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S2-03 - Why Clinical Care Pathways Matter

S2-E3 – Why Clinical Care Pathways Matter

In this episode of the Rising Tide series, co-hosts Ken Cusi and Roger Green are joined by KOL in public health, Jeff Lazarus, and physician and associate professor of internal medicine, Jeff Budd. The panelists focus on why clinical care pathways matter and drive the message that primary care plays an integral role in fighting fatty liver.

In this episode of The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide, co-hosts Ken Cusi and Roger Green are joined by Jeff Lazarus and Jeff Budd to explore why clinical care pathways matter for fighting fatty liver.

Jeff Lazarus (referred to as ‘Laz’ for clarity) is the head of the Health Systems Research Group at ISGlobal and contributes as Associate Professor at the University of Barcelona where he is based. Jeff Budd is an Associate Professor within the division of general internal medicine at the University of Florida, providing primary care perspective for this session.

00:00 Introduction with Ken Cusi and Roger Green
15:55 Recognizing Fatty Liver Prevalence
24:28 Shifting Primary Care Perceptions and Utilizing FIB-4
31:54 Impact of Fatty Liver on Metabolic Health
46:41 Final Takeaway Notes from the Panelists

15:55
There are an estimated 100 million patients in the US with NAFLD and around 10,000 total hepatologists and gastroenterologists to treat. Laz elaborates on the idea that there are simply not enough human resources to rely on standalone fatty liver care services. From here, Ken picks up on the importance of identifying fatty liver patients in primary care settings. He reintroduces the frontline screening tool, FIB-4, which helps to estimate the amount of scarring in the liver through a simple calculation based on routine blood work results. The goal is to develop a reliable reflex in screening for fatty liver that has similarly been accomplished in kidney disease (albumin in urine) and diabetes (eye disease and neuropathy). An elevated FIB-4 is an urgent prompt for primary care to investigate cause and course of action.

24:28
Jeff describes when and why his own thinking around liver disease shifted. He emphasizes that NAFLD ought to be recognized on the frontlines as a “widely prevalent and progressive disease that can potentially be reversed if caught early.” Ken raises the challenge of optimizing pop-up metadata in electronic medical records. The idea is to prompt urgent and effective notifications to the primary care treaters without being too obstructive.

31:54
Roger steers the conversation to consider how fatty liver impacts a myriad of conditions pertinent to primary care services. For example, fatty liver increases risk for cardiovascular outcomes, complications of COVID, hepatocellular carcinoma and a swath of obesogenic cancers. Laz explains that in Hepatitis C, the aim is to catch it early to avoid extrahepatic manifestations. The group discusses the challenge of educating patients in a mere <13 minute consultation. Ken returns to his plea for providers to consider what is available today for treating diabetes and obesity using GLP-1s and pioglitazone. 46:41 As the session winds down, each panelist parts with a final takeaway message for the listeners. Tune in to learn more, and thank you for listening. If you enjoy the episode, have questions or interest around its contents, we kindly ask that you spread the word and help us put a major dent in fatty liver disease. We also encourage our audience to write us questions and look forward to integrating your on-ground perspectives in the discourse. This podcast series and all episodes are produced under a non-restricted grant from Novo Nordisk. Novo Nordisk has neither influenced nor reviewed the contents of this podcast in any way. This content represents the views of the speakers and does not necessarily represent the views of Novo Nordisk. The content herein is for educational purposes only and should not be taken as medical advice.

S2-5 – Key Insights from the American Diabetes Association 83rd Scientific Sessions

Ken Cusi and Roger Green are joined by family practice researcher and KOL Eric Johnson and diabetologist and primary care KOL Jay Shubrook in a discussion around exciting news emerging from the ADA 83rd Scientific Sessions meeting. Layering in practical takeaways, the group explores their impressions from the meeting, the utility of FIB-4 as a frontline screening tool, guidelines and recommendations, therapeutic options both now and in the imminent future, and lastly the new nomenclature rollout for Fatty Liver disease.

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S2-E3 – Why Clinical Care Pathways Matter

In this episode of the Rising Tide series, co-hosts Ken Cusi and Roger Green are joined by KOL in public health, Jeff Lazarus, and physician and associate professor of internal medicine, Jeff Budd. The panelists focus on why clinical care pathways matter and drive the message that primary care plays an integral role in fighting fatty liver.

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S2-E2 – A Deeper Dive Into Fatty Liver, NAFLD, and NASH

In this episode of the Rising Tide series for frontline professionals, the patients themselves and caregivers, co-hosts Ken Cusi and Roger Green are joined by KOL in hepatology, Manal Abdelmalek and KOL in endocrinology, Scott Isaacs for a deeper dive into Fatty Liver, NAFLD and NASH. The group discusses: morbidities and mortalities related to fatty liver disease, paradigm-shifting data, screening for risk stratification, pediatric and adolescent populations, unique key takeaways and much more.

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S2-1 – Combating Swelling NAFLD and NASH Prevalence: Drugs, Diagnostics and Guidelines for the Frontline

In the Season 2 debut of the Rising Tide series for healthcare professionals who treat diabetic patients, the patients themselves and their caregivers, co-hosts Ken Cusi and Roger Green are joined by Mazen Noureddin to talk about prevalence and taking action on the frontlines today. The trio explore emerging NASH drugs, noninvasive testing and guidelines for treating different stages of disease progression.

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S1-E2 — What’s Behind The New AACE Fatty Liver Guidelines?

Drs. Mary Rinella, Zobair Younossi and Diana Barb join co-hosts Dr. Ken Cusi and Roger Green to explore the new AACE Fatty Liver guidelines. Learn about the epidemiology and research behind the guidelines and what they recommend for endocrinologists, primary care physicians and allied health professionals when screening, diagnosing and managing Type 2 Diabetes patients for Fatty Liver disease.

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S1-E1.1 – Fatty Liver Prevalence May Be Higher Than Previously Thought, Especially Among Type 2 Diabetes Patients

Hepatology Researcher and Key Opinion Leader Stephen Harrison discussed results of his 2021 publication in the Journal of Hepatology that reported, in a prospective random sample of 835 people with a median age of 55, NAFLD prevalence as being 37%, NASH as being 14% and advanced fibrosis as being 6% in a random asymptomatic patients. Among patient with Type 2 Diabetes, NAFLD prevalence was 70% and NASH was 35%.

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S1-E1 – New Podcast: Growing NAFLD-Diabetes Dual Prevalence Increases CVD Risk for Diabetics

In this Premier episode of The NASH Tsunami in Diabetes: Getting Ahead of the Rising Tide, key opinion leaders Doctors Stephen Harrison, Kathleen Corey and Kay Pepin join co-hosts Dr. Ken Cusi and Roger Green to discuss key issues related to the NAFLD-Diabetes Link, NAFLD-Diabetes Dual Prevalence: very high NAFLD and NASH prevalence in diabetics leads to increased CVD risk and other metabolic issues.

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