Clinical Practice Update in Endocrinology and Diabetes

This continuing medical education program is hosted by Alex Abitbol and Dr. Peter Lin, and features presentations by Dr. David Macklin and Dr. Megha Poddar. The program's objectives include exploring current obesity treatment paradigms and discussing the latest clinical trial data. Key topics covered included clinical pearls from Obesity Week 2023, the four “must-do” behaviour treatment principles and the latest clinical data on semaglutide. The overarching aim is to enrich understanding of evolving obesity management strategies.  

Highlighting Obesity Week & Effective Management Strategies for Primary Care

In the opening session of this webinar Dr. Alex Abitbol emphasizes a comprehensive approach to obesity management, including behavioral strategies, pharmacotherapy, and surgical interventions. The presentation covers real-world evidence from Ontario, analyzing the challenges in accessing specialized care for obesity. It also includes insights from the Step trial, exploring the impact of antidepressant use on weight loss outcomes with semaglutide. The transcript concludes with findings from the Oasis One trial, highlighting the efficacy of higher doses of oral semaglutide in weight loss and improvements in cardiovascular risk factors. 

Three "Must Do" Behaviour Treatment Principles to Pair with Anti-Obesity Medications

In the second presentation, Dr. David Macklin discusses key principles in obesity management, emphasizing the importance of behavioral therapy alongside anti-obesity medications. He highlights three essential behavioral principles: challenging internalized weight bias, managing weight loss expectations, and understanding the role of appetite. Dr. Macklin addresses the significance of considering obesity as a real disease, genetically influenced and primarily centered in the brain's appetite system. He explains the progressive and relapsing nature of weight loss and urges practitioners to help patients understand the brain's defense mechanism against fat loss. The presentation concludes with practical suggestions for clinicians to integrate these principles into patient care for improved medication effectiveness and adherence. 

Semaglutide, Cardiovascular Disease and Obesity: Key Insights from the SELECT Trial

Dr. Mega Poddhar presents the Select trial, focusing on semaglutide's impact on cardiovascular disease (CVD) in obese patients without diabetes. The talk emphasizes the need to address obesity beyond weight loss due to its complications, especially in cardiovascular health. Exploring obesity's pathophysiology and its connection to CVD, the speaker reviews data from prior cardiovascular outcome trials. Dr. Poddar covers key findings from the Select trial, such as the reduction of major adverse cardiovascular events (MACE) and key safety data that encourages longer term use. Teasing upcoming trials, the speaker anticipates a new era of pharmacotherapy for obesity-related CVD. 

Discussion Summary

Following the complete program was a robust Q&A session covering many questions such as long term saftey, glucose toxicity, whether their are studies for GLP-1 in Type 1 diabetes, pancreatitis, lean body mass and many more.