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CardioNerds (Drs. Gurleen Kaur and Richard Ferraro) and episode FIT Lead Dr. Spencer Carter (Cardiology Fellow at UT Southwestern) discuss the clinical implementation of GLP-1 receptor agonists with Dr. Neha Pagidapati (Faculty at Duke University School of Medicine). In this episode of the CardioNerds Cardiovascular Prevention Series, we discuss the clinical implementation of glucagon-like peptide-1 (GLP-1) receptor agonists. We cover the clinical indications, metabolic and cardiovascular benefits, and potential limitations of these emerging and exciting therapies. Show notes were drafted by Dr. Spencer Carter. Audio editing was performed by CardioNerds Academy Intern, student Dr. Pacey Wetstein. This episode was produced in collaboration with the American Society of Preventive Cardiology (ASPC) with independent medical education grant support from Novo Nordisk. See below for continuing medical education credit. Claim CME for this episode HERE. CardioNerds Prevention PageCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Clinical Implementation of GLP-1 Receptor Agonists GLP-1 agonists work through a variety of mechanisms to counteract metabolic disease. They increase insulin secretion, inhibit glucagon secretion, slow gastric motility, and increase satiety to limit excess energy intake. Patients with type II diabetes and an elevated risk for atherosclerotic cardiovascular disease should be considered for GLP-1 agonist therapy regardless of hemoglobin A1c. GLP-1 agonists offer significant ASCVD risk reduction even in the absence of diabetes. Newer data suggest a significant reduction in cardiovascular events with GLP-1 agonist therapy in patients who are overweight or obese and have a prior history of heart disease. GLP-1 agonists should generally be avoided in patients with a history of medullary thyroid cancer or MEN2. As these medications slow gastric emptying, relative contraindications include history of recurrent pancreatitis and gastroparesis. GLP-1 agonists should be initially prescribed at the lowest dose and slowly uptitrated to avoid gastrointestinal side effects. Show notes - Clinical Implementation of GLP-1 Receptor Agonists What were the groundbreaking findings of the STEP1 and SURMOUNT-1 trials and how these impact cardiovascular wellness? The STEP1 and SURMOUNT trials demonstrated sustained clinically relevant reduction in body weight with semaglutide and tripeptide, respectively, in patients with overweight and obesity. As obesity is an important risk factor for the development of cardiovascular disease, weight reduction meaningfully contributes to cardiovascular wellness. What were the findings of the LEADER trial and their implications for patients with type II diabetes and high cardiovascular risk? The LEADER trial demonstrated a significant reduction in the rate of cardiovascular death, nonfatal MI, or nonfatal stroke in patients with type II diabetes treated with liraglutide. GLP-1 receptor agonist therapy should be considered in all patients with type II diabetes and elevated ASCVD risk regardless of A1c or current hyperglycemic therapy. What are current indications for GLP1 agonists in the context of cardiometabolic disease. GLP-1 receptor agonists should be considered in patients with type II diabetes and high ASCVD risk OR patients without diabetes who are overweight/obese and have a history of cardiovascular disease. What are important side effects or contraindications to GLP1 agents when used for cardiovascular risk reduction and wellness? GLP-1 receptor agonists should be avoided in patients with a history of medullary thyroid cancer or MEN2. Relative contraindications include recurrent pancreatitis, gastroparesis,

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In his presentation, Dr. Carlos Barrios discusses the integration of metabolic and functional principles in psychiatry, with a focus on child and adolescent psychiatry. He emphasizes the importance of medication independence through dietary interventions. Dr. Barrios shares his personal health journey, overcoming throat cancer and various health issues through diet changes, specifically transitioning from a vegan to a ketogenic and then a carnivore diet. He highlights the rising trends in pediatric obesity, hypertension, and psychiatric conditions such as ADHD, anxiety, depression, and autism. Dr. Barrios advocates for holistic treatment plans that incorporate nutrition, exercise, and lifestyle changes, providing examples from his practice to illustrate the positive impacts of these interventions. 0:01 - Introduction and Background 1:00 - Commitment to Knowledge Sharing 1:21 - Personal Health Journey and Throat Cancer Diagnosis 2:01 - Health Complications and Medical Leave 2:24 - Transition to Keto Diet and Improvements 3:02 - Carnivore Diet Success Story 4:02 - Pediatric Obesity and Hypertension Trends 5:03 - Critique of DASH Diet and Medication 6:02 - Ethical Concerns with New Medications 6:27 - Rising ADHD, Anxiety, and Depression Rates 7:00 - Autism and the Ketogenic Diet 8:01 - Case Study: Juvenile Arthritis and Carnivore Diet 9:00 - Holistic Treatment Approach in Practice 10:01 - Case Study: Cassie’s Mental Health Challenges 10:54 - Importance of Family Support and Fighting Misinformation 11:09 - Case Study: Aubrey’s Success with Diet Changes 12:40 - Conclusion and Call to Action

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Father Shares Inspiring Weightloss Journey And Life Transformation

Conquering Weight Loss with GLP-1 Medications: Diane's Journey In this episode of The Downsized Dish, host Laraine Durham interviews Diane, a 73-year-old retired math teacher from Tallahassee, Florida, who successfully lost 93 pounds using GLP-1 medications like Tirzepatide and Zepbound. Diane shares her lifelong battle with weight, her experiences with various diets, and how GLP-1 medications transformed her relationship with food. She discusses her journey in depth, from the early struggles due to emotional eating to achieving and maintaining her goal weight. Diane also emphasizes the importance of support from family and the medical community for a sustainable weight loss journey. Tune in to hear Diane's inspiring story and insights into using GLP-1 medications for weight management. DOWNSIZED WEBSITE: https://thedownsized.org/ DOWNSIZED GLP-1 COMPANION PRODUCT STORE: https://thedownsized.org/downsized-store JOIN CLUB DOWNSIZED: @thedownsized FOR SPONSORSHIPS, BRAND DEALS & COLLABS: https://thedownsized.org/contact/ 00:00 Welcome to The Downsized Dish 01:11 Meet Diane: A Journey of Resilience 02:18 Diane's Weight Loss Journey 06:17 Struggles and Triumphs 12:07 Discovering GLP-1 Medications 14:44 Life on Zepbound 20:14 Maintaining Weight Loss 23:02 Diet and Lifestyle Changes 26:56 Cooking and Family Life 27:48 Running and Health Challenges 29:44 Struggles with Medical Care 30:33 Finding a Supportive Community 31:37 Life in Tallahassee 35:11 Weight Loss Journey and Family Support 35:57 The Impact of GLP-1 Medication 40:58 Challenges and Misconceptions 48:53 Final Thoughts and Advice

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