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Richard Bergenstal Part 5, The Future of Diabetes Management

In part 5 of this Exclusive Interview, Richard Bergenstal talks with Diabetes in Control Publisher Steve Freed about the necessity of combining the separate cardio- and microvascular treatment methods for more effective overall diabetes management.

Richard Bergenstal MD, is an endocrinologist and Executive Director of the International Diabetes Center at Park Nicollet Methodist Hospital in Minneapolis, Minnesota.


Transcript of this video segment:

Freed: With your knowledge of diabetes and with all the trials that you’ve participated in, what are you looking for into the future that could be one of the greater achievements? You know, like we have SGLT2s and DPP4s and we have CGM, all these things have come within the last five or six years. What are you looking for into the future, if you can have your way and have — ?

Bergenstal: Yeah. Well, I think — for me, my future is going to be — I think, actually, first implementing. I think we’ve had those two major breakthroughs. CGM has been a major breakthrough and these drugs for type 2 that are non-hypoglycemic and have cardiovascular benefits. Okay. So, we have two things now. And right now, I’m afraid they’re competing. Oh, no, you can’t — we have to use SGLT, GLP-1s, and we can’t — we don’t need CGM or we can’t use — I think it’s a dual track that we’ve got to get across. The macrovascular diseases are going to need some of these new drugs, so we’ve got to have that pathway. What’s the cardiovascular risk should I use one of these? And then, we need the glucose control pathway for the microvascular. So, to me, my next five years is seeing that primary care sees this dual pathway; cardiovascular, microvascular. Let’s have it all. If we can get that done, we’re going to save a lot of hearts, and eyes, and kidneys.

Freed: Any future studies regarding those issues?

Bergenstal: Well, I think, here’s what I’d love to do. So, to put those together I want to — these cardiovascular outcome trials that are coming hot and heavy still, I don’t know if they’re going to continue forever, but I want to add CGM into those trials, so we can finally say once and for all, “Why does the SGLT2 and the GLP-1, why exactly are they preventing heart disease? Does it have anything to do with glucose variability, hypoglycemia?” So, I’m trying to marry those two. If I can get that done, I think we’ll all learn a lot.

Freed: Well, I want to thank you for your time. We appreciate you stopping by and giving us some great information. And look forward to seeing you at ADA.

Bergenstal: Yeah. Pleasant talking to you, I hope we can talk again.

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