Unlocking the Mystery of Type 1 Diabetes – The TEDDY & Cascade Studies with Michael Killiam

What if you could take your basal insulin once a week instead of every day? Once-weekly basal insulin has arrived, offering a new approach that could make insulin therapy simpler while providing glucose control comparable to daily basal insulin. In this episode, Dr. Steve Edelman is joined by Dr. Athena Philis-Tsimikas, a leading diabetes researcher who has been directly involved in clinical trials of once-weekly basal insulins. Together, they explain how these ultra-long-acting insulins work, how a single injection can provide steady background insulin throughout an entire week, and what studies have shown when once-weekly insulin is compared with traditional daily basal insulin. The conversation gets practical with how once-weekly insulin is started, adjusted, and switched from daily basal insulin. Dr. Edelman and Dr. Philis-Tsimikas discuss the dosage differences with once-weekly basal insulin, how concentrated insulin keeps the actual injection volume small, and how fasting glucose can help guide dose adjustments. They also discuss what happens if you miss a dose and why reaching a steady state is an important part of understanding how these longer-acting insulins work. They also dive into the clinical trial results, including A1C, time in range, and hypoglycemia. In studies of people living with type 2 diabetes, once-weekly basal insulin provided similar A1C lowering to daily basal insulin without an increase in hypoglycemia. They also explain why the story is different for people living with type 1 diabetes, where studies found higher rates of hypoglycemia with weekly basal insulin, and what that means for its use in the United States. Finally, Dr. Edelman and Dr. Philis-Tsimikas look at how once-weekly insulin could make diabetes management easier. Going from seven basal injections a week to just one could help reduce some of the daily burden of diabetes and make it easier to consistently take your insulin. They also explore using weekly insulin alongside GLP-1 medications, potential combination therapies, cost and access, and what we still need to learn as these newer insulins move from clinical trials into everyday diabetes care. Key Topics: How once-weekly basal insulin works Once-weekly vs. daily basal insulin Starting, dosing, and adjusting weekly insulin Why weekly insulin doses may look surprisingly large A1C, time in range, and hypoglycemia results What to do if you miss a weekly dose Once-weekly insulin in type 1 vs. type 2 diabetes Who may benefit from once-weekly insulin? Reducing the burden of daily injections Using once-weekly insulin with GLP-1 medications Future insulin and GLP-1 combination therapies Cost, access, and real-world considerations What the future of basal insulin could look like This episode was supported by Lilly. ✨ Subscribe for practical diabetes management tips, technology updates, and treatment breakthroughs that help people with diabetes live healthier, more flexible lives.

Managing type 2 diabetes can change over time, but having the right information for your patients can make those changes feel a lot more manageable. CGM can help your patients see what’s happening with their blood sugar and guide what comes next.

Chronic kidney disease (CKD) is one of the most common complications of diabetes, but here’s the tricky part: you can have it for years without feeling any symptoms. The good news? Kidney disease can often be detected early, and with the right screening, treatments, and lifestyle changes, its progression can be dramatically slowed. In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus are joined by nephrologist Dr. Bethany Karl to break down what everyone with diabetes should know about kidney health. Dr. E also steps into the patient seat to share his own experience living with chronic kidney disease, from discovering it without symptoms to navigating kidney tests and newer treatments. Together, they explain the two simple tests that can uncover kidney problems, why blood pressure and cardiovascular health matter, and how today’s growing toolbox of medications is giving people with diabetic kidney disease more reasons for hope.

Hot flashes, blood sugar swings, brain fog... is it menopause, diabetes, or both?

Have you or someone you know been diagnosed with type 2 diabetes, only to discover later it was actually type 1? You're not alone.