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Texas Tech MedCast >> Diabetes Mellitus Series

Texas Tech Medcast The Texas Tech Medcast is a podcast for medical residents, medical students, practicing physicians, and others involved in medical education and high quality, patient-centered primary care. The Texas Tech MedCast Series are available as a subscription or as individual episodes at no charge from the Apple iTunes Music Store (search Texas Tech or MedCast).


Texas Tech MedCast Podcast Series:

Podcast Description & Learning Objectives Presenters

Diabetic Nephropathy

Fact Sheet

Posted: 2/10/2006
Length: 11:04

This episode describes the natural history of diabetic nephropathy and includes a review of screening for diabetic nephropathy, prescribing treatment to reverse early kidney disease, and recommending dietary and supplemental therapy.

Learning Objectives: the physician audience should be able to:

  • Describe the natural history of diabetic neophropathy
  • Screen patients for diabetic nephropathy
  • Prescribe treatment for the reversal of early diabetic nephropathy
  • Recommend dietary and nutritional supplemental therapy for diabetic nephropathy

Podcast Pearl: Tips on how to reduce patients' hemoglobin A1C levels by following up with pharmacists and patients to improve compliance. (Dr. Mike Ragain)

Mike Ragain, M.D.
Mike Ragain, MD
Ron Cook, M.D.
Ron Cook, DO
Family Medicine, Lubbock

Diabetic Foot Care

Fact Sheet

Posted: 2/10/2006
Length: 16:05

This episode describes the foot problems that diabetic patients face and reviews guidelines for examining the feet of patients with diabetes and helping patients care for their feet.
Learning Objectives: the physician audience should be able to:

  • Describe recent statistics on amputation rates, foot examinations, and hospitalizations for feet problems related to diabetics
  • Correctly examine the feet of diabetic patients
  • Educate patients with diabetes on how to care for their own feet
  • Prescribe foot care and shoes to meet medicare requirements

Podcast Pearl: Reminders for reducing diabetic nephropathy (Dr. Jennifer Mitchell)

Tommie Farreel, M.D.
Tommie Farrell, MD
Fiona Prabhu, M.D.
Fiona Prabhu, MD
Family Medicine, Lubbock

Diabetes and Stages of Change

Fact Sheet

Posted: 4/3/2006
Length:28:20

This episode outlines the stages of behavior change and discusses the importance of assessing patients� readiness for change, as is often required by a diagnosis of diabetes.
Learning Objectives: the physician audience should be able to:

  • Explain why behavior change is important to diabetic patients
  • Explain the stages of change model
  • Describe how the stages of change model is applicable to behavior change with diabetic patients
  • Assist diabetic patients with appropriate behavior change

Podcast Pearl: High intake of calcium & vitamin D (particularly from supplements) may lower the risk of diabetes by 33% (Dr. Ron Cook)

Lance Evans, Ph.D
Lance Evans, PhD
Betsy Jones, Ed.D
Betsy Jones, EdD
Family Medicine, Lubbock

Diabetes and Cardiovascular Disease

Fact Sheet

Posted: 4/10/2006
Length: 16:21

This episode outlines the link between DM and CVD, focusing on means for reducing the risk of further cardiovascular complications.
Learning Objectives: the physician audience should be able to:

  • Describe the significance of the link between diabetes and cardiovascular complications
  • Identify the metabolic complications associated with diabetes
  • Associate the risks for cardiovascular complications in patients with diabetes with those in patients who have had a heart attack
  • Assist diabetic patients in reducing their risk for further cardiovascular complications

Podcast Pearl: The significance of the difference between microvascular disease and macrovascular disease in diabetes (Dr. Tom Tenner)

Tom Tenner, PhD
Tom Tenner, PhD
Pharmacology & Neuroscience, Lubbock
& Betsy Jones, EdD
Family Medicine, Lubbock

10 Steps to Improved Glycemic Control (Part I)

Fact Sheet

Posted:4/24/2006
Length: 14:21

This episode is the first of a 2-part podcast that addresses why it's important for your patient to achieve glycemic control and 5 ways to help them do it.
Learning Objectives: the physician audience should be able to:

  • Explain the importance of helping patients achieve glycemic control
  • Apply 5 steps to improve patients� glycemic control:
  1. Aim for good glycemic control, defined as HbA1c < 6.5%.Measure A1C every 3 months
  2. Monitor HbA1C every 3 months in addition to regular glucose self-monitoring
  3. Aggressively manage hyperglycemia, dyslipidemia and hypertension with the same intensity to obtain the best patient outcome
  4. Recognize that DM is complicated and requires multiple treatments
  5. Address the underlying pathophysiology, including treatment of insulin resistance
  • Use control therapies sooner to achieve target glucose levels more quickly
  • Treat co-morbid conditions aggressively in patients with diabetes
  • Take advantage of a team approach that includes other health care professionals and the patient�s own disease management

Podcast Pearl: The bane of the diabetic patient: smoking (Dr. Mike Ragain)

Jack Dyer, MD
Jack Dyer, MD
Family Medicine, Lubbock
& Mike Ragain, MD
Family Medicine, Lubbock

10 Steps to Improved Glycemic Control (Part 2)

Fact Sheet

Posted: 4/25/2006
Length: 14:22

This episode is the second of a 2-part podcast that addresses why it's important for your patient to achieve glycemic control and 5 ways to help them do it.
Learning Objectives: the physician audience should be able to:

  • Explain the importance of helping patients achieve glycemic control
  • Apply 5 more steps to improve patients� glycemic control:
  1. Don�t wait to titrate
  2. After 3 months, if patients are not at target HbA1C < 6.5%, consider combination therapy
  3. Initiate combination therapy or insulin immediately for all patients with HbA1C > 9% at diagnosis
  4. Use combinations of agents with different courses of action.
  5. Use an interdisciplinary approach to diabetes management to encourage patient education and self-care
  • Use control therapies sooner to achieve target glucose levels more quickly
  • Treat co-morbid conditions aggressively in patients with diabetes
  • Take advantage of a team approach that includes other health care professionals and the patient�s own disease management

Podcast Pearl: Male patients with DM may experience erectile dysfunction, but may be too embarrassed to ask the physician about treatment options (Dr. Jack Dyer)

Jack Dyer, MD
Family Medicine, Lubbock
& Mike Ragain, MD
Family Medicine, Lubbock

Metabolic Syndrome and TLC (Therapeutic Lifestyle Changes)

Fact Sheet

Posted: 5/2/2006
Length: 15:49

This episode defines the Metabolic Syndrome (MetS) and discusses helping the patient to make therapeutic lifestyle changes, including improved nutritional choices and exercise.
Learning Objectives: the physician audience should be able to:

  • Define and diagnose the Metabolic Syndrome and identify its risk factors
  • Help patients apply Therapeutic Lifestyle Changes (TLC) to the management of MetS and use laboratory values to help reinforce TLC
  • Provide patients with tools for self-care and self-monitoring for MetS
  • Perform simple dietary assessments

Podcast Pearl: Diagnosis guide and lab values for the diagnosis of MetS (Dr. Kathy Chauncey)

Kathy Chauncey, PhD, RD, CDE
Kathy Chauncey, PhD, RD, CDE
Family Medicine, Lubbock
& Betsy Jones, EdD
Family Medicine, Lubbock

Controlling Blood Pressure for Diabetic Patients

Fact Sheet

Posted: 5/10/2006
Length: 14:48

In this episode, we eavesdrop on a patient visit between a family physician and a new patient who has Type 2 diabetes and high blood pressure; we�ll hear about health complications from elevated blood pressure, as well as lifestyle and medication therapy to control it.
Learning Objectives: the physician audience should be able to:

  • List the recommended blood pressure goals in diabetics.
  • Explain the importance of blood pressure control for diabetics and the complications that may result from uncontrolled blood pressure.
  • Recommend to diabetic patients the lifestyle changes that can help control blood pressure
  • Prescribe appropriate medications for drug therapy

Podcast Pearl: New techniques for assessing diabetic foot ulcers.  Summary of a new article in Diabetes Care. (Dr. Tommie Farrell)

Tommie Farrell, MD

Family Medicine, Lubbock

Special guest appearance by John Parker, MS3 student in Lubbock

Cultural Competency and Diabetes

Fact Sheet

Posted: 5/22/2006
Length: 22:47

This episode addresses cultural competency and the importance of cultural sensitivity in interactions with patients who have diabetes..
Learning Objectives: the physician audience should be able to:

  • Describe the significance of the physician's own medical culture in dealing with patients
  • Outline the cultural challenges that are unique to diabetes and diabetic patients
  • Use the Kleinman Explanatory Model to help cope with patient and family needs as well as to interpret the culture of Western medicine to others

Podcast Pearl: The importance of language issues and using translators to improve cultural competency (Dr. Arthur Islas)

Arthur Islas. MD
Arthur Islas, MD
Family Medicine, El Paso

Elements of a Diabetic Visit

Fact Sheet

Posted: 5/24/2006
Length: 10:46

This episode addresses the purpose and elements of regular diabetes maintenance visits, as well as how to cover those elements in a time-efficient, yet patient-centered manner.
Learning Objectives: the physician audience should be able to:

  • Describe the purpose of regular Diabetes Maintenance Visits
  • List the main elements to be covered in a Diabetes Maintenance Visit
  • Cover the elements in a time-efficient, yet patient-centered manner

Podcast Pearl: Level of service for diabetes/chronic disease maintenance visits (Dr. Mary Spalding)

Mary Spalding, MD
Mary Spalding, MD
Oscar Noriega, MD
& Oscar Noriega, MD
Family Medicine, El Paso

HDL & Triglycerides: Forgotten Lipids (part1)

Fact Sheet

Posted: 6/1/2006
Length: 14:38

This episode is the first of a 2-part series on HDL and Triglycerides, lipids sometimes overlooked in the management of diabetes. Part 1 discusses therapy goals and treatment techniques.
Learning Objectives: the physician audience should be able to:

  • List the goals of therapy for triglycerides and HDL
  • Define and calculate non-HDL cholesterol
  • Identify effective treatment therapies to reduce triglycerides and increase HDL

Podcast Pearl: How to improve patients' willingness to check their own blood glucose levels and record their results (Dr. Rodney Young)

Rodney Young, MD
Rodney Young, MD
Eric MacLaughlin, PharmD & Eric MacLaughlin, PharmD
Family Medicine, Amarillo

HDL & Triglycerides: Forgotten Lipids (part 2)

Fact Sheet

Posted: 6/6/2006 Length: 19:14

This episode is the second of a 2-part series on HDL and Triglycerides, lipids sometimes overlooked in the management of diabetes. Part 1 discusses therapy goals and treatment techniques.
Learning Objectives: the physician audience should be able to:

  • List the goals of therapy for triglycerides and HDL
  • Describe the benefits and side-effects of niacin and plant stanol esters
  • Identify effective treatment therapies to reduce triglycerides and increase HDL

Podcast Pearl: Processes used in large-scale randomized clinical trials to identify effective medications (Dr. Ron Warner)

Rodney Young, MD & Eric MacLaughlin, PharmD
Family Medicine, Amarillo

Hypertension and Diabetes

Fact Sheet/ Slides

Posted: 6/13/2006
Length: 13:16

This episode addresses hypertension and diabetes. In the U.S., nearly 1 in 4 adults has HTN; HTN rates double among patients with diabetes.
Learning Objectives: the physician audience should be able to:

  • Define hypertension and classify high blood pressure
  • Evaluate a patient with hypertension and its possible causes
  • Order appropriate lab tests for HTN
  • Determine an appropriate treatment protocol for hypertensive patients
  • Identify possible complications of HTN

Podcast Pearl: The importance of patient education in dealing with diabetic patients (Dr. Oscar Noriega)

Lorenzo Aragon, MD
Lorenzo Aragon, MD
& Oscar Noriega, MD
Family Medicine, El Paso

Metformin for Type2 Diabetes

Fact Sheet

Posted: 6/21/2006
Length: 19:38

This episode gives an overview of the use of Metformin to treat patients with Type 2 diabetes.
Learning Objectives: the physician audience should be able to:

  • List Metformin's mechanisms of action and place in therapy
  • Counsel patients about Metformin's contraindications, side effects, and cost
  • Use Metformin appropriately to treat patients with Type 2 diabetes

Podcast Pearl: Correct and current nomenclature for diabetes (Dr. Rodney Young's Podcast Pet Peeve)

Rodney Young, MD & Eric MacLaughlin, PharmD
Family Medicine, Amarillo

One-handed Pharmaco-therapy for Diabetes

Fact Sheet

Posted:6/30/2006
Length: 18:24

This episode offers a reminder of 5 drug classes to consider when treating patients with diabetes.
Learning Objectives: the physician audience should be able to:

  • Address glycemic control, blood pressure, lipids, renal function & anti-thrombotics
  • Counsel patients about the medications' contraindications, side effects, and cost
  • Use pharmaco-therapy appropriately to treat patients with Type 2 diabetes

Podcast Pearl: Screening for kidney dysfunction in diabetics with the spot albunin: creatinine ratio (Dr. Eric MacLaughlin)

Rodney Young, MD & Eric MacLaughlin, PharmD
Family Medicine, Amarillo

Diabetic Eye Disease

Fact Sheet

Posted:10/30/2006
Length: 25:35

This episode provides an overview of diabetic retinopathy and diabetic eye disease.
Learning Objectives: the physician audience should be able to:

  • Define the terms "diabetic retinopathy" and "diabetic eye disease"
  • Screen diabetic patients for diabetic eye disease
  • Refer patients to an ophthamologist for regular eye care

Podcast Pearl: Screening recommendations for eye disease (Dr. Jennifer MItchell)

Kelly Mitchell, MD
Kelly Mitchell, MD
Ophthamology & Pediatrics, Lubbock   &
Jennifer Mitchell, MD, FAAFP
Family Medicine, Lubbock

Checking for A1C Levels for Diabetes

Fact Sheet

Posted:11/16/2006
Length: 12:54

This episode provides an overview of the importance of accurate A1C testing and point-of-care testing.
Learning Objectives: the physician audience should be able to:

  • Explain the importance of accurate A1C testing
  • Describe point-of-care testing for diabetes

Podcast Pearl: Reminder: Recommend a flu shot & pneumovax for all diabetic patients (Dr. Ron Warnerl)

Doyle Cummings, PharmD
Doyle Cummings, PharmD
East Carolina University
& Betsy Jones
Family Medicine, Lubbock

Januvia for Diabetes Mellitus

Januvia Website

Posted:11/16/2006
Length: 8:28

This episode provides an overview of a new treatment for diabetes: Januvia, a DPP-4 Inhibitor newly available to treat diabetes.
Learning Objectives: the physician audience should be able to:

  • Explain the mechanism of action for Januvia
  • List Januvia's side effects, impact on A1C, indications and contraindications, and renal issues
  • Be able to make an informed prescribing choice

Podcast Pearl: Reminder about therapies newly approved to treat diabetes, Bayetta and Januvia (Dr. Ragain)

Mike Ragain, MD
& Ron Cook, DO
Family Medicine, Lubbock

FAQ on Lipids and Nutrition for Diabetes

Fact Sheet

Posted:11/16/2006
Length: 22:31

This episode addresses frequently asked questions and nutrition and lipids that patients have for physicians and that physicians have for nutritionists.
Learning Objectives: the physician audience should be able to:

  • Answer patients' questions about making improved food choices for their diabetes
  • Help patients begin to make lifestyle modifications
  • Take steps to reduce LDL Cholesterol for patients with diabetes
  • Define the term "trans fat"

Podcast Pearl: In the news: Coffee may be good for diabetics? (Drs. Chauncey & Tran)

Kathy Chauncey, PhD, RD, CDE
& Hoa Tran
Family Medicine, Lubbock

Documenting a Diabetic Visit

Fact Sheet

Posted:11/16/2006
Length: 13:19

This provides an example of a diabetic patient visit and reminders about writing an effective SOAP note.
Learning Objectives: the physician audience should be able to:

  • Explain special problems in documenting a chronic disease patient visit
  • List the key parts of documentation for a history of a chronic illness
  • Write an effective SOAP note for a patient with diabetes

Tommie Farrel, MDI
Family Medicine, Lubbock

Caring for Diabetic Patients: A Summary

Fact Sheet

Posted:11/16/2006
Length: 13:20

This provides an summary of issues related to screening, lab tests and values, and preventive care for diabetic patients, as well as office systems that enhance care of diabetic patients
Learning Objectives: the physician audience should be able to:

  • List lab screening tests and target values for diabetic patients
  • List preventive screenings and immunizations recommended for diabetic patients
  • Describe office systems that are important in improving care of diabetic patients
  • Provide effective care of patients with diabetes
  • Perform continuing self-assessment and quality assurance regarding the care of diabetic patients

Mike Ragain, MD
Ron Cook, DO
& Betsy Jones, EdD
Family Medicine, Lubbock

For more information about the Texas Tech MedCast series,
contact Betsy Goebel Jones, EdD, Podcast Producer and Project PI.

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