GLP-1 medications, long-established as treatments for type 2 diabetes, are now recognised as highly effective treatments for managing obesity. In this episode of the Clinical Update podcast, Professor John Wilding talks to Dawn Liz Powell about how evidence is building for new ways to support people living with obesity.

As well as the development of subcutaneous and oral GLP-1 medications and how they work, Professor Wilding discusses their current role in the management of type 2 diabetes and obesity, their potential additional benefits (such as cardiovascular risk reduction), and their possible side-effects.

Looking to the future, he says that there are ‘over 50 drugs in either phase II or phase III development’ including amylin analogues, triple analogues, and a monthly GLP-1/GIP antibody injection.

Educational objectives

After listening to this podcast, healthcare professionals should be more aware of:

• How GLP-1 medications work for both type 2 diabetes and for obesity
• Their current role in the management of obesity
• The risks and benefits of GLP-1 medications
• What new oral preparations for weight loss are emerging
• New and combination medications that may be available in the future

You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

MIMS Learning

Obesity in adults

Obesity and pregnancy

Obesity podcourse with Dr Patrick Holmes, part 1: metabolic vulnerability

Obesity podcourse with Dr Patrick Holmes, part 2: established metabolic disease

Obesity podcourse with Dr Patrick Holmes, part 3: obesity and multiple comorbidities

MIMS

Obesity treatments

Hosted on Acast. See acast.com/privacy for more information.

0.5 CPD hours

Parkinson’s disease is ‘not a condition of one person’ because the families of people with Parkinson’s are very much affected by the condition, according to Dr Alistair Church.

In this episode of the Clinical Update podcast, he talks to MIMS Learning editor Pat Anderson about the role of GPs in the management of the condition. He says GPs are ‘the spider in the middle’ of support for patients — first in picking up signs and symptoms, referring promptly, and helping patients with all the aspects of the condition that can be managed in primary care.

Dr Church also highlights ‘lots of energy’ around the development of disease-modifying therapy for Parkinson’s in the medium term.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Recall the prevalence of Parkinson’s disease
• Understand how Parkinson’s is a ‘family disease’ in terms of the family’s role
• Pick up signs and symptoms that may suggest Parkinson’s
• Be alert to the possibility of Parkinson’s in younger patients
• Distinguish Parkinson’s from other neurological conditions
• Understand the key role of exercise in managing Parkinson’s
• Support patients by managing non-motor aspects of the disease
• Be aware of the prospects for disease-modifying therapy in future

You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

Resources

MIMS Learning

Guidance update: latest NICE guidelines on neurological conditions

Tremor - red flag symptoms

Guidance update: latest NICE guidelines on neurological conditions

Hosted on Acast. See acast.com/privacy for more information.

Sophie is 28 years old, lives with obesity, and has just discovered that she is pregnant with her second child. Prior to her pregnancy, a blood glucose test indicated that she had pre-diabetes. In this episode, the first of a three-part podcourse, GP Dr Patrick Holmes reviews how to support Sophie through pregnancy, and after delivery,how to reduce the risk of further weight gain and progression to type 2 diabetes.

Educational objectives

After listening to this podcourse episode, healthcare professionals should be more aware of:

• How to raise the issue of weight sensitively
• The modifiable and non-modifiable factors that can drive obesity
• Management priorities in a pregnant woman with obesity
• Long-term goals after pregnancy in a woman living with obesity

Listen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and test your knowledge, to ensure you are up to speed with all the key points primary care professionals need to know about obesity management.

If you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you.

MIMS Learning

Obesity podcourse with Dr Patrick Holmes, part 1: metabolic vulnerability

Obesity podcourse with Dr Patrick Holmes, part 2: established metabolic disease

Obesity podcourse with Dr Patrick Holmes, part 3: obesity and multiple comorbidities

Hosted on Acast. See acast.com/privacy for more information.

In the second episode of this three-part podcourse, Sophie is now 35 years old and is approaching obesity class 3. She has also developed young-onset type 2 diabetes, dyslipidaemia, and hypertension. This represents disease progression from when we first met Sophie in episode 1 where she was 28 years old and living with obesity class 1. GP Dr Patrick Holmes discusses available treatment options for Sophie now that she has established metabolic disease, and how to reduce the risk of further disease progression.

Educational objectives

After listening to this podcourse episode, healthcare professionals should be more aware of:

• The available treatment options for established metabolic disease
• NICE recommendations for managing young-onset type 2 diabetes
• The effect of established metabolic disease on quality of life
• How parental obesity can affect the health of the whole family

Listen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and test your knowledge to ensure you are up to speed with all the key points primary care professionals need to know about obesity management.

If you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you.

MIMS Learning

Obesity podcourse with Dr Patrick Holmes, part 1: metabolic vulnerability

Obesity podcourse with Dr Patrick Holmes, part 2: established metabolic disease

Obesity podcourse with Dr Patrick Holmes, part 3: obesity and multiple comorbidities

Hosted on Acast. See acast.com/privacy for more information.

After seeing Sophie at 28 years (first episode) and at 35 years (second episode), the third and final episode of this podcourse looks at Sophie at 40 years old. She now has multiple obesity-related comorbidities — hypertension, type 2 diabetes, dyslipidaemia, obstructive sleep apnoea and metabolic dysfunction-associated steatotic liver disease. GP Dr Patrick Holmes reviews how to reduce Sophie's risk of experiencing a cardiac event and improve her quality of life.

Educational objectives

After listening to this episode, healthcare professionals should be more aware of:

• The effect of having multiple obesity-related comorbidities on life expectancy and quality of life
• How weight loss medication, such as tirzepatide, could improve the health status of a person living with multiple obesity-related comorbidities
• The need to provide non-pharmacological support to people living with obesity, regardless of whether they are taking weight loss medications
• How, without effective intervention, a person with obesity can progress from metabolic vulnerability, to established metabolic disease, and to having multiple comorbidities

Listen to this three-part audio series, then go to mimslearning.co.uk to read downloadable worksheets and test your knowledge to ensure you are up to speed with all the key points primary care professionals need to know about obesity management.

If you enjoy a blend of online learning and podcast-style listening that you can fit into your busy life, then this podcourse is for you.

MIMS Learning

Obesity podcourse with Dr Patrick Holmes, part 1: metabolic vulnerability

Obesity podcourse with Dr Patrick Holmes, part 2: established metabolic disease

Obesity podcourse with Dr Patrick Holmes, part 3: obesity and multiple comorbidities

Hosted on Acast. See acast.com/privacy for more information.

‘Successful opioid deprescribing is built on trust. Listen to patients, acknowledge that their pain is real, avoid stigmatising language, and involve them in every decision. Patients are much more likely to engage when they feel supported rather than judged,’ Dr Faheem Shakur says in this episode of the Clinical Update podcast.

Dr Shakur explains that while opioids do have a role in the management of acute pain, they should not routinely be used to manage chronic pain. He reviews how primary care teams can identify patients who may benefit from coming off opioids, how best to reduce opioid use while deploying other ways to manage pain, and how to build trust with patients so that they engage in the process.

If an opioid is appropriate, according to Dr Shakur, it should be prescribed at the lowest effective dose for the shortest possible duration with a clear stop date or review date. Patients should be informed, from the beginning, that the opioid will only be used for a limited time.

Educational objectives

After listening to this podcast, healthcare professionals should be more aware of:

• When prescribing an opioid is, and is not, appropriate in primary care
• The place of opioid deprescribing within strategies for better pain management
• How to ensure patients are not left on opioids long term
• How practices can identify patients on opioids who would benefit from a medication review
• Red flags that indicate a patient may be dependent on opioids
• Strategies for deprescribing opioids, including how to engage patients in the process
• How to identify and manage withdrawal symptoms

You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

MIMS Learning

Osteoarthritis: clinical review

Case study: chronic pain review

Guidance update: NICE guidelines on chronic pain in over 16s

Hosted on Acast. See acast.com/privacy for more information.

0.5 CPD hours

‘There are a lot of things the GP can do’ for transgender patients, according to GP lead for East of England gender services Dr Kamilla Kamaruddin, interviewed for the Clinical Update podcast by MIMS Learning editor Pat Anderson. She says this begins with listening to patients and using preferred names and pronouns, and develops into long-term support as patients navigate their way through gender identity clinics and other services.

She says providing support in this way promotes the physical and mental health of transgender individuals, who are at substantial risk of self-harm and suicide, and addresses inequalities in healthcare.

This podcast episode contains references to self-harm and suicide. Sources of support include the Samaritans, BMA Your Wellbeing service, and NHS Practitioner Health.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Reflect on the high prevalence of self-harm and suicidality among transgender individuals
• Listen to transgender patients and communicate sensitively
• Understand that supporting transgender patients is a long-term process
• Consider how best to meet the needs of transgender patients
• Provide services for patients on gender identity clinic waiting lists
• Help patients attending gender identity services
• Provide long-term care for transgender patients
• Know where to find more support to improve their practice

You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

Resources

MIMS Learning

Transgender healthcare: why is it important?

Transgender healthcare: consultation skills

Transgender healthcare: management and referral to gender identity clinics

Skin problems in transgender people

Hosted on Acast. See acast.com/privacy for more information.

‘Resistant hypertension is when you’re taking three or more medications and you’ve not reached target, and usually one of those medications is a diuretic,’ Professor Terry McCormack explains in this episode of the Clinical Update podcast. He adds that determining whether patients are truly resistant or just not taking their medication can be difficult. However, he recommends asking subtle questions such as ‘We all forget to take our tablets. How, how often do you forget to take your medication’ to gain meaningful answers.

Professor McCormack also looks at management options — including combination pills, NICE-recommended therapies, and new treatments that are on the horizon. He observes that patients with resistant hypertension are the ‘highest risk patients’ for adverse outcomes such as stroke and, therefore, ‘we need to try our best to get them to take at least the three medications that are available to us at this time, to consider single pill combinations and, in the future, consider other treatments,’.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Sensitively ask patients about their adherence to antihypertensive medications
• Encourage patients to adhere to medications regimens by discussing of risks of not taking their medications (such as a debilitating stroke)
• Understand the pros and cons of single-pill combination therapy for managing hypertension
• Review NICE recommendations on managing resistant hypertension
• Discuss new treatments on the horizon for managing resistant hypertension

You can access the website version of this podcast, along with key learning points, on MIMS Learning. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser and note-taking for appraisal.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

MIMS Learning

Guidance update: NICE guidelines on hypertension

Ischaemic heart disease: clinical review

Stroke: clinical review

Hosted on Acast. See acast.com/privacy for more information.