CGM-Guided Insulin Initiation and Titration in Type 2 Diabetes

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.

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.

In this episode, Dr. Steve Edelman and Dr. Jeremy Pettus are joined by Dr. Shara Bialo, Senior Medical Director of Type 1 Diabetes Immunology at Sanofi, pediatric endocrinologist, and person living with type 1 diabetes, for an in-depth discussion about what happens before type 1 diabetes is diagnosed. Together, they explore the autoimmune process that begins months or even years before symptoms appear, why early detection matters, and how screening is changing the future of type 1 diabetes care. Dr. Bialo shares her personal diagnosis story, discusses common misconceptions about what causes type 1 diabetes, and explains the three stages of the disease. The conversation also covers who should be screened, how diabetes autoantibody testing works, the benefits of preserving beta cell function, and why identifying people before they develop symptoms can lead to better long-term outcomes and fewer cases of diabetic ketoacidosis (DKA). Whether you have type 1 diabetes, have a family member at risk, or simply want to better understand the latest advances in prevention and early detection, this episode provides valuable insights into one of the fastest-moving areas of diabetes research. Key Topics: Dr. Shara Bialo's personal journey living with type 1 diabetes Why type 1 diabetes is an autoimmune disease, not simply a blood sugar problem The role of genetics, viral infections, and the immune system Understanding the three stages of type 1 diabetes Why most people diagnosed with type 1 diabetes have no family history Adult-onset type 1 diabetes and why it is often mistaken for type 2 diabetes What diabetes autoantibodies are and how screening works Who should consider screening for type 1 diabetes Available screening options, including blood tests and home screening kits The emotional challenges families face when considering screening The importance of preventing diabetic ketoacidosis through early detection Why preserving beta cell function can improve long-term outcomes Italy's national screening program and the future of population-wide screening Resources available through screenfortype1.com This content was produced with support from Sanofi and screenfortype1.com.