In Episode 49 of Think Like a Pancreas—The Podcast, host Gary Scheiner is joined by Integrated Diabetes Services clinician, Dr. Paula Diab. Together they discuss the off-label use of type 2 diabetes medications in type 1 patients.

Paula and Gary describe the hormonal balance necessary for blood sugar management and how the off-label use of medications like metformin, GLP-1 receptor agonists, and SGLT2 inhibitors can help.

During their conversation, they emphasize the importance of patient education and informed discussions with healthcare providers regarding medication options.

Meet Your Host and His Guest

Gary Scheiner, MS, CDCES, is the award-winning author of Think Like a Pancreas as well as numerous other books that act as guides for people living with diabetes. A Certified Diabetes Care & Education, ADCES Fellow, Masters-level Exercise Physiologist, and person living with type 1 diabetes since 1985, Gary was named 2014 Diabetes Educator of the Year by the American Association of Diabetes Educators. He trained at the Joslin Diabetes Center and has dedicated his career to helping others live well with diabetes through education, advocacy, and innovation.

Dr Paula Diab PhD, CDCES is a Family Physician and Diabetologist who runs a multi-disciplinary practice specializing in the management of chronic diseases, particularly diabetes and obesity in South Africa. Her approach is to walk the journey with her patients and to allow them to manage their disease rather than allow the disease to define who they are.

Despite carrying the burden of being the only member of the IDS clinical team without type 1 Diabetes, her skills and passion for diabetes care & education are exemplary (she did successfully manage her own gestational diabetes during her pregnancies).

What you will learn:

✔️ The role of other hormones in managing type 1 diabetes

✔️How biguanides, SLGT-2 inhibitors, and GLP-1s work in people with diabetes.

✔️What is double diabetes?

✔️ The safety of metformin use for people with diabetes

✔️ How to safely use SLGT-2s when you have diabetes

✔️ The benefits of GLP-1s.

 

Chapters

00:11  Welcome and introduction

02:19  Gary Scheiner--ADCES Fellow

02:50 Meet Dr. Paula Diab

05:20 The hormones involved in diabetes management

09:19 Why are there so few medications available to manage type 1 diabetes?

11:27 Understanding off-label use of diabetes medication

14:44 Type  2 diabetes medications that are prescribed off-label to people with type 1 diabetes

28:17 The best candidates for biguanides, SLGT-2 inhibitors, or GLP-1s use.

30:57  What to do if your doctor is uncomfortable prescribing drugs off-label?

 

Resources Mentioned

REMOVAL Trial

https://pubmed.ncbi.nlm.nih.gov/28615149/

DEPICT study – SGLT2 inhibitors (dapaglif) in T1D https://pubmed.ncbi.nlm.nih.gov/30352894/

EASE study – SGLT2 inhibitors (empaglif) in T1D https://pubmed.ncbi.nlm.nih.gov/30287422/

Liraglutide (GLP-1 RA) Trials in T1D

https://www.thelancet.com/journals/landia/article/PIIS2213-8587%2815%2900436-2/abstract

Semaglutide (Weekly GLP-1 RA) Trials in T1D

https://pubmed.ncbi.nlm.nih.gov/39794615/

Connect with Us

🔵Website: integrateddiabetes.com

🔵 Follow on Social Media: @integrated_diabetes_services and @ integrateddiabetesservices on Facebook

🔵To work with the Integrated Diabetes Services Team , visit https://integrateddiabetes.com/how-to-start-the-process/ ,  or email info@integrateddiabetes.com

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Disclaimer

The information contained in this program is based on the experience and opinions of the Integrated Diabetes Services clinical team. Please discuss any changes to your treatment plan with your personal healthcare provider before implementing.