Hands On Webinar | De-escalate Therapy as a Result of CGM and GLP-1 Impact | Recording-De-escalate Therapy as a Result of CGM and GLP-1 Impact

Video Transcription

Video Summary

This webinar focused on practical strategies to improve diabetes care through therapy de-escalation facilitated by continuous glucose monitors (CGMs) and GLP-1 agonists. Dr. Bhakti Paul and Dr. Dennis Small shared insights on using CGMs for lifestyle modification and safely reducing medications like insulin.<br /><br />Dr. Paul emphasized CGMs’ role in empowering patients to experiment with diet, movement, sleep, and stress management by providing immediate glucose feedback. She introduced the "three Ps" for dietary improvement: start meals with protein (25-30g), pace eating, and end with physical activity. A detailed case study of a patient successfully tapered off insulin using CGM data and GLP-1 dual receptor agonist therapy illustrated real-world application.<br /><br />Dr. Small supplemented with practical guidelines to de-escalate weight-gaining and hypoglycemia-risk medications like sulfonylureas, meglitinides, and insulin when initiating GLP-1 therapies, tailoring reductions based on hemoglobin A1c levels and individual risk. He addressed managing GLP-1 side effects (mainly GI upset) with diet adjustments, slow titration, and symptomatic treatments, as well as converting between GLP-1 agents and restarting them after interruptions.<br /><br />Both emphasized individualized, data-driven approaches with frequent follow-ups and remote monitoring to ensure safe medication adjustment and optimize patient outcomes. Insurance coverage for CGMs, support for vulnerable populations, and managing therapy challenges such as hair loss and bowel obstruction were also discussed. The webinar concluded with a Q&A session addressing participant concerns and reinforcing the value of CGMs and GLP-1s in enabling more personalized and effective diabetes management.

Keywords

diabetes care

therapy de-escalation

continuous glucose monitors

CGMs

GLP-1 agonists

insulin tapering

dietary strategies

medication reduction

hypoglycemia risk

patient empowerment

remote monitoring