Endo in a Bite

In this episode, we review the 2026 Consensus Statement algorithm for the management of chronic kidney disease in adults with Type 2 Diabetes. Topics include SGLT2 inhibitors as foundational renoprotective therapy, evidence based pharmacologic management of diabetic kidney disease, and strategies to reduce CKD progression, kidney failure, and cardiovascular events. We discuss canagliflozin, dapagl...

In this episode, we review the 2026 Consensus Statement algorithm for heart failure management in adults with Type 2 Diabetes. Topics include the foundational role of SGLT2 inhibitors, heart failure with reduced and preserved ejection fraction, and evidence based pharmacologic therapy. We discuss dapagliflozin, empagliflozin, sotagliflozin, GLP-1 receptor agonists, and the role of semaglutide, tir...

In this episode, we review the 2026 Consensus Statement hypertension algorithm for adults with Type 2 Diabetes. Topics include blood pressure targets, screening for secondary causes of hypertension, proper blood pressure measurement techniques, lifestyle interventions, and evidence based pharmacologic therapy. We discuss ACE inhibitors, ARBs, thiazide diuretics, calcium channel blockers, resistant...

In this episode, we review the 2026 Consensus Statement on Lipid Management in Adults with Type 2 Diabetes. Topics include ASCVD risk assessment, LDL-C treatment targets, statin therapy, coronary artery calcium scoring, nonstatin lipid lowering therapies, triglyceride management, and key differences between ACC/AHA and AACE recommendations. We also discuss practical treatment strategies and board...

In this episode, we review the 2026 Consensus Statement on Diabetes Classification in Adults. Topics include diagnostic criteria for diabetes, distinguishing type 2 diabetes from autoimmune, pancreatogenic, monogenic, endocrinopathy associated, and medication induced diabetes, and the role of phenotype, autoantibody testing, and C-peptide measurement in establishing the correct diagnosis. We also...

In this episode, we review the latest 2026 Consensus Statement recommendations for the evaluation and management of prediabetes. Topics include updated diagnostic criteria, the recognition of prediabetes as a cardiometabolic disease state, lifestyle interventions as the foundation of therapy, and strategies to prevent progression to type 2 diabetes. We also discuss comprehensive cardiovascular ris...

This episode reviews major updates in ASCVD risk stratification and lipid management from the AHA/ACC lipid guideline. Topics include cumulative apolipoprotein B exposure assessment, updated low density lipoprotein cholesterol estimation methods, expanded clinical use of apolipoprotein B and lipoprotein(a), integration of cardiovascular kidney metabolic syndrome into preventive cardiology, revised...

This episode reviews major updates in lipid management for ASCVD risk reduction. Topics include revised LDL-C estimation equations, expanded clinical application of apolipoprotein B for residual atherogenic risk assessment, universal lipoprotein(a) screening, and cardiovascular kidney metabolic syndrome as a risk enhancing condition. The episode also discusses triglyceride referral thresholds, rep...

This episode applies risk based lipoprotein targets across specific clinical scenarios for atherosclerotic cardiovascular disease risk reduction. It highlights how severe hypercholesterolemia, diabetes, subclinical atherosclerosis, hypertriglyceridemia, and clinical ASCVD are stratified using the same three tier framework of 100/130/90, 70/100/70, and 55/85/55. It emphasizes the role of coronary a...

This episode reviews risk based lipoprotein targets for atherosclerotic cardiovascular disease risk reduction. It highlights LDL-C, non-HDL-C, and apolipoprotein B as key parameters, with goals stratified by overall ASCVD risk category. It emphasizes the three tier framework of 100/130/90 for low risk, 70/100/70 for intermediate risk, and 55/85/55 for high or very high risk patients. It also cover...

This episode reviews the clinical application of lipoprotein(a) and apolipoprotein B in cardiovascular risk assessment based on AHA ACC guidance. It emphasizes the genetic determination and stability of lipoprotein(a), supporting its role as a one time measurement for risk stratification, along with the importance of cascade screening in identifying inherited risk. The discussion outlines how lipo...

This episode reviews standard lipid measurements for cardiovascular risk assessment based on AHA/ACC guidelines. It highlights the use of non-fasting lipid testing for most patients, key indications for fasting testing, and modern LDL cholesterol calculation methods. It also covers the role of non-HDL cholesterol and the limited utility of advanced lipoprotein testing in clinical practice.

This episode reviews the importance of dyslipidemia screening across both pediatric and adult populations based on AHA ACC guidelines. It highlights the epidemiology and clinical impact of dyslipidemia, emphasizing the role of cumulative low density lipoprotein cholesterol exposure in determining lifetime cardiovascular risk. The discussion covers universal screening strategies, limitations of fam...

This episode reviews the clinical significance of hypoglycemia in diabetes care, including its classification into Level 1, Level 2, and Level 3 events. The discussion highlights early recognition, variability in symptom thresholds, and the importance of prompt treatment to prevent severe outcomes. Key takeaways include the use of 15 to 20 grams of fast acting carbohydrates for conscious patients,...

This episode reviews the evolution of vitamin D management frameworks, highlighting the shift from intake based recommendations by the National Academy of Medicine to the 2011 Endocrine Society’s laboratory driven approach, and back to a modern intake focused strategy in the 2024 guideline. The discussion emphasizes when vitamin D testing is appropriate, the role of 25 hydroxyvitamin D in assessin...

This episode reviews clinical management of gastrointestinal symptoms associated with semaglutide therapy and strategies to maintain treatment when intolerance occurs. The discussion explains the role of delayed gastric emptying in nausea and highlights practical approaches including dietary modification, slower dose titration, and symptom directed therapy. Additional topics include pregnancy plan...

This episode reviews the cardiovascular kidney metabolic (CKM) syndrome framework introduced by the American Heart Association, which describes the interconnected progression of obesity, type 2 diabetes, chronic kidney disease, and cardiovascular disease. The discussion highlights CKM staging and emphasizes early cardiometabolic risk recognition and preventive therapy including statins, blood pres...

This episode reviews the American Heart Association PREVENT™ cardiovascular risk calculator and its role in modern primary prevention. The discussion highlights the shift from the pooled cohorts equation to contemporary risk prediction models that incorporate kidney function, cardiometabolic risk staging, and updated population data. Emphasis is placed on risk refinement strategies including coron...

This episode reviews the 2025 ACE consensus framework for individualized obesity pharmacotherapy, moving beyond standardized algorithms toward condition based medication selection. Emphasis is placed on comorbidities, organ specific risk stratification, safety monitoring, and long term therapeutic benefit to support precision management of adiposity based chronic disease.

This episode reviews the 2025 ACE consensus approach to cost conscious obesity pharmacotherapy, emphasizing access driven treatment sequencing, payer mandated step therapy, and stage based medication selection for adiposity based chronic disease. Focus is placed on balancing clinical efficacy, affordability, and long term sustainability, with escalation and override strategies guided by therapeuti...

This episode reviews the 2025 ACE consensus on complication centric obesity management, with a focus on organ system based medication prioritization. Topics include pharmacologic selection across cardiometabolic, renal, hepatic, cardiovascular, and biomechanical complications, emphasizing outcome driven therapy rather than weight alone in adiposity based chronic disease (ABCD).

This episode reviews the 2025 ACE consensus on biologically informed lifestyle therapy for obesity and adiposity based chronic disease (ABCD), including personalized nutrition strategies to achieve and sustain an energy deficit, protein and micronutrient requirements to preserve lean mass and metabolic health, physical activity and resistance training targets for weight maintenance, the role of sl...

This episode reviews the 2025 ACE consensus on therapeutic weight loss response, threshold based outcomes, early pharmacologic response assessment, and how to align intervention intensity with disease severity in adiposity based chronic disease (ABCD).

This episode reviews the clinical component of the 2025 ACE consensus, shifting from identifying excess adiposity to staging adiposity based chronic disease (ABCD). It explains how clinicians assess obesity related complications, apply disease staging independent of BMI, and account for contributing factors such as medications, endocrine causes, genetics, psychological influences, and social deter...

This episode examines the anthropometric component of the 2025 ACE consensus on obesity, emphasizing the role of BMI as a screening tool rather than a diagnostic endpoint. It outlines population specific BMI thresholds, the clinical need for assessing abdominal adiposity, and the importance of standardized waist circumference and waist to height ratio measurements in evaluating cardiometabolic ris...