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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Aug 7, 2017

Get cozy with these new drugs for diabetes. Don’t be scared, they won’t bite. On this episode,  we interview Endocrinologist and current president of AACE, Dr. Jonathan D. Leffert, MD, FACP, FACE, ECNU about how to utilize the myriad of new diabetes drugs on the marketplace including SGLT2 inhibitors, DPP4 inhibitors, GLP1 agonists, and new ultra long acting insulins. Plus, we’ll teach you how to choose between agents, common side effects, A1C goals, and the cardiovascular benefits of these newer agents.

Full show notes available at

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Case: Case from Kashlak Memorial Hospital: 49 yo M with HTN, BMI 29, hyperlipidemia, family history of premature CAD (dad age 45yo), and DM2 with A1C increase from 6.4% to 9% while on metformin monotherapy.

Time Stamps

00:00 Intro

04:33 Getting to know our guest

09:50 Clinical case of diabetes

12:40 Latent autoimmune diabetes

15:16 Life expectancy and A1C goal

16:47 Anemia’s effect on A1C

18:40 Back to our case, choice of agent

20:57 Lifestyle changes effect on A1C

22:55 Starting an SGLT2 inhibitor, what to look for

26:45 SGLT2 inhibitor use in patient already on diuretic

27:53 Discussion of CV risk reduction and newer DM meds

33:27 Euglycemic DKA

34:30 Choice of agent GLP1 vs SGLT2

37:10 Use of DPP4 inhibitors

38:55 Back to the case

39:37 Degludec, long acting insulin

41:34 Clinical case conclusion

43:03 Take home points

45:15 Outro

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