Advancing Care in Type 2 Diabetes and Obesity: A Coordinated, Guideline-Driven Approach

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Nihar Desai, MD, MPH; Kenny J. Cole, MD, MS; Jacinda Mawson Nicklas, MD, MPH, MA; Esra Karslioglu French, MD, MBA, and Goutham Rao, MD, discuss how recent advances in GLP-1 receptor agonists and other therapies are transforming the treatment of type 2 diabetes and obesity by enabling a paradigm shift from reactive glucose management to proactive weight-focused care that addresses the root causes of cardiometabolic disease, while emphasizing the critical need for multidisciplinary teams, bias-free patient communication, and systematic healthcare delivery changes to overcome barriers like provider time constraints, medication access, and weight stigma.

Episodes

June 6th 2025EP. 1: Hormonal Adaptations in Type 2 Diabetes and Obesity

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how hormonal adaptations during weight loss in diabetes patients improve insulin sensitivity, while the DiRECT trial demonstrates that structured weight management programs can achieve diabetes remission in nearly half of newly diagnosed patients.

June 6th 2025EP. 2: Importance of Clinical Trials and Guideline Recommendations

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how ADA recommendations emphasize treating diabetes as part of overlapping conditions requiring cardiovascular and kidney protection, moving beyond just glycemic control to comprehensive care that addresses the whole person.

June 13th 2025EP. 3: Barriers Associated with Guideline-Directed Care

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how barriers to implementing evidence-based obesity and diabetes care include limited provider time, lack of multidisciplinary teams, insufficient education about obesity physiology, and high costs of medications and programs.

June 13th 2025EP. 4: The Role of Weight Management and Glycemic Control in the Management of Type 2 Diabetes

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how treating obesity as the root cause can create a "virtuous cycle" where weight loss improves insulin resistance, reduces medication needs, and enables better physical activity, breaking the traditional reactive approach to diabetes management.

June 20th 2025EP. 5: Improving Patient Outcomes Beyond Glycemic Control

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how GLP-1 receptor agonists represent a paradigm shift by providing weight loss, glycemic control, and cardiovascular protection simultaneously, moving focus beyond A1C control to comprehensive risk reduction.

June 20th 2025EP. 6: Taking a Cardiometabolic Health Approach in Patients with Type 2 Diabetes

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how implementing cardiovascular-kidney-metabolic health requires a team-based approach using the analogy of football, where physicians coach multidisciplinary teams to help patients overcome barriers and achieve health goals.

June 27th 2025EP. 7: Seamless Management Between Primary Care Providers and Specialists

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how UPMC's integrated delivery and financing system enables coordinated care through e-consults, proactive outreach to primary care physicians, case management, telemedicine, and streamlined referral processes that reduce friction for patients and providers.

June 27th 2025EP. 8: Supporting Patients and Primary Care Providers

Nihar Desai, MD, MPH;Kenny J. Cole, MD, MS;Jacinda Mawson Nicklas, MD, MPH, MA;Esra Karslioglu French, MD, MBA;Goutham Rao, MD

Panelists discuss how supporting primary care providers requires moving beyond passive quality measures to peer-to-peer education, transparent performance feedback, multidisciplinary team resources, and creative care delivery models that address the "27-hour day" problem.