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Richard Pratley Part 1, Obesity and Diabetes

In part 1 of this Exclusive Interview, Richard Pratley talks with Diabetes in Control Publisher Steve Freed during the AACE meeting in Austin, Texas about his work with diabetes patients and the growing epidemic of overweight and obesity among patients with type 1 diabetes.

Richard E. Pratley, MD serves as the Medical Director of the Florida Hospital Diabetes Institute. He is also a senior scientist at the Florida Hospital /Sanford- Burnham Translational Research Institute for Metabolism and Diabetes.

Transcript of this video segment:

Steve Freed: This is Steve Freed with Diabetes in Control. We’re here at AACE 2017 meeting. We have with us a very special guest, Dr. Richard Bradley. He’s presenting here. Maybe we can start off with tell us a little bit about yourself and what you do?

Richard Pratley: Well, thanks, Steve. I’m delighted to be here with you this afternoon. In Orlando, Florida, I have multiple roles. I am a practitioner and co-director of the Florida Hospital Diabetes Institute. I have a rather large practice with 9 endocrinologists, 15 mid-level practitioners, about 12 CDEs. We see a lot of patients with type 2 diabetes in the Orlando area, so I see patients with diabetes on a regular basis. I also spend a great deal of my time doing clinical research in both type 1 and type 2 diabetes. I find that very satisfying to be able to do the bench-to-bedside research that we hope will lead to a cure for type 2 and type 1 diabetes.

Steve Freed: What is the title of your presentation?

Richard Pratley: This afternoon I’m going to be talking about differing approaches to the treatment of obesity and type 2 diabetes and type 1 diabetes

Steve Freed: Diabetes is an epidemic in this country, obviously, especially for type 2. Do you also work with type 1s?

Richard Pratley: Indeed, I do. The data with type 2 diabetes, I think everybody is aware of. It’s almost 85% of our patients with type 2 diabetes are either overweight or obese and we know that obesity leads to type 2 diabetes in many cases. People are not as aware that obesity is also a problem in type 1 diabetes. This is a growing problem over the last couple of decades, but just like the general population obesity has increased in prevalence in the type 1 population. The latest data from the type 1 diabetes exchange, which we participate in, shows that about two-thirds of patients who are adults with type 1 diabetes are either overweight or obese so it’s a huge problem in that population as well.

Steve Freed: You’re at the meeting for the endocrinologists, but most of your type 2 patients see family practitioners. Our audiences made up of family practitioners, nurses and pharmacists. What would you like for them to take away from your presentation?

Richard Pratley: Well, I think that the treatment of obesity is inherent in the treatment of type 2 diabetes. It’s a little bit different from type 1 diabetes because there’s so many complicating factors, but with type 2 diabetes, we have a number of options. First of all, we should probably try to avoid medications that lead to weight gain where possible since we know that in many cases this complicates the treatment of type 2 diabetes. Second, there are options for diabetes drugs to promote weight loss, things such as GLP-1 receptor agonists and the SGLT-2 inhibitors. Third, we should realize that there is pretty good evidence that some of the new approved weight loss drugs are also effective at lowering weight and at reducing A1C in patients with type 2 diabetes. Unfortunately, we have a paucity of data in type 1 diabetes. Although it’s a growing problem we don’t have any real evidence for the treatment of obesity with pharmacologic agents in type 1 diabetes.

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