.

Speaker 1: 9:54

Yeah, yeah. So what do you think is the reason for more type one diagnoses?

Speaker 2: 10:01

Yeah, good question. You know, obviously it's genetic and it's, you know we're, we're getting close. I say that you know that we, meaning the diabetes world, is getting close to actually identifying which virus triggers the cascade response that you know destroys the beta cell, simplistically. You know what is that virus? And then you know I mean thinking about it what if we develop, and we find out what the virus is, we can develop a vaccine and diabetes could be preventable. Type one. But you know there's speculation, of course. When COVID hit, we saw an uptick. So was that part of the virus? You know that started this. Or you know people who have the gene who are susceptible there's, you know, a lot of talk to with inflammation. So do we have an answer? Not really, but it just seems that more and more people are being diagnosed. The other question is were people misdiagnosed before? And now that we have these guidelines in place for proper diagnosis, we are actually identifying?

Speaker 2: 11:08

oh, wait a minute, you really are type two, you're type one, yeah yeah, you're recognizing that the reason for the uptick in younger people with type two, it goes back to lifestyle, you know, ultra process foods, inactivity, lack of sleep, all of that.

Speaker 1: 11:25

So well that kind of leads into. You know, obviously the entire world now is talking about GLP ones. I mean, I think I can't turn on the news and see something about it, whether it's compounding or adverse effects or oh my gosh.

Speaker 1: 11:39

I remember I'll give a little editorial comment I saw today's show story on it maybe a year ago, and people were talking about ozempic face and you know some of the complaining that they were losing weight in certain areas and I thought, oh my gosh, what is this world coming to Like? They just want to lose weight in all the places that it's important to them, but not the other places. Like, oh, one thing leads to another. But you know, the splash that they're having on weight loss in this country has been a game changer. I feel like I can even look at people and know who are taking it. So what are your thoughts on that as it relates to patients with diabetes, because I know everybody's looking at it as this weight loss miracle drug. But how?

Speaker 2: 12:21

does that?

Speaker 1: 12:21

impact your patient population.

Speaker 2: 12:24

You know. So fortunately I can't complain. Our patients can actually get the GLP ones. So you know we do limit the, which ones. We have, unfortunately again, a free clinic. So I know access to getting these products is very challenging but more and more patients are able to get it. It is frustrating when the drugs are being used or given prescribed for people without diabetes when people with diabetes need this. So that is frustrating and I think it was it's a supply-demand issue. You know, having known about GLP ones and you know again, full disclosure, big fan, I've always loved them.

Speaker 2: 13:06

They fix multiple broken organs. You know they have preventative effects for cardiovascular. You know, coming down the pipeline, liver issues etc. Even dementia. But you know, if we think about it, they were not really heavily used. Despite the guideline changes they were still not actively being prescribed. But once they got that weight loss indication it became, as you put it, you know, the next bus thing out there and it's because we want that easy fix.

Speaker 2: 13:37

The concern is the drug by itself will not fix the problem. You know you have to go to lifestyle and that is important and they have to go hand in hand. So what obesity and we'll talk about this during the webinar is because obesity is part of the problem and that's not only leading to diabetes but cardiovascular disease. You know non-alcoholic fatty liver, you know liver stenosis, etc. So again, we want to make sure that you know people are getting the help that they need, especially to lose some of this weight. But you have to remember, just because you're taking the drug doesn't mean you get to drive through McDonald's and make every day, yeah, yeah.

Speaker 1: 14:21

Do you feel like I mean, what are the conversations that you have with your patients? Like I mean, this is kind of a miracle drug, truly and like you said it's not just weight loss but it's all the other things that go along with it that are so positive. I mean, are your diabetes patients kind of taking that as a jump start and doing the other things along with it? What are the conversations we can, you know, have as we give those drugs?

Speaker 2: 14:47

Right, this is, yeah, absolutely. I love how you said that. It's kind of like a jump start. So you know some people will come in and they're always hesitant. You know they're always hesitant for medication, especially my population. They, you know if they can get away with lifestyle or natural. Of course they want that. But they'll come in and you know they have an A1C.

Speaker 2: 15:05

I had a lady a few weeks ago and her A1C. We did a point of care on her. Her A1C was 12.3. Blood glucose right then and there was 396.

Speaker 2: 15:17

So you know, first thing, I'm not letting her walk out the door, right? You know I'm fortunate that I have a prescriber right there with me. So we of course give her some, you know, fast acting insulin to kind of get brought down slowly. We did find she was not adherent to her medications. So we talked about adherence. But in the meantime I said to her you know we're going to add on this other medicine to help you.

Speaker 2: 15:43

And she's like, but what if I just take my medicine correctly? I said that's good, but the problem is it's so high right now. We need to jump start, we need to get you down and then, once you are, once the sugar becomes more manageable and things are going well. We can deep prescribe Now in general, of course, and we'll disclose here. She was on my form and as well. So I said we can deep prescribe them at Foreman, but I'd rather you on this GLP one. Now, again, benefit of where I'm at, we have them do the injection right there in the office. She was completely surprised about it. Didn't hurt a bit. So you know, when they go through it with you and I use the demo pen on me, so it's like here I'm going to do this with you, you're not alone, they feel better and they're comforted in knowing oh, look at you know the pharmacist is actually injecting herself, even though it's a dry injection. She's injecting herself because she's working with me and not had really any issues with this.

Speaker 2: 16:45

And oh they're doing so much so that the prescriber that I work with not too long ago we finished early and she's like, wow, you're done early today, everybody's doing fine, I don't need to see them for three to six months. And she just looked at me like, really, how do you do that? So again, the opportunity of knowing your patient, working with them, hearing what they have to say, what they're willing to do, and making it work.

Speaker 1: 17:11

Yeah, yeah, that's a great example, something easy for us to do that you know, gives people comfort. Yeah, that's great. So there are some immunization guidelines in there as well for patients with diabetes. Can you talk a little bit about those and what you see as our role in pharmacy related to that?

Speaker 2: 17:32

So to talk the update and again, I don't wanna give the whole webinar away, but talk the update. The update really focuses on RSV, so that's the one that has come out now. Really want all folks to get that are eligible for that. And then, of course, covid. You know before it was like strongly recommended, now it's just part of the standard. But one of the things that every pharmacist can do is check the patient's profile. Which immunizations do they have? In Illinois, and I believe Iowa too has this.

Speaker 2: 18:06

Where you're at, you can get onto the website, like we have iCare. We can actually look to see which immunizations the patient has. So when we're meeting with them we can do a quick check and then recognize hey, wait a minute, they're missing this. They're missing their HEPB series, they're missing their you know it's time for their tetanus. So we can look at that. And then it's an opportunity again service we can provide to say do you realize it's? You know it's time for you to get this shot. Yeah, looking at their profile, making sure that they're up to date with everything that they need and offering that service to them.

Speaker 1: 18:42

Yeah, and we should be doing that for all adult patients particularly because even I was so behind and I'm just in the process of getting caught up, because that just happens, I think, when you know if you don't have a primary care provider or you're kind of not on the right schedule, it just sort of gets away from you.

Speaker 1: 18:57

So it's a great policy for all of our patients to be asking those questions. But I think it's a great start with diabetes, because there are higher risks that maybe that's an easy way to jump into it If you're not already doing that is, you know, flag those diabetes patients and ask them, and then you kind of can get in the habit of doing that with all your adult patients. So that's great. I also noticed just continued emphasis I think because this has been in before on cultural sensitivity in self-management education. Have you seen this improve in your practice over the years and, if so, what are some tips that you might have for people who are trying to ensure that we're providing the best resources for our diverse patient populations and, you know, just taking social determinants of health into consideration? I know you mentioned your patient who wasn't adherent and you know what are some things that we can do in that space. You know, related to the guidelines.

Speaker 2: 19:51

You know, I think the biggest thing is to listen to the patient and to be able to accept that patient for who they are. You know, I have several patients. I work in a very large Hispanic community. We have a lot of Middle Eastern folks who have, you know, very different cultural beliefs, religious beliefs, and respecting them and respecting what they're going to do. As a matter of fact. You know, we were just recently, yesterday, talking about fasting. You know, coming up holidays for some religions and they're going to go into fasting and of course, every religion provides people that have diabetes and other chronic illness they're exempt. But people don't always recognize diabetes as a serious illness and so they don't want to be exempt. They want to live a normal life and we're touting we want you to live a normal life. So how do we adapt fasting into your daily routine? How is that going to affect your medicine? So that's kind of one example. The other two is, if at all possible, to have a staff, a pharmacy staff, that will adapt to these people. So I'm very fortunate I have students that speak multiple different languages and, just to share a very brief story, one of the things we do, we actually go into food pantries and you know it's about prevention. So if we can do health screenings of food pantries, these are a high risk population, people that are housing, insecure, you know, low income. They're struggling If we can identify them early by checking their sugar, their blood pressure. You know we do pulse socks, we have an A and C check, so can we get them into the system earlier if we identify.

Speaker 2: 21:39

And a couple of weeks ago I had a young first year pharmacy student with me who speaks Spanish fluently, the Hispanic girl, and she came in and she was working with a patient and she was having this conversation.

Speaker 2: 21:53

The patient and my student were very animated and you know my student, of course, will pause and translate for me and ask questions and go back and forth and I know little bits and pieces of Spanish, but nothing where I would even attempt to talk. But at the end the patient walked out and she was smiling and like holding the girl's hands and just very happy. And my student says to me the patient commented that she was happy to see people like me in the profession because we don't get these opportunities and that really hit home. That really hit me. We think we're diverse, but for this student to feel the power of what she did as a first year pharmacy student for one person by just being herself. Yeah, you know it was very empowering for me as the old professor but to see how happy it made my student and how happy it made this patient. So if we have the opportunity to provide that comfort or sense of familiarity with our people, that's what we need to do.

Speaker 1: 23:00

Yeah, that is such a great story and it is. You know, we think that we're providing, you know we're trying to provide those services. But sometimes you can only do that when you know, when you can kind of speak the same language, so to speak literally and figuratively. So that's a great story. I feel like CGMs are also kind of having a moment within diabetes and outside of diabetes too.

Speaker 1: 23:25

We talked a little bit before we started recording. I follow a lot of health and wellness people on social media and that kind of thing and so many of them are wearing CGMs to track you know what food and drink and the order that we eat food, what all of that does to our blood glucose and you know talking about inflammation, and you know all the impacts of having high blood glucose and what that does. So I think it's just really interesting that even people that are trying to prevent and be healthy are wearing CGMs. So what do you think about that? For one question? And then, how do you feel it impacts care for patients with diabetes who utilize CGMs as you know, a necessity for safety and dosing and what has been the latest thing, I guess, in CGMs in your practice?

Speaker 2: 24:15

So you know, I completely agree. I think CGMs are very powerful and the data that we get from them really help people make healthy choices. So that's, you know. That's the overall arching statement. Something for folks to realize is that CGMs are designed and approved for people with diabetes, and so I know many. You know, like obesity clinics, weight loss programs, are starting to tout using these CGMs because it does help us to make informed decisions. You know we're saying oh, this is what two pieces of pizza does. This is what, oh my gosh. You know I got to get the kids to the bus and the bus is there and the kids aren't ready. You know the stress does to my, to our sugar. We didn't get a good night's sleep, we got way too much sleep. What does that do to your body? And so I think that's where we're getting powerful lifestyle information that hopefully leads us to make healthier lifestyle changes.

Speaker 2: 25:20

But with that said again, just kind of a quick story here. As a matter of fact, right now, as we are talking, my students who are in the diabetes elective are wearing CGMs. Oh, that's great. Yeah, so we do this every year. If they take the diabetes elective for two weeks, they have to live and breathe like a person with diabetes. So they are actually wearing CGM, they have to chart what they're eating, exercise, activity, and this is the second year we're doing it and I'll share a story here because my students that are doing it now this is week one, they're finished week one, so they'll take it off next week and then we debrief and we talk about this and they actually have to write kind of a reflection.

Speaker 2: 26:01

But last year I'll share a story. I had a student who historically is probably not the healthiest eater but she skips meals a lot and she found she was running low and in general people without diabetes will probably run low and I think that surprises a lot of people. So in this particular case, this student, she didn't believe me because I will always say test, test your sugar with the CGM before you go into one of your therapeutic exams. After and sure enough, you know this girl who runs in the 60s. She went into her therapeutics exam in the 120s, 130s, which was super high. Yeah, exams over and she comes out. You know her blood sugar is like 68. I did not believe it, but going in it was really high and that was the stress because it was a very high stakes exam and that's what stressed us to our body.

Speaker 2: 26:57

So to realize that you know, in contrast that with again, I've had patients where they, you know, will recognize. Oh, when I go to family dinner on Sunday I noticed my sugar goes well over the target of 180. I'm in the 200s but during the week when I'm working and I'm busy, I'm within target range. So it allows them to make decisions. So the role we use CGM with our patients, because many of our patients, again, type two, not always on insulin, and so you know insurance won't cover it.

Speaker 2: 27:29

But people are willing to pay out of pocket and I know we've talked about that. So they're willing to pay out of pocket for what we're now calling and it has a term intermittent CGM, and so they'll wear it for two weeks and then not have to, you know, making lifestyle choices, recognizing what things do to their body, but then they might not wear it again for another three months. So I have one patient, as a matter of fact, realized he would have coffee with cream every morning and he sipped on that coffee all morning long and his sugar remained constantly elevated. Now he has pre-diabetes and so his sugar was up, but then when he only drank coffee in the morning still coffee with cream drank it in the morning and did not have coffee after that until again at lunch his sugar was normal. So lifestyle decisions now is that for everybody? Not necessarily, but that's what worked for him, yeah oh, that's so great.

Speaker 1: 28:24

And I mean knowledge is power, you know, and measuring that data, I think, can give you so much information. I wore over COVID, I wore it reminds me of I wore a whoop band. I don't know if you've heard of that, but you know there's all these wearables but it's, you know, one that tracks your sleep and all of that. But I started wearing it because my brother told me about it and I could.

Speaker 1: 28:46

Literally when I got COVID I knew about it like three days before I had any symptoms and it was just I loved I don't wear it anymore because I just found that I wasn't looking at it as much as when I had some time, when, you know, when we were all home, stuck home, I'm like give me the information, but it is, I mean, it's very similar in that you know what stress does and you can make those changes. And once you know that, you know that, you know, you know that that happens every time. So I love the idea of maybe just doing it for a couple weeks where you can kind of track your regular patterns and know what happens, and then you have the power to change that Exactly. So interesting. Yeah, there's just as more and more of this technology, you know, it's just great how we can use it for prevention as well as as well as in diabetes.

Speaker 1: 29:33

So what else? Is there anything that I have? Those are kind of the things that stuck out to me that I wanted to ask you about. You know, in the new standards and I know we're gonna talk about that during the live webinar on the middle of February it's February 13th and I'll give some information on that but is there anything else that I didn't touch on that you think is really important to just at least highlight, kind of at a 10,000 foot level.

Speaker 2: 29:56

Yeah, I think probably the big take home message that I have for the webinar is that they're managing sugar is no longer what diabetes is about, is more than that. We must look beyond just sugar, and I know we've talked to yours about this. You know blood pressure and lipids, but it's more than that. It's the liver, it's the kidneys, and the big thing now is cognitive function. And even with the CGMs and again, not giving things away but what we're realizing is when we have these glucose fluctuations or our sugar is elevated, that is where cognitive impairment happens, and so we're starting to see some of the diabetes drugs now being looked at in prevention for dementia.

Speaker 2: 30:43

So I don't know about anybody else, but I'd like to keep my cognitive function, yes, and as long as I possibly can. So I think when we're starting to look beyond just the sugar and looking at everything else involved gout, you know, as a matter of fact, even some of the new drugs with SGLT2s. Right now they're starting to look into rheumatoid arthritis, so rheumatoid diseases, you know we're looking beyond just sugar where these play a role. So I think we have to start looking not as diabetes drugs, but as metabolic, cardiometabolic, renal or multi morbidity drugs. I don't know what we want to call them yet, but we have to look beyond the sugar, and managing diabetes is much more than sugar.

Speaker 1: 31:33

Yeah, absolutely. It's just reframing how we think about it and I mean that you know it's been around. We talked about metabolic syndrome, but we haven't, you know there hasn't been a drug that kind of touches on all of those points. And I think you know, with the GLP1s, that sort of change the game in the way that we talk about it. So that's a really good point. So you are hosting the live annual Diabetes Update on Tuesday, february 13th. That's at 7 pm central, and I love the title for this. It's A1C to Z A Sweet Update on Diabetes Guidelines.

Speaker 1: 32:06

So it's very fitting for the day before a thing or before a Thanksgiving, before Valentine's Day. Valentine's Day yes, the world is going too fast. It's already almost Valentine's Day and I'm looking forward to that. It's always one of my highlights of the year, honestly, because I do think there is so much in the space that's changing very rapidly. I think we went for a long time without a lot of innovation, I think, in this area. We actually did a podcast last week on one week once weekly basal insulin.

Speaker 1: 32:39

So that is also going to be a game changer, I think, in this next calendar year as it relates to type one. So just so much in this space, and I feel like for a long time we didn't have a lot of advancements and I feel like now it's kind of ramping up at full speed. So I'm excited to be able to dig into that a little bit more on all of the topics that we talked about today and more than that. So thank you so much for joining me today and giving a little Cliff Note version and kind of a teaser. I really appreciate your time and I know you're so busy with your students and with your patients and your partnership with CEMPAC to ensure that we keep people up to date in this area. It's just. I'm really grateful for it. So thank you so much. Happy to be here, looking forward to February 13th yes, me too.

Speaker 1: 33:24

And so don't forget to enroll in that live update CE Plan members. It's already in your profile, so you just need to go to that and click register and then you'll get the Zoom link. And if you aren't a CE Plan member, be sure to sign up so that you could participate in this great CE with Dr Cornell. So thank you again so much, and thank you to all of our listeners and, as always, have a great week and keep learning. Talk to you soon. Be sure to check out our education at cempackcom. You'll find it to be your one stop shop for all the CE resources you need. Become a Pharmacist by design member today to access it all for free, including CE, for this podcast. Thanks for listening. We'll talk to you next week on Game Changers Clinical Conversations.