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Dr. Pam R. Taub Part 1, A Cardiologist’s Perspective on Diabetes

Jan 13, 2017

Dr. Pam R. Taub talks with Diabetes in Control Publisher Steve Freed at the 2016 AACE Meeting. In part 1 of this Exclusive Video, Dr. Taub explains her work with diabetes patients, who are a large percent of her practice and often start diabetes treatment with her before seeing a diabetes specialist.

Dr. Pam R. Taub, MD, FACC is a board-certified cardiologist who focuses on general and preventive cardiology. As a general cardiologist, she works with patients to diagnose and prevent heart disease, as well as manage conditions such as hypertension (high blood pressure), diabetes, coronary artery disease, or heart failure. Her own research—focused on how epicatechin (a compound found in dark chocolate) can improve mitochondrial structure and exercise capacity in patients with heart failure and diabetes—has received funding from the National Institutes of Health and the American College of Cardiology, and has resulted in multiple publications in top journals. She is also developing and testing new biomarkers (blood tests) to predict cardiovascular risk, as well as studying the mechanisms of statin-related muscle complaints and decreases in exercise capacity and using epicatechin to treat them.

Transcript of this video segment:

Steve Freed: This is Diabetes in Control. We’re here at AACE 2016 in Orlando, Florida. We have with us a special guest and a cardiologist, not an endocrinologist. It’s always great to get a different opinion. So maybe you can tell us a little bit about yourself, even where you went to school, where you’re practicing, what type of practice?

Dr. Taub: I am a cardiologist at University of California, San Diego. I’m an associate professor of medicine and I’m also a director of the cardiac wellness and rehab center at UC-San Diego. I did my medical school at Boston University. I did my Internal Medicine residency at University of Washington in Seattle and my cardiology fellowship at University of California, San Diego.

Steve Freed: So tell us a little bit about your practice? What do you do on a daily basis?

Dr. Taub:  I see patients about 50% of the time. The other 50% of the time I’m engaged in research and administrative work. I have a very busy clinical practice. I see a lot of patients with various cardiac disease, from coronary disease to arrhythmias to valvular disease. But I would say patients with diabetes comprise over 75% of the patients that I see.

Steve: That’s interesting. You’re a cardiologist and you probably see more diabetic patients than an internist would.

Dr. Taub: Definitely.

Steve:  Because, obviously most patients with diabetes have increased cardiovascular risk. In fact, if you think about it, most people with diabetes don’t die from diabetes.

Dr. Taub: They die from heart disease.

Steve: They die from heart disease. Obviously, the two are really interrelated and our newsletter basically focuses not just on diabetes, even things that are related like gum disease. It causes inflammation. It causes heart problems. Sometimes we don’t think of all these other things being involved. My personal feeling as a diabetes educator is that if a person has diabetes, and they’re not in control with their blood sugars, they’re at risk for every disease known to man, whether it be dry skin, amputation, blindness, colds and flus, yeast infections…. Every disease known to man because their resistance is open for infections. I’m sure you see a lot of the same thing, nobody comes to you just for their diabetes. Nobody comes to you just because they have hypertension. Really, you have to look at all those different things.

Dr. Taub:  You have to manage everything aggressively. So, patients with diabetes that I typically see have often already had their first heart attack. So we focus a lot on their management of their cholesterol. We focus on their blood pressure. I work very closely with my endocrinology colleagues in managing their diabetes. Many times I will make suggestions based on drugs that have good cardiac data to the endocrinologist on what patients should be started on. And often, many times when patients don’t have an endocrinologist, I will often be the first one to start them on medication for their diabetes.

Steve:  You work in a large institution. I always see that large institutions, you probably have at least a couple of dietitians that you work with. You probably have a couple of nurse diabetes educators that you work with. You probably have some pharmacists that you work with. So you have the luxury of having all these other people part of the diabetes team working with you as a real team, different from going to a family practitioner who has none of these people and has to send out, if he does, to all these other people. So your results should be a lot better than a family practitioner’s. You actually, I presume, you get graded in some way for lowering A1Cs, lowering blood pressure, meeting goals. Is that right?

Dr. Taub:  Yes, we do. We are constantly being evaluated on how well we manage all of those parameters. One thing I will say. It’s not necessarily about having a large team. Sometimes patients just want the physician’s time and they want to be engaged with the physician. So a family practitioner that doesn’t have a lot of resources can still do an incredible job, as long as they’re engaged with the patient.

To view other segments in this video series:

Part 1: A Cardiologist’s Perspective on Diabetes
Part 2: New Cholesterol Drugs PCSK9 Inhibitors
Part 3: PCSK9 Side Effects
Part 4: Working with Diabetes Patients
Part 5: Advice on Treatment Methods
Part 6: Starting on PCSK9s
Part 7: Recommending New Drugs
Part 8: Results of Using New Drugs