Diabetes Core Update

In this special episode titled “Lipids – Beyond Statins and LDL Cholesterol”, our host, Dr. Neil Skolnik will discuss with two expert guests the details of treatment for LDL-Cholesterol, Triglycerides, and other lipid risk markers.  This special episode is supported by an independent educational grant from Amarin. 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 James Underberg, M.D. , Clinical Assistant Professor of Medicine at NYU School of Medicine and the NYU Center for Prevention of Cardiovascular Disease, Director of the Bellevue Hospital Lipid Clinic, and Past President of the National Lipid Association. Layla A. Abushamat, M.D., MPH, Assistant Professor, Department of Medicine in the Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine,  Houston, Texas   Selected references referred to the in the Podcast: 1.     Icosapent Ethyl: REDUCE-IT - N Engl J Med 2019; 380:11-22 2.     Omega-3 Fatty Acids: STRENGTH trial - JAMA. 2020;324(22):2268-2280 3.     Lipoprotein(a) Blood Levels and Cardiovascular Risk Reduction With Icosapent Ethyl. JACC. 2024 Apr, 83 (16) 1529–1539 4.     Icosapent ethyl following acute coronary syndrome. European Heart Journal 2024; 45:1173–1176 5.     Cardiovascular Disease and Risk Management: ADA Standards of Care in Diabetes—2024. Diabetes Care 2024;47(supp 1): S179–S218

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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Age of diabetes diagnosis and lifetime risk of dementia 2.     Glucagon-Like Peptide 1 Receptor Agonists and 13 Obesity-Associated Cancers in Patients With Type 2 Diabetes 3.     Association of Semaglutide With Tobacco Use Disorder in Patients With Type 2 Diabetes: Target Trial Emulation Using Real-World Data 4.     Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk 5.     Long-Term Neurobehavioral and Metabolic Outcomes in Offspring of Mothers with Diabetes During Pregnancy   For more information about each of ADA’s science and medical journals, please visitwww.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

In this special episode on Low and No Calorie Sweeteners,  our host, Dr. Neil Skolnik will take a deep dive into the randomized evidence about the efficacy of Low and No Calorie Sweeteners. Also discussed will be observational trials on NNS, as well as safety. Finally, there will be a discussion of the World Health Organization recommendations on Nonnutritive sweeteners as well as practical clinical insights.   This special episode is supported by an independent educational grant  from Heartland Food Group, the maker of the Splenda Group of Products.  For more information just go to: www.splenda.com .   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 Kathrine Appleton, PhD, Professor of Psychology, Bournemouth University.   Articles discussed: The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies. Int J Obes (Lond). 2021 Mar;45(3):464-478 Use of non-sugar sweeteners: WHO guideline Non-nutritive sweeteners and their impacts on the gut microbiome and host physiology. Front Nutr.2022;9:988144

In this special episode recorded live at the American Diabetes Association’s 2024 Scientific Session the hosts of all of ADA’s podcasts – that is Diabetes Care ‘On Air’, DiabetesBio, Diabetes Core Update and Diabetes Day by Day - discuss making podcasts and discuss some of the presentations that they found compelling at the Scientific Sessions.  This special episode is supported by an independent educational grant from Bayer.   The group discusses high-impact research presented at the meeting, implications for future research, and clinical considerations and take-aways --- across the “bench-to-beside” spectrum of biomedical research, clinical research, and treatment advances. More information about ADA’s portfolio of podcasts can be found at:      https://diabetesjournals.org/journals/pages/podcasts. The participants in the live recording include: Alice Cheng, MD, chair of ADA’s 2024 Scientific Sessions Planning Committee and co-host of Diabetes Care ‘On Air’ Kirk Habegger, PhD, cohost of DiabetesBio Michael Rickels, MD, MS, cohost of Diabetes Care ‘On Air’ Darleen Sandoval, PhD, cohost of DiabetesBio Neil Skolnik, MD, cohost of Diabetes Core Update and Diabetes Day by Day Kevin Williams, PhD, cohost of DiabetesBio

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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Effects of Semaglutide on Chronic Kidney Disease in Patients with Type 2 Diabetes 2.     Association between the Burden of Microvascular Disease and Cardiorespiratory Fitness among Adults with Type 2 Diabetes 3.     Association of metabolic syndrome with neuroimaging and cognitive outcomes 4.     Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity 5.     Semaglutide and Cardiovascular Outcomes by Baseline HbA and Change in HbA in SELECT   For more information about each of ADA’s science and medical journals, please visit www.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

In this special episode on Oral Health our host, Dr. Neil Skolnik will discuss the bidirectional relationship between oral health and diabetes with Dr. Wenche Borgnakke.  This special episode is supported by an independent educational grant from Haleon. 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 Dr. Wenche Borgnakke.  Dr Borgnakke DDS, MPH, PhD ,  Adjunct Clinical Assistant Professor of Dentistry in the department of Periodontics and Oral Medicine at the University of Michigan School of Dentistry.  

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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Fair Allocation of GLP-1 and Dual GLP-1–GIP Receptor Agonists 2.     Medical Assistant Health Coaching for Type 2 Diabetes in Primary Care 3.     Glycemic Control and Cognitive Aging 4.     Tirzepatide for Metabolic Dysfunction–Associated Steatohepatitis with Liver Fibrosis – 5.     Is Weight Loss–Induced Muscle Mass Loss Clinically Relevant?   For more information about each of ADA’s science and medical journals, please visit www.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

In this special episode on Residual Risk: A Focus on Triglycerides, our host, Dr. Neil Skolnik will discuss Metabolic Syndrome: A Focus on Triglycerides with Dr. Peter Toth.  Dr. Toth is Director of Preventive Cardiology, CGH Medical Center, and an adjunct professor of medicine at Johns Hopkins Medical School. This special episode is supported by an independent educational grant from Amarin. 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 Peter Toth, M.D.,PhD,   Director of Preventive Cardiology, CGH Medical Center, Adjunct Professor of Medicine, Johns Hopkins Medical School.  Selected references  in the Podcast: Icosapent Ethyl: REDUCE-IT - N Engl J Med 2019; 380:11-22 Omega-3 Fatty Acids: STRENGTH trial - JAMA. 2020;324(22):2268-2280 Pemafibrate: PROMINENT - N Engl J Med 2022; 387:1923-1934 Icosapent Ethyl: JELIS - Lancet. 2007;369(9567):1090-1098 Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study.BMJMED 2024;3:e000451

Diabetes Core Update – June 2024 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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes 2.     Habitual Short Sleep Duration, Diet, and Development of Type 2 Diabetes in Adults 3.     Tirzepatide Versus Basal Insulins in People with Type 2 Diabetes and Different Baseline Glycemic Patterns 4.     Early-onset type 2 diabetes and tirzepatide 5.     Cardiovascular and mortality benefits of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists as third-step glucose-lowering medicine in patients with type 2 diabetes 6.     Association of continued use of SGLT2 inhibitors from the ambulatory to inpatient setting with hospital outcomes in patients with diabetes mellitus   For more information about each of ADA’s science and medical journals, please visit www.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

In this special series on obesity, our host, Dr. Neil Skolnik, discusses the obesity epidemic with some of the foremost experts in the world. In Part 4 of the series, Dr. Skolnik is joined by Drs. Deborah Horn and Robert Kushner. Together they discuss challenges, and potential solutions, in obesity management. The Focus on Obesity series is a collaborative project of the American Diabetes Association and the American Academy of Family Physicians. The entire program will comprise a total of seven episodes: four episodes of Diabetes Core Update, which will cover topics of interest for family physicians, primary care clinicians, and other health care professionals; as well as three episodes of its sister podcast, Diabetes Day by Day, which will be tailored for people with overweight or obesity and their caregivers. The combined seven-episode program will be released between February and June 2024 and can be freely accessed at https://diabetesjournals.org/journals/pages/podcasts_obesity. Funding support for the “Focus on Obesity” series is jointly provided by Lilly and Novo Nordisk. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Deborah B. Horn, DO, MPH, Medical Director for the UT Center of Obesity Medicine and Metabolic Performance; Fellowship Program Director, Allison Family Foundation Fellowship in Clinical Obesity Medicine and Metabolism, McGovern Medical School Robert Kushner, MD, Professor of Medicine (Endocrinology) and Medical Education Feinburg School of Medicine at Northwestern University and Medical Director of the Wellness Institute at Northwestern Memorial Hospital in Chicago Selected references:  STEP – 4 Trial - Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021; 325(14), 1414-1425. DOI: 10.1001/jama.2021.3224 SURMOUNT-4 Trial - Aronne LJ, Sattar N, Horn DB, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024;331(1):38–48. doi:10.1001/jama.2023.24945

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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Loneliness and the risk of type 2 diabetes 2.     Microplastics and Nanoplastics in Atheromas and Cardiovascular Events 3.     Tirzepatide vs Insulin Glargine by BMI 4.     Influence of a diet and/or exercise intervention on long-term mortality and vascular complications in people with impaired glucose tolerance 5.     Timing of moderate-to-vigorous physical activity, mortality, cardiovascular disease, and microvascular disease in adults with obesity and type 2 diabetes For more information about each of ADA’s science and medical journals, please visit www.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

In this special series on obesity, our host, Dr. Neil Skolnik, discusses the obesity epidemic with some of the foremost experts in the world. In Part 3 of the series, Dr. Skolnik is joined by Drs. Susan Fidler, Charles Vega, and Margot Savoy. Together, they talking about discussing obesity with patients – how to open the conversation on this sensitive topic, how to handle resistance to addressing the topic, and how to avoid stigma and bias. The Focus on Obesity series is a collaborative project of the American Diabetes Association and the American Academy of Family Physicians. The entire program will comprise a total of seven episodes: four episodes of Diabetes Core Update, which will cover topics of interest for family physicians, primary care clinicians, and other health care professionals; as well as three episodes of its sister podcast, Diabetes Day by Day, which will be tailored for people with overweight or obesity and their caregivers. The combined seven-episode program will be released between February and June 2024 and can be freely accessed at https://diabetesjournals.org/journals/pages/podcasts_obesity. Funding support for the “Focus on Obesity” series is jointly provided by Lilly and Novo Nordisk. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Dr. Susan Fidler is Associate Director of the Family Medicine Residency Program at Abington Jefferson Health. Charles Vega, M.D., Clinical Professor of Family Medicine, Director, UC Irvine Program in Medical Education for the Latino Community, and Associate Dean in the School of Medicine at the University of California, Irvine. Margot L. Savoy, MD, MPH, FAAFP serves as senior vice president for education, inclusiveness, and physician well-being at the American Academy of Family Physicians

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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     A Phase 3, Randomized, Controlled Trial of Resmetirom in NASH with Liver Fibrosis 2.     Long-Term Outcomes of Medical Management vs Bariatric Surgery in Type 2 Diabetes 3.     Improved Glycemic Outcomes With Diabetes Technology Use Independent of Socioeconomic Status in Youth With Type 1 Diabetes 4.     Cardiovascular and Kidney Risks in Individuals With Type 2 Diabetes: Contemporary Understanding With Greater Emphasis on Excess Adiposity 5.     Epidemiology and Prognostic Implications of Coronary Artery Calcium in Asymptomatic Individuals With Prediabetes   For more information about each of ADA’s science and medical journals, please visit www.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health

In this special series on obesity, our host, Dr. Neil Skolnik, discusses the obesity epidemic with some of the foremost experts in the world. In Part 2 of the series, Dr. Skolnik is joined by Drs. Deborah Horn, Thomas Wadden, and Donna Ryan. Together, they discuss, in detail, approaches to obesity including lifestyle, medications and bariatric surgery. The Focus on Obesity series is a collaborative project of the American Diabetes Association and the American Academy of Family Physicians. The entire program will comprise a total of seven episodes: four episodes of Diabetes Core Update, which will cover topics of interest for family physicians, primary care clinicians, and other health care professionals; as well as three episodes of its sister podcast, Diabetes Day by Day, which will be tailored for people with overweight or obesity and their caregivers. The combined seven-episode program will be released between February and June 2024 and can be freely accessed at https://diabetesjournals.org/journals/pages/podcasts_obesity. Funding support for the “Focus on Obesity” series is jointly provided by Lilly and Novo Nordisk. Presented by: Neil Skolnik, MD, Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University; Associate Director, Family Medicine Residency Program, Abington Jefferson Health Thomas Wadden PhD,  is a Professor of Psychology in Psychiatry at the Perelman School of Medicine at the University of Pennsylvania. He is the former director of the Center for Weight and Eating Disorders at Penn.   Donna Ryan, MD Professor emeritus at the Pennington Biomedical Research Center in Baton Rouge, Louisiana. Deborah B. Horn, DO, MPH, Medical Director for the UT Center of Obesity Medicine and Metabolic Performance; Fellowship Program Director, Allison Family Foundation Fellowship in Clinical Obesity Medicine and Metabolism, McGovern Medical School Selected references:  STEP-1 Trial (Semaglutide) – Wilding J,  Batterham RL, Calanna S, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity. The New England Journal of Medicine. 2021; 384(11), 989-1002. DOI: 10.1056/NEJMoa2032183 SURMOUNT-1 Trial (Tirzepatide) - Jastreboff, A.M., Aronne, L.J., Ahmad, N.N., et. al. Tirzepatide Once Weekly for the Treatment of Obesity. The New England Journal of Medicine. 2022; 387(3), 205-216. DOI: 10.1056/NEJMoa2206038 STEP – 4 Trial - Rubino D, Abrahamsson N, Davies M, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021; 325(14), 1414-1425. DOI: 10.1001/jama.2021.3224 SURMOUNT-4 Trial - Aronne LJ, Sattar N, Horn DB, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA. 2024;331(1):38–48. doi:10.1001/jama.2023.24945 Diabetes Prevention Program Trial:  Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393– 403  Look Ahead Trial: Wing RR, Bolin P, Brancati FL, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145–54.

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. Welcome to diabetes core update where every month we go over the most important articles to come out in the field of diabetes. Articles that are important for practicing clinicians to understand to stay up with the rapid changes in the field.  This issue will review: 1.     Leisure-time physical activity may attenuate the impact of diabetes on cognitive decline in middle-aged and older adults 2.     Outcomes of SGLT-2i and GLP-1RA Therapy Among Patients With Type 2 Diabetes and Varying NAFLD Status 3.     Sodium-Glucose Cotransporter 2 Inhibitors and Nephrolithiasis Risk in Patients With Type 2 Diabetes 4.     Association of body weight time in target range with the risk of kidney outcomes in patients with overweight/obesity and type 2 diabetes mellitus 1 Diabetes 5.     Modifiable Lifestyle Factors, Genetic Risk, and Incident Peripheral Artery Disease among Individuals with Type 2 Diabetes   For more information about each of ADA’s science and medical journals, please visit www.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; Director, Family Medicine Residency Program, Chair-Department of Family Medicine, Abington Jefferson Health