This issue will review:

1. Real-World Prospective Validation and Economic Evaluation of Deep Learning-based Diabetic Retinopathy Detection from Fundus Photographs: A Systematic Review and Meta- Analysis

2. Orforglipron, an oral small-molecule GLP-1 receptor agonist, for the treatment of obesity in people with type 2 diabetes (ATTAIN-2): a phase 3, double-blind, randomised, multicentre, placebo-controlled trial

3. FDA removal of SI for GLP-1s – FDA Announcement Neil Read/John Comment

4. Effectiveness and Safety of Statins in Type 2 Diabetes According to Baseline Cardiovascular Risk: A Target Trial Emulation Study

5. GLP-1 Receptor Agonists and Risk of Optic Nerve or Vision-Threatening Events in Patients with Type 2 Diabetes or Cardiometabolic Diseases: A Meta-Analysis of Randomized Controlled Trials

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals.

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org.

Hosts:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health

In this special edition on Obesity as a Chronic Disease our host, Dr. Neil Skolnik will discuss the root causes of obesity, the hormonal changes and metabolic adaptation that occurs when a person has obesity, and the implications of understanding obesity as a chronic disease for clinical practice. This special episode is supported by an independent educational grant from Lilly.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

Donna Ryan, M.D, Professor Emeritus at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. Past President of both the Obesity Society and the World Obesity Federation

Susan Kuchera, M.D, Associate Clinical Professor of Family and Community Medicine in the Sidney Kimmel Medical College of Thomas Jefferson University, Program Director of the Jefferson Health Abington Family Medicine Residency Program.

Selected references:

Changes in Energy Expenditure Resulting from Altered Body Weight. N Engl J Med 1995;332:621-628

Long-Term Persistence of Hormonal Adaptations to Weight Loss. N Engl J Med 2011;365:1597-1604

Show notes

With the launch of a new journal, the American Diabetes Association (ADA) is also launching a brand new podcast. The Points of CARE, the official podcast of Diabetes, Obesity, and Cardiometabolic CARE, will highlight key research findings, clinical implications, and emerging themes across diabetes, obesity, and cardiometabolic health through interviews with journal authors and subject-matter experts. In this special inaugural episode, host Richard Beaser, MD also discusses the ADA's Obesity Association and the "Standards of Care in Overweight and Obesity."

4:15 Beaser speaks with Alissa Segal, PharmD, RPh, CDCES, CDTC, FCCP. Dr. Segal is editor in chief of Diabetes, Obesity, and Cardiometabolic CARE and professor of pharmacy practice at the Massachusetts College of Pharmacy and Health Sciences. Her editorial, "Diabetes, Obesity, and Cardiometabolic CARE: Building New From a Strong Foundation," is available for free at doi.org/10.2337/doci25-0010.

13:00 Samar Hafida, MBCCh, joins the conversation. Dr. Hafida is a board-certified endocrinologist and weight management specialist at Boston Medical Center and assistant professor of medicine (Endocrinology, Diabetes, Nutrition & Weight Management) at the Boston University Chobanian & Avedisian School of Medicine. She is also vice president of the ADA's Obesity Association. Her editorial, "Introducing the Obesity Association and the Launch of Our Official Journal," is available for free at doi.org/10.2337/doci25-0012.

17:55 Dr. Hafida discusses "Pharmacologic Treatment of Obesity in Adults: Standards of Care in Overweight and Obesity." This article is available for free at doi.org/10.2337/doci25-0008.

20:05 Richard and Alissa highlight a few articles from the first issue of Diabetes, Obesity, and Cardiometabolic CARE.

• Simpkins et al. "Association of Type 2 Diabetes Subgroups With Incident Peripheral Neuropathy" doi.org/10.2337/doc25-0051

• Livingston et al. "The Benefits and Costs of Treating Obesity Among Adults in the Medicaid Program" doi.org/10.2337/doci25-0005.

• Davidson et al. "Effectiveness of Using Patient-Defined Meal Sizes to Determine Bolus Doses of Insulin" doi.org/10.2337/doc25-0018

• Ali et al. "Patterns of Prescription Discontinuation, Reinitiation, and Switching of Subcutaneous Semaglutide and Tirzepatide in Adults With Obesity" doi.org/10.2337/doc25-0026

• Masiano et al. "Type 2 Diabetes Treatment and Experience With Hospitalization in Older Adults: A Convergent Mixed-Methods Study" doi.org/10.2337/doc25-0009

• Young et al. "The Critical Role of Diabetology Pharmacists in Improving Cardiovascular-Kidney-Metabolic Care and Outcome" doi.org/10.2337/doc25-0049

To learn more about Diabetes, Obesity, and Cardiometabolic CARE please visit diabetesjournals.org/docm-care. Thank you for listening, and don't forget to subscribe.

In this special series on Metabolic-Dysfunction Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-associated steatohepatitis (MASH) our host, Dr. Neil Skolnik will discuss diagnosis and treatment of MASH using a case-based approach with two master clinicians, one a hepatologist and the other a primary care physician. This special episode is supported by an independent educational grant from Boehringer Ingelheim.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

Alina M. Allen, M.D. Associate Professor of Medicine at Mayo Clinic in Rochester, Minnesota, where she serves as the Director of Hepatology and Director of the MASLD Clinic.

Susan Kuchera, M.D. - Program Director of the Jefferson Health Abington Family Medicine Residency Program, Clinical Associate Professor of Family and Community Medicine in the Sidney Kimmel Medical College of Thomas Jefferson University

Selected references:

Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association. Diabetes Care 2025;48(7):1057–1082

In this special series on Oral GLP-1 Receptor Agonists, Dr. Neil Skolnik will discuss the first of the GLP-1 RAs to receive FDA approval, Semaglutide. This special episode is sponsored with support from Novo Nordisk.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

W. Timothy Garvey, MD., Butterworth Professor and University Professor of Medicine in the Department of Nutrition Sciences at the University of Alabama at Birmingham.

Selected references:

Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial. Knop, Filip K et al. The Lancet, Volume 402, Issue 10403, 705 – 719

Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity. Wharton Sean et al. N Engl J Med 2025;393:1077-1087

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes. Lincoff, A Michael, et al. N Engl J Med 2023;389:2221-2232

In this special series on Automated Insulin Delivery our host, Dr. Neil Skolnik will discuss with the benefits of Automated Insulin Delivery for people with Type 2 Diabetes with two master clinicians, one an diabetes specialist, the other a primary care doctor. This special episode is supported by an independent educational grant from Insulet.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

Davida Kruger, MSN, APN-BC,BC-ADM, Henry Ford Health, Detroit, Michigan. Past Chair of the American Diabetes Associations Research Foundation, Past president, Health Care and Education of the American Diabetes Association.

Susan Kuchera, M.D. - Program Director of the Jefferson Health Abington Family Medicine Residency Program, Clinical Associate Professor of Family and Community Medicine in the Sidney Kimmel Medical College of Thomas Jefferson University

Selected references:

Automated Insulin Delivery in Adults With Type 2 Diabetes A Nonrandomized Clinical Trial. JAMA Network Open. 2025;8(2):e2459348.

A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes. N Engl J Med 2025;392:1801-12

Automated Insulin Pump in Type 2 Diabetes – Editorial - N Engl J Med 2025;392:1862-1863

In this special series on Weight Bias and Stigma our host, Dr. Neil Skolnik will discuss weight bias and stigma and its importance because weight bias and stigma have an important impact the experience of living with obesity, leads to measurable adverse outcomes, and when it is present in health care interactions it affects all subsequent care that a patient receives. This special episode is sponsored with support from Lilly.

Presented by:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

Sean Wharton, M.D., Medical Director of the Wharton Medical Clinic, Adjunct Professor McMaster University and York University.

Patty Nece - Lawyer and Former Counsel for Regulations and Legislation at U.S. Department of Labor; Past Chair of the Obesity Action Coalition (OAC); Member National Academy of Sciences' Roundtable on Obesity Solutions; Member, World Obesity Federation Policy and Prevention Committee; Commissioner on The Lancet Commission on Obesity.

Selected references:

Weight stigma and bias: standards of care in overweight and obesity—2025. BMJ Open Diab Res Care 2025;13:e004962. doi:10.1136/ bmjdrc-2025-004962

Canadian Adult Obesity Clinical Practice Guidelines: reducing weight, bias, and obesity management, practice, and policy

This issue will review:

1. Semaglutide and cardiovascular outcomes by baseline and changes in adiposity measurements: a prespecified analysis of the SELECT trial

2. Impact of Oral Semaglutide on Kidney Outcomes in People with Type 2 Diabetes: Results from the SOUL Randomized Trial

3. The effect of substituting water for artificially sweetened beverages on glycemic and weight measures in people with type 2 diabetes: The Study of Drinks with Artificial Sweeteners (SODAS), a randomized trial

4. Effects of carbohydrate-restricted diets and macronutrient replacements on cardiovascular health and body composition in adults: a meta-analysis of randomized trials Trial

Diabetes Core Update is a monthly podcast that presents and discusses the latest clinically relevant articles from the American Diabetes Association's four science and medical journals – Diabetes, Diabetes Care, Clinical Diabetes, and Diabetes Spectrum. Each episode is approximately 25 minutes long and presents 5-6 recently published articles from ADA journals.

Intended for practicing physicians and health care professionals, Diabetes Core Update discusses how the latest research and information published in journals of the American Diabetes Association are relevant to clinical practice and can be applied in a treatment setting.

For more information about each of ADA's science and medical journals, please visit Diabetesjournals.org.

Hosts:

Neil Skolnik, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health

John J. Russell, M.D., Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Chair-Department of Family Medicine, Abington Jefferson Health