Starting Medications for T2DM: When Metformin Isn’t the First Choice - Frankly Speaking Ep 403

Frankly Speaking About Family Medicine

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Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-403

Overview: Recorded live at Pri-Med East! - The American Diabetes Association (ADA) has updated their standards of care for patients with diabetes. In this episode, we discuss some of the changes in the initial selection of glucose-lowering medications for type 2 diabetes mellitus (T2DM), including when alternatives to metformin may be appropriate. Hear strategies for making personalized, guideline-recommended choices that enhance care for patients with T2DM.

Episode resource links:

Pharmacologic Approaches to Glycemic Treatment. In: American Diabetes Association. Standardsof Care in Diabetes2024 - DiabetesCare 2024 Jan 1;47(Suppl 1):S1-S321

Guest: Alan M. Ehrlich, MD, FAAFP

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

434 حلقات

#Medicine #Continuingmedicaleducation #Familymedicine #Familypractice #Medical #Primarycare #Science #PriMed Podcasts #Podcasting Education

Frankly Speaking About Family Medicine

Starting Medications for T2DM: When Metformin Isn’t the First Choice - Frankly Speaking Ep 403

Frankly Speaking About Family Medicine

197 subscribers

published منذ عام واحد

MP3•منزل الحلقة

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-403

Episode resource links:

Pharmacologic Approaches to Glycemic Treatment. In: American Diabetes Association. Standardsof Care in Diabetes2024 - DiabetesCare 2024 Jan 1;47(Suppl 1):S1-S321

Guest: Alan M. Ehrlich, MD, FAAFP

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

434 حلقات

#Medicine #Continuingmedicaleducation #Familymedicine #Familypractice #Medical #Primarycare #Science #PriMed Podcasts #Podcasting Education

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Frankly Speaking About Family Medicine

1
The Wine Debate: Cardiovascular Benefits Vs Cancer Risks - Frankly Speaking Ep 422 9:05

منذ 4 أيام9:05

9:05

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-422 Overview: Conflicting data on alcohol’s health effects leave clinicians uncertain about patient guidance. In this episode, we review the PREDIMED trial’s findings on wine and cardiovascular outcomes, explore objective biomarkers for intake, and examine the National Academy of Sciences’ recent report to clarify the risks and benefits of moderate consumption, giving you confidence in counseling patients. Episode resource links: Inés Domínguez-López, Rosa M Lamuela-Raventós, Cristina Razquin, et al. Urinary tartaric acid as a biomarker of wine consumption and cardiovascular risk: the PREDIMED trial, European Heart Journal, 2024;, ehae804, https://doi.org/10.1093/eurheartj/ehae804 National Academies of Sciences, Engineering, and Medicine. 2025. Review of Evidence on Alcohol and Health. Washington, DC: The National Academies Press. https://doi.org/10.17226/28582 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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The Nurse Practitioner Will See You Now - Frankly Speaking Ep 421 19:05

منذ 11 يومًا19:05

19:05

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-421 Overview: Join us as we discuss a recent meta-analysis examining randomized controlled trials to investigate healthcare costs, quality of care, and patient well-being when delivered by advanced nurse practitioners (ANPs). Explore the evidence behind ANPs’ effectiveness and their potential to enhance patient outcomes while optimizing healthcare resources. Episode resource links: Melati Fajarini, Agus Setiawan, Chien-Mei Sung, Ruey Chen, Doresses Liu, Chiu-Kuei Lee, Shu-Fen Niu, Kuei-Ru Chou, Effects of advanced practice nurses on health-care costs, quality of care, and patient well-being: A meta-analysis of randomized controlled trials, International Journal of Nursing Studies, Volume 162, 2025,104953, ISSN 0020-7489, https://doi.org/10.1016/j.ijnurstu.2024.104953 The miseducation of America’s nurse practitioners, July 24, 2024 Perloff, J., Clarke, S., DesRoches, C. M., O'Reilly-Jacob, M., & Buerhaus, P. (2019). Association of State-Level Restrictions in Nurse Practitioner Scope of Practice With the Quality of Primary Care Provided to Medicare Beneficiaries. Medical care research and review : MCRR, 76(5), 597–626. https://doi.org/10.1177/1077558717732402 Yang, B. K., Johantgen, M. E., Trinkoff, A. M., Idzik, S. R., Wince, J., & Tomlinson, C. (2021). State Nurse Practitioner Practice Regulations and U.S. Health Care Delivery Outcomes: A Systematic Review. Medical care research and review : MCRR, 78(3), 183–196. https://doi.org/10.1177/1077558719901216 Taylor K (2023) Bridging the Gap to Health Care Access: The Role of the Nurse Practitioner. Int Arch Public Health Community Med 7:091. doi.org/10.23937/2643-4512/1710091 Guest: Susan Feeney, DNP, FNP-BC, NP-C, Jill M. Terrien PhD, ANP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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“I Guess I Won’t Have Another”—Alcohol and Cancer Risk - Frankly Speaking Ep 420 13:32

منذ 18 يومًا13:32

13:32

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-420 Overview: Listen in as we discuss the US Surgeon General’s new advisory on the impact of alcohol on cancer incidence and mortality. We review the latest data, explore alcohol’s role in carcinogenesis, and provide evidence-based guidance to help you counsel patients on safer consumption and cancer prevention. Episode resource links: U.S. Surgeon General Issues New Advisory on Link Between Alcohol and Cancer Risk | HHS.gov Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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Fluoride in Drinking Water: Why Is There Controversy? - Frankly Speaking Ep 419 12:20

منذ 25 يومًا12:20

12:20

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-419 Overview: Water fluoridation has been an area of periodic controversy since it was first introduced in the 1950s. This episode dives into recent reports on the benefits and potential impacts of water fluoridation on children’s IQ. Gain valuable insights and feel prepared when addressing patient questions about this topic. Episode resource links: Taylor KW, Eftim SE, Sibrizzi CA, et al. Fluoride Exposure and Children’s IQ Scores: A Systematic Review and Meta-Analysis. JAMA Pediatr. Published online January 06, 2025. Iheozor-Ejiofor Z, Walsh T, Lewis SR, Riley P, Boyers D, Clarkson JE, Worthington HV, Glenny AM, O'Malley L. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev. 2024 Oct 4;10(10):CD010856. Schluter PJ, Hobbs M, Atkins H, Mattingley B, Lee M. Association Between Community Water Fluoridation and Severe Dental Caries Experience in 4-Year-Old New Zealand Children. JAMA Pediatr. 2020 Oct 1;174(10):969-976 Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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My Tummy Hurts—Reasonable Options for Fluid Replacement in Mildly Dehydrated Children - Frankly Speaking Ep 418 13:54

منذ 5 weeks13:54

13:54

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-418 Overview: Acute episodes of nausea, vomiting, and diarrhea due to gastroenteritis in children are common complaints seen in primary and urgent care settings. Join us as we discuss recent evidence suggesting that apple juice can be as effective as commercial electrolyte solutions, offering a cost-effective and convenient option for oral replacement therapy for mild dehydration. Episode resource links: Freedman SB, Willan AR, Boutis K, Schuh S. Effect of Dilute Apple Juice and Preferred Fluids vs Electrolyte Maintenance Solution on Treatment Failure Among Children With Mild Gastroenteritis: A Randomized Clinical Trial. JAMA. 2016;315(18):1966-1974. doi:10.1001/jama.2016.5352 Goldman RD, Friedman JN, Parkin PC. Validation of the clinical dehydration scale for children with acute gastroenteritis. Pediatrics. 2008;122(3):545-549. doi:10.1542/peds.2007-3141 Jauregui J, Nelson D, Choo E, et al. External validation and comparison of three pediatric clinical dehydration scales. PLoS One. 2014;9(5):e95739. Published 2014 May 2. doi:10.1371/journal.pone.0095739 https://primarycarenotebook.com/pages/haematology/world-health-organization-who-scale-for-dehydration AAP: Signs of Dehydration in infant and children https://primarycarenotebook.com/pages/haematology/world-health-organization-who-scale-for-dehydration Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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A Matter of the Heart—Screening Guidelines for Cardiovascular Disease - Frankly Speaking Ep 417 11:30

منذ 6 weeks11:30

11:30

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-417 Overview: Joseph is a 57 year old male who presents today for his routine annual exam. He is a healthy male, who is active and has no complaints today. He reports that since he was seen last he generally has been doing well but did have a ER visit for persistent cough in the setting of recovering from Covid. While in the Emergency Department he did undergo testing. On a CT Chest scan there was an incidental finding of moderate coronary artery calcifications. He asked today, what does moderate coronary artery calcification? Is my heart ok, my dad had a heart attack at 60. Episode resource links: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) https://odphp.health.gov/healthypeople/objectives-and-data/browse-objectives/heart-disease-and-stroke#:~:text=Heart%20disease%20and%20stroke%20can,and%20high%20cholesterol%20through%20treatment . Vikulova, D. N., Lee, M. K., Humphries, K. H., Pinheiro-Muller, D., Dawes, M., Pimstone, S. N., & Brunham, L. R. (2024). Preventive Lipid-Lowering Therapy and Interactions With Health Care in Patients Who Develop Premature Coronary Artery Disease. JACC: Advances, 101316. Maron, D. J., Budoff, M. J., Sky, J. C., Bommer, W. J., Epstein, S. D., Fisher, D. A., ... & DeMaria, A. N. (2024). Coronary Artery Calcium Staging to Guide Preventive Interventions: A Proposal and Call to Action. JACC: Advances, 3(11), 101287. https://www.cdc.gov/heart-disease-family-history/about/index.html Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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My Back Still Hurts! Nonpharmacologic Approaches to Chronic Back Pain - Frankly Speaking Ep 416 14:23

منذ 7 weeks14:23

14:23

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-416 Overview: Listen in as we discuss chronic sacroiliac (SI) dysfunction and the role of nonpharmacological therapies, including acupuncture, in managing back pain and improving function. Hear evidence-based considerations for integrating acupuncture into your practice to offer effective, medication-free options for patients with chronic SI pain. Episode resource links: Kim G, Kim D, Moon H, et al. Acupuncture and Acupoints for Low Back Pain: Systematic Review and Meta-Analysis. Am J Chin Med. 2023;51(2):223-247. doi:10.1142/S0192415X23500131 Mu J, Furlan AD, Lam WY, Hsu MY, Ning Z, Lao L. Acupuncture for chronic nonspecific low back pain. Cochrane Database Syst Rev. 2020;12(12):CD013814. Published 2020 Dec 11. doi:10.1002/14651858.CD013814 Tu J-F et al. Acupuncture vs sham acupuncture for chronic sciatica from herniated disk: A randomized clinical trial. JAMA Intern Med 2024 Oct 14; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5463) Wu M, Fan C, Liu H, et al. The Effectiveness of Acupuncture for Low Back Pain: An Umbrella Review and Meta-Analysis. Am J Chin Med. 2024;52(4):905-923. doi:10.1142/S0192415X2450037X https://www-dynamed-com.umassmed.idm.oclc.org/condition/sciatica Guest: Susan Feeney, DNP, FNP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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It’s Time to Equip Patients with PEP - Frankly Speaking Ep 415 11:24

منذ 8 weeks11:24

11:24

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-415 Overview: Join us as we discuss the role of postexposure prophylaxis (PEP) in reducing the incidence and adverse outcomes of sexually transmitted infections (STIs), including chlamydia, gonorrhea, and syphilis. Discover when, why, and how to prescribe PEP to better provide your patients with effective prevention options to help reduce rising STI rates and disproportionate impacts on women. Episode resource links: Stewart, J., Oware, K., Donnell, D., Violette, L. R., Odoyo, J., Soge, O. O., ... & Baeten, J. M. (2023). Doxycycline prophylaxis to prevent sexually transmitted infections in women. New England Journal of Medicine, 389(25), 2331-2340. https://www.cdc.gov/sti/php/from-the-director/doxy-pep-sti-prevention-strategy.html#:~:text=Doxy%20PEP%20has%20proven%20to,syphilis%2C%20chlamydia%2C%20gonorrhea). Guest: Mariyan L. Montaque, DNP, FNP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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Is Standing Better than Sitting for Decreasing Cardiovascular Risk? - Frankly Speaking Ep 414 9:27

منذ 9 weeks9:27

9:27

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-414 Overview: Standing desks are a popular choice for people with sedentary jobs who want to increase their physical activity. In this episode, we look at the latest data on the benefits and risks of prolonged standing and provide actionable strategies to help patients reduce cardiovascular risk through informed movement choices. Episode resource links: Ahmadi MN, Coenen P, Straker L, Stamatakis E. Device-measured stationary behaviour and cardiovascular and orthostatic circulatory disease incidence. Int J Epidemiol. 2024 Oct 13;53(6):dyae136. doi: 10.1093/ije/dyae136. PMID: 39412356; PMCID: PMC11481281. Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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A Vitamin for Skin Cancer Prevention? - Frankly Speaking Ep 413 11:54

منذ 10 weeks11:54

11:54

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-413 Overview: Listen in to learn about the role of nicotinamide (vitamin B3) in reducing the risk of certain skin cancers. This episode reviews key prevention strategies, the latest evidence on skin cancer management, and practical approaches to support patients with sun-damaged skin. Episode resource links: Discuss the prevalence of basal cell and squamous cell carcinomas Review the potential benefits of nicotinamide (vitamin B3) for the prevention of skin abnormalities Identify additional methods to prevent skin cancer Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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Positioning is Everything for Accurate BPs! - Frankly Speaking Ep 412 8:05

منذ 11 weeks8:05

8:05

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-412 Overview: Discover how improper arm positioning can lead to inaccurate blood pressure readings and influence hypertension management as we discuss a recent randomized controlled trial. Hear evidence-based techniques to ensure proper arm and cuff positioning, improving hypertension diagnosis in your clinical practice. Episode resource links: JAMA Intern Med. Published online October 7, 2024. doi:10.1001/jamainternmed.2024.5213 Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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Don’t Miss the Red Flags for Early-Onset Colorectal Cancer - Frankly Speaking Ep 411 11:56

منذ 12 weeks11:56

11:56

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-411 Overview: This episode focuses on the rising prevalence of early-onset colorectal cancer and its critical indicators. Learn to recognize key symptoms, ensure timely diagnostic workups, and effectively address red flags to prevent delayed diagnosis. Episode resource links: Demb, J., Kolb, J. M., Dounel, J., Fritz, C. D. L., Advani, S. M., Cao, Y., Coppernoll-Blach, P., Dwyer, A. J., Perea, J., Heskett, K. M., Holowatyj, A. N., Lieu, C. H., Singh, S., Spaander, M. C. W., Vuik, F. E. R., & Gupta, S. (2024). Red Flag Signs and Symptoms for Patients With Early-Onset Colorectal Cancer: A Systematic Review and Meta-Analysis. JAMA network open, 7(5), e2413157. https://doi.org/10.1001/jamanetworkopen.2024.13157 US Preventive Services Task Force Screening Guidelines for Colorectal Cancer: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/colorectal-cancer-screening American Cancer Society Infographic for Patients: Colorectal Cancer: Catching it Early https://www.cancer.org/cancer/types/colon-rectal-cancer/prevention-infographic.html Gómez-Molina R, Suárez M, Martínez R, Chilet M, Bauça JM, Mateo J. Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review. Healthcare. 2024; 12(16):1645. https://doi.org/10.3390/healthcare12161645 Guest: Jill M. Terrien PhD, ANP-BC Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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To D or Not to D? New Guidance on Vitamin Supplementation - Frankly Speaking Ep 410 11:05

منذ 13 weeks11:05

11:05

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-410 Overview: In this episode, we discuss the latest updates on vitamin D. Learn about its link to common disorders, when to consider supplementation, and what the most recent practice guideline says about vitamin D and disease prevention—empowering you to make informed decisions and improve patient care without unnecessary screenings or treatments. Episode resource links: Marie B Demay, Anastassios G Pittas, Daniel D Bikle, Dima L Diab, Mairead E Kiely, Marise Lazaretti-Castro, Paul Lips, Deborah M Mitchell, M Hassan Murad, Shelley Powers, Sudhaker D Rao, Robert Scragg, John A Tayek, Amy M Valent, Judith M E Walsh, Christopher R McCartney, Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 109, Issue 8, August 2024, Pages 1907–1947, https://doi.org/10.1210/clinem/dgae290 Michael F. Holick, Neil C. Binkley, Heike A. Bischoff-Ferrari, Catherine M. Gordon, David A. Hanley, Robert P. Heaney, M. Hassan Murad, Connie M. Weaver, Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 7, 1 July 2011, Pages 1911–1930, https://doi.org/10.1210/jc.2011-0385 Guest: Jillian Joseph, PA-C Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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Bright Light Therapy for Depression: Useful in Any Season - Frankly Speaking Ep 409 10:23

منذ 13 weeks10:23

10:23

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-409 Overview: Listen in as we discuss how bright light therapy extends beyond seasonal affective disorder, potentially offering benefits for nonseasonal depression. Learn how to counsel patients effectively on its use and integrate this treatment into your practice, enhancing patient care and broadening treatment strategies for depression. Episode resource links: Menegaz de Almeida A, Aquino de Moraes FC, Cavalcanti Souza ME, Cavalcanti Orestes Cardoso JH, Tamashiro F, Miranda C, Fernandes L, Kreuz M, Alves Kelly F. Bright Light Therapy for Nonseasonal Depressive Disorders: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2024 Oct 2:e242871 Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

Frankly Speaking About Family Medicine

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Teenage Suicide and Social Media Use - Frankly Speaking Ep 408 14:12

منذ 15 weeks14:12

14:12

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-408 Overview: This episode explores the connection between adolescent mental health and social media use. We discuss actionable strategies for clinicians, emphasizing practical screening, effective conversation starters, and tech tools to guide families. Improve outcomes by learning to balance screen time discussions and proactive mental health interventions in primary care. Episode resource links: JAMA Netw Open. 2024 Jul 1;7(7):e2419881. doi: 10.1001/jamanetworkopen.2024.19881 https://www.cdc.gov/healthyyouth/data/yrbs/yrbs_data_summary_and_trends.htm Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com…

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Frankly Speaking About Family Medicine « » Starting Medications for T2DM: When Metformin Isn’t the First Choice - Frankly Speaking Ep 403

Starting Medications for T2DM: When Metformin Isn’t the First Choice - Frankly Speaking Ep 403

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Starting Medications for T2DM: When Metformin Isn’t the First Choice - Frankly Speaking Ep 403