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Culturally-Sensitive Nutrition Education Studied for Pre-Diabetic African American Patients

2 min read

Withings remote patient monitoring devices will be used by The Strelitz Diabetes Center at Eastern Virginia Medical School (EVMS) in a multi-year ADA-funded study to investigate the efficacy of a culturally-sensitive nutrition program to prevent Type 2 diabetes in African Americans. We interviewed Dr. Henri Parson (EVMS) who is leading the clinical trial, and her co-investigator Ann-Marie Stephens, co-founder of WelFore Health, who is developing the nutritional program and accompanying app, to learn more. 

 

It is well established that the African American population is disproportionately affected by diabetes. The Office of Minority Health at the US Department of Health and Human Services reports that African Americans are: 

 

  • 60% more likely to be diagnosed with diabetes (1)
  • 2.5 times more likely to be hospitalized with long-term diabetes (2) complications.
  • Twice as likely to die from diabetes as Non-Hispanic Whites (3) 

The EVMS study will follow 160-180 African American adults who are pre-diabetic or at risk of developing diabetes over the course of 48 weeks. Participants will be brought into the center for quarterly in-person assessments, but they will also be provided Body Pro 2 smart scales and BPM Connect Pro blood pressure monitors for at home use because as Dr. Parson explains, “In a prospective study, we want to capture all the secondary measures we can and have regular remote monitoring.” 

 

The researchers note that there is a gap in the research when it comes to nutrition education. To address this, the nutrition program will emphasize a “food as medicine” approach and will focus on building empathy, trust, and engagement with participants who often have a distrust of clinical trials. Interventions will include meal plans, cooking lessons, daily nudges, and meetings with nutritionists. It will highlight easy-to-follow advice such as making sure non-starchy vegetables make up half the plate and leveraging the power of portion control. 

 

Because Type 2 diabetes tends to follow an intergenerational cycle, WelFore’s Ann-Marie Stephens explains, “We need to help people learn healthier ways to enjoy their cultural heritage foods so they don’t accept the inevitability of diabetes. That to me is the total end game. You’ve got to break that mental mindset.” Heritage foods are such a binding force in the community so preserving culinary traditions is essential to ensure adherence to the program. 

 

When asked for her key takeaway Dr. Parson says, “Healthcare should not be just what the clinical practice guidelines say. It is much much more complex than that. Treat the person as a whole rather than as a symptom. As my mentor Dr. Aaron Vinik often said, “When you understand diabetes, you understand all of health.”

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Delivering a breakthrough biomarker in the at-home setting

An estimated 38.4 million people in the U.S. have diabetes, according to the Centers for Disease Control and Prevention. Up to 70% of people with diabetes will be affected by diabetic peripheral neuropathy, and nearly half have no symptoms to alert them that it’s happening. This often silent condition increases the risk of foot ulcers and potential amputations. Patients with diabetic foot ulcers have a two-fold greater increase in mortality.

Unfortunately, diabetic neuropathy is often not discovered until it is well advanced when it may be irreversible. Early diagnosis of diabetic peripheral neuropathy is critical for preventing further complications, but diagnostic tools have been lacking in identifying the condition in the asymptomatic early stages.

Improving patient outcomes requires better prevention strategies

A common side effect of diabetes, peripheral autonomic neuropathy often is a result of poorly controlled blood sugar. The high blood sugar concentrations damage blood vessels, restricting their ability to deliver nutrients and oxygen to small nerves. This causes the nerves to die. Poor sweat gland function leads to drier skin and increased risk of cracking and wounds. Uncontrolled diabetes can affect circulation. The resulting poor circulation makes it more difficult for wounds to heal. In some cases, this leads to amputation.

To manage these issues, the American Diabetes Association recommends annual foot exams, but these appointments are often skipped by patients. Even when patients are compliant, their care teams have been reliant on invasive and frequently inaccurate methods of detecting diabetic peripheral neuropathy. They typically have relied on monofilament to press on the foot, which results in misdiagnosis 47% of the time.

The only other alternative was for patients to undergo painful skin biopsies, the prospect of which is not appealing to diabetic patients, who are at high risk of infections and lengthy wound healing.

Addressing the gaps in diagnosing diabetic peripheral neuropathy 

Peripheral neuropathy is a common cause of diabetic foot ulcers. Early detection and appropriate treatment of foot ulcers may prevent up to 85% of amputations, according to the American Academy of Family Physicians.

That’s why it’s critical for the journey to diagnosing diabetic peripheral neuropathy to  change. Addressing these serious complications much earlier will improve care teams’ ability to diagnose and provide higher quality care. Though there is no cure for diabetic peripheral neuropathy, diagnosing it early can help providers intervene and encourage patients to make lifestyle changes to slow the progression.

To provide a more reliable tool to healthcare providers, Impeto Medical - now part of Withings - invented SudoscanⓇ, a device that measures the sudomotor function. That is, the autonomic nervous systems’ control of sweat glands. Sudomotor dysfunction is one of the earliest signs of peripheral neuropathy in diabetes and other diseases. The test uses sweat production in the feet and then analyzes the body's response.

When a patient steps on the Sudoscan, it sends a small painless current to the feet using electrodes to stimulate the sweat glands and small nerve fibers. This causes an electrochemical reaction and induces a current that produces an Electrochemical Skin Conductance score indicating the level of sweat gland function loss. 

The Sudoscan provides a quantitative measure of chloride conductance, serving as a biomarker to assess sweat gland function in relation to sweat gland innervation. High conductance means no dysfunction whereas low conductance is indicative of dysfunction of sweat glands and the presence of neuropathy. 

Used by hospitals for more than a decade, the Sudoscan has been proven in comparison with the existing methods. It soon became the gold standard for diagnosing diabetic peripheral neuropathy at its earliest stages. However, since it was only available at hospitals, care teams were limited to monitoring patients’ progress only once or twice a year. 

Bringing the gold standard to patients’ homes

Withings embedded Sudoscan’s breakthrough technology in its Body Pro 2 cellular scale. This one-of-a-kind device complements in-hospital monitoring with the ability to track patients’ progress day to day from the convenience of their own homes. Body Pro 2, CE marked in Europe and available upon prescription in the US, has been tested to validate that it offers the same accuracy level as the Sudoscan. 

With this move, Withings Health Solutions pioneered a modular approach to in-home monitoring devices, offering the Electrochemical Skin Conductance Score as its first biometric measurement in a cellular scale.

Supporting early interventions and lifestyle changes 

Body Pro 2 contributes to early detection of peripheral autonomic neuropathy. The device allows for consistent remote monitoring of patients on a daily basis to identify any deterioration in sudomotor function. By facilitating easy, daily screening, it helps care teams to track patients’ risk of diabetic peripheral neuropathy, allowing for early intervention with coaching, diet and exercise changes, medications, vitamin prescriptions, and other measures to slow and hopefully prevent complications. 

Similarly, if a patient has already been diagnosed with peripheral autonomic neuropathy, the device can help in the follow-up by monitoring disease progression or improvement. Patients can follow their own progress as well, helping to motivate them to continue making lifestyle changes to reduce their chances of complications.  

Improving patient outcomes

Body Pro 2’s ability to support healthcare professionals better care for patients with diabetes is a major turning point for the healthcare industry. Electrochemical Skin Conductance is a breakthrough measurement that provides physicians access to the health data they need to make critical decisions about their patient’s health. Body Pro 2 will transform a traditionally underdiagnosed condition to one that can be regularly monitored from the patient’s home. 

As further modules are released, care teams will be able to gain a holistic view of patients for better disease management and improved patient outcomes. 

[post_title] => Pioneering Real Change in Diabetes Care [post_excerpt] => Up to 70% of people with diabetes will be affected by diabetic peripheral neuropathy, and nearly half have no symptoms to alert them that it’s happening. This often silent condition increases the risk of foot ulcers and potential amputations. Patients with diabetic foot ulcers have a two-fold greater increase in mortality. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pioneering-real-change-in-diabetes-care-body-pro-2 [to_ping] => [pinged] => [post_modified] => 2024-06-27 09:48:20 [post_modified_gmt] => 2024-06-27 09:48:20 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1032 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 4 [filter] => raw ) [1] => WP_Post Object ( [ID] => 1149 [post_author] => 1 [post_date] => 2024-04-01 06:00:16 [post_date_gmt] => 2024-04-01 06:00:16 [post_content] =>

Exploring the Surge in Remote GLP-1 Prescription Access

New medications like GLP-1 agonists offer a promising tool to help patients achieve a healthy weight. But supporting patients in long-term weight loss with GLP-1 remote patient monitoring involves more than medication. “Obesity is a complex, chronic medical condition that requires comprehensive care. GLP-1 medications are powerful tools in the obesity medicine toolkit, but they must be paired with lifestyle counseling and medical oversight for success & safety,” said Lauren Lemieux, MD, FACP, Dipl. ABOM at FORM, a virtual obesity medicine clinic that empowers patients with obesity to take control of their health through a personalized weight loss plan.

 

Uncertainties persist regarding the long-term effectiveness of these medications and the best approach to determine which patients can safely discontinue the medication while maintaining weight loss, and which patients would benefit from a prolonged therapy regimen. As we continue to learn more about GLP-1 agonists, daily measurement of biometrics such as weight, BMI, blood pressure, heart rate, sleep patterns, and body composition is particularly critical to making informed care decisions. 

 

The rise in remote prescribing of GLP-1 medications reflects a broader trend toward telemedicine and GLP-1 remote patient monitoring, which is driven by technological advancements and the need for increased care access. Healthcare teams continue to face challenges in treating and managing patients remotely, including:

 

  • Limited to no regular physical patient assessment 
  • Low patient engagement and communication in their treatment plan 
  • Technical issues with devices and unreliable data measurements 
  • Inability to correlate long-term data patterns with intervention strategies

Bridge the virtual care gap. Adopt smarter healthtech.

Care teams don’t always need more technology. They need smarter technology that improves their ability to provide better patient care. Withings offers a range of digital health solutions, from connected health devices like cellular scales and blood pressure monitors to an all-in-one self service remote patient monitoring platform. These solutions directly address many of the technological barriers of virtual care.

In a March 2024 survey, Withings asked their database of device users about their experience with GLP-1 treatments. Nearly a quarter of respondents reported taking GLP-1s, with a significant majority (93%) being prescribed healthy habits alongside their treatment. 60% of users noted biomarker changes associated with their GLP-1 regimen and 76% reported Withings products had a positive influence on their treatment journey. 

 

Withings newest cellular scale, Body Pro 2, combines habit-forming user features with a pioneering modular approach to manage chronic conditions like obesity. Its core capabilities allow care teams to capture advanced health metrics such as weight and body composition, while additional features can track advanced and clinically validated biomarkers typically only available in a professional setting. 

 

Withings Health Solutions simplifies access to long-term patient data, resulting in improved support GLP-1 remote patient monitoring and faster decision-making for treatments and care strategies.

Part 2: Learn why measuring body composition is key for patients on GLP-1s

Keep Reading [post_title] => Part 1: Supporting Safe and Sustainable Weight Loss With GLP-1s - Finding the right remote health technologies [post_excerpt] => New medications like GLP-1 agonists offer a promising tool to help patients achieve a healthy weight. But supporting patients in long-term weight loss involves more than medication. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => supporting-safe-and-sustainable-weight-loss-with-glp-1s-part-1-finding-the-right-remote-health-technologies [to_ping] => [pinged] => [post_modified] => 2024-07-11 09:25:38 [post_modified_gmt] => 2024-07-11 09:25:38 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1149 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) [2] => WP_Post Object ( [ID] => 1150 [post_author] => 1 [post_date] => 2024-04-01 06:20:45 [post_date_gmt] => 2024-04-01 06:20:45 [post_content] =>

A key biomarker in remote GLP-1 medication management

GLP-1 agonists are remarkably effective in helping patients lose weight. But this can’t be done in a vacuum. “Ensuring safety and appropriate rate of weight loss is always a concern among healthcare providers who are remotely monitoring patients on GLP1 medication. Without having patients come into a physical clinic, there hasn’t been a means of checking health metrics, such as weight and blood pressure, in a way that they can be easily transferred into their electronic medical record for trending over time” said Kristin Baier, MD VP, Clinical Development at Calibrate, the leading clinician-guided and value-based obesity treatment program. Highlighting the importance of GLP-1 remote patient monitoring regarding weight management. 

 

One data point that’s often overlooked in a patient’s journey on GLP-1s is body composition — the proportion of lean mass and fat mass within the body, which can be subdivided into muscle mass, fat mass, water percentage, and bone mass. We now know this data is more telling than Body Mass Index (BMI). In fact, research has shown that BMI is a poor indicator of overall health and does not take into consideration the difference between muscle and fat mass. BMI oversimplifies health assessments, neglecting insight into crucial factors that measuring body composition can provide. (Science Behind Body Composition, A Withings Study)

 

“When patients lose weight, they are losing a combination of adipose (fat) tissue and lean body mass, which includes skeletal muscle mass, organ density and bone density. Ideally, we want patients to lose adipose tissue and preserve their lean body mass,” continued Kristin Baier, MD. Monitoring body composition over time is crucial, as changes and trends can provide valuable insights into a patient's health status — often more so than individual measurements.

Preventing muscle loss

One known side effect of GLP-1 medications is the loss of muscle mass along with body fat. If care teams only monitor patient progress using a standard scale, they won’t know if their patients are losing too much muscle mass too quickly. Some patients receive a one-time measurement of their body composition during their doctors’ office visit to determine if they’re eligible for a GLP-1 and sometimes during their annual checkup, so care teams are only seeing the data at the beginning and end of the patient journey. Other patients undergo treatment without any assessment of their body composition. By neglecting to measure aspects such as muscle mass, fat distribution, and hydration levels, healthcare providers may overlook crucial indicators that could impact treatment efficacy and patient well-being.

 

Muscle is important for burning calories and maintaining a healthy metabolism, which helps with long-term weight loss success. Loss of muscle mass is associated with an increased risk for lower bone density, fatigue, injuries, decreased strength, and more frequent hospitalizations. Preserving muscle is necessary not just to ensure ongoing physical movement but to protect against cancer, cardiovascular disease, and pulmonary disease. This can be tracked by using a GLP-1 remote patient monitoring to support the patient's journey.   

 

“By measuring body composition, we can accurately determine if this is, in fact, occurring. If we see that pounds are going down but their body fat percentage is staying the same and their muscle mass is decreasing, we can modify lifestyle components such as their type and frequency of exercise and food intake, for instance” shared Kristin Baier, MD.

Combatting GLP-1 agonist plateau

Although GLP-1 agonists tend to spark significant weight loss, most patients eventually reach a plateau in their weight and other metabolic markers like blood pressure. Focusing solely on weight or BMI can sometimes lead to short-term thinking and unsustainable weight loss strategies.

 

By helping patients focus less on specific weight numbers and more on changes in their body composition data, care teams can promote a more holistic approach that supports sustainable weight loss. 

For example, if a patient’s body weight increases or remains stable during treatment, GLP-1 remote patient monitoring and body composition monitoring may reveal that their body fat percentage has decreased while their muscle mass has increased. Although the individual is gaining weight in this scenario, it’s attributed to the growth of muscle tissue rather than an increase in body fat. This type of weight gain, known as lean mass gain, is generally considered positive for overall health and fitness as it can improve strength and metabolic rate.

Moving Forward

In a March 2024 survey conducted by Withings, patients taking GLP-1 medication were asked about the biomarkers they’ve been monitoring throughout their health journey. Among respondents, 37% highlighted body composition as a crucial metric they actively tracked using their Withings devices during their treatment regimen.

 

Write-in responses highlighted the value of regular body composition tracking in supporting healthy habits and addressing concerns about muscle loss.

"[My Withings scale] encouraged daily weigh-ins, identification of more clear lean body mass decrease, [and] increased focus on protein intake and resistance exercise per HCP guidance.” "I watch my muscle mass through the Withings scale. I don’t need my weight to decrease quickly, but I do want to keep or gain muscle.” "I was fearful that I would lose muscle, and the scale helped me to monitor.” "Daily reminder of weight, body composition, and BP (blood pressure) reinforced healthy eating and exercise goals."

Withings Body Pro 2 is an advanced body composition scale that accurately and reliably collects advanced patient biomarkers from the at-home setting and sends them directly to care teams via cellular connectivity.

 

Daily body composition analysis allows for a more personalized approach to treatment. Measuring patients’ body composition while on a GLP-1 therapy is important for assessing treatment effectiveness, monitoring metabolic health, preserving lean body mass, and ensuring overall health and safety for individuals undergoing this type of treatment.

Part 3: Discover the importance of remote monitoring devices after medication ends

Keep Reading [post_title] => Part 2: Supporting Safe and Sustainable Weight Loss With GLP-1s - Why body composition matters [post_excerpt] => GLP-1 agonists are remarkably effective in helping patients lose weight. But this can’t be done in a vacuum. One data point that’s often overlooked in a patient’s journey on GLP-1s is body composition. [post_status] => publish [comment_status] => closed [ping_status] => closed [post_password] => [post_name] => part-2-supporting-safe-and-sustainable-weight-loss-with-glp-1s-part-2-why-body-composition-matters [to_ping] => [pinged] => [post_modified] => 2024-06-27 09:56:59 [post_modified_gmt] => 2024-06-27 09:56:59 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1150 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 3 [current_post] => -1 [before_loop] => 1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 1032 [post_author] => 1 [post_date] => 2023-12-04 13:07:56 [post_date_gmt] => 2023-12-04 13:07:56 [post_content] =>

Delivering a breakthrough biomarker in the at-home setting

An estimated 38.4 million people in the U.S. have diabetes, according to the Centers for Disease Control and Prevention. Up to 70% of people with diabetes will be affected by diabetic peripheral neuropathy, and nearly half have no symptoms to alert them that it’s happening. This often silent condition increases the risk of foot ulcers and potential amputations. Patients with diabetic foot ulcers have a two-fold greater increase in mortality.

Unfortunately, diabetic neuropathy is often not discovered until it is well advanced when it may be irreversible. Early diagnosis of diabetic peripheral neuropathy is critical for preventing further complications, but diagnostic tools have been lacking in identifying the condition in the asymptomatic early stages.

Improving patient outcomes requires better prevention strategies

A common side effect of diabetes, peripheral autonomic neuropathy often is a result of poorly controlled blood sugar. The high blood sugar concentrations damage blood vessels, restricting their ability to deliver nutrients and oxygen to small nerves. This causes the nerves to die. Poor sweat gland function leads to drier skin and increased risk of cracking and wounds. Uncontrolled diabetes can affect circulation. The resulting poor circulation makes it more difficult for wounds to heal. In some cases, this leads to amputation.

To manage these issues, the American Diabetes Association recommends annual foot exams, but these appointments are often skipped by patients. Even when patients are compliant, their care teams have been reliant on invasive and frequently inaccurate methods of detecting diabetic peripheral neuropathy. They typically have relied on monofilament to press on the foot, which results in misdiagnosis 47% of the time.

The only other alternative was for patients to undergo painful skin biopsies, the prospect of which is not appealing to diabetic patients, who are at high risk of infections and lengthy wound healing.

Addressing the gaps in diagnosing diabetic peripheral neuropathy 

Peripheral neuropathy is a common cause of diabetic foot ulcers. Early detection and appropriate treatment of foot ulcers may prevent up to 85% of amputations, according to the American Academy of Family Physicians.

That’s why it’s critical for the journey to diagnosing diabetic peripheral neuropathy to  change. Addressing these serious complications much earlier will improve care teams’ ability to diagnose and provide higher quality care. Though there is no cure for diabetic peripheral neuropathy, diagnosing it early can help providers intervene and encourage patients to make lifestyle changes to slow the progression.

To provide a more reliable tool to healthcare providers, Impeto Medical - now part of Withings - invented SudoscanⓇ, a device that measures the sudomotor function. That is, the autonomic nervous systems’ control of sweat glands. Sudomotor dysfunction is one of the earliest signs of peripheral neuropathy in diabetes and other diseases. The test uses sweat production in the feet and then analyzes the body's response.

When a patient steps on the Sudoscan, it sends a small painless current to the feet using electrodes to stimulate the sweat glands and small nerve fibers. This causes an electrochemical reaction and induces a current that produces an Electrochemical Skin Conductance score indicating the level of sweat gland function loss. 

The Sudoscan provides a quantitative measure of chloride conductance, serving as a biomarker to assess sweat gland function in relation to sweat gland innervation. High conductance means no dysfunction whereas low conductance is indicative of dysfunction of sweat glands and the presence of neuropathy. 

Used by hospitals for more than a decade, the Sudoscan has been proven in comparison with the existing methods. It soon became the gold standard for diagnosing diabetic peripheral neuropathy at its earliest stages. However, since it was only available at hospitals, care teams were limited to monitoring patients’ progress only once or twice a year. 

Bringing the gold standard to patients’ homes

Withings embedded Sudoscan’s breakthrough technology in its Body Pro 2 cellular scale. This one-of-a-kind device complements in-hospital monitoring with the ability to track patients’ progress day to day from the convenience of their own homes. Body Pro 2, CE marked in Europe and available upon prescription in the US, has been tested to validate that it offers the same accuracy level as the Sudoscan. 

With this move, Withings Health Solutions pioneered a modular approach to in-home monitoring devices, offering the Electrochemical Skin Conductance Score as its first biometric measurement in a cellular scale.

Supporting early interventions and lifestyle changes 

Body Pro 2 contributes to early detection of peripheral autonomic neuropathy. The device allows for consistent remote monitoring of patients on a daily basis to identify any deterioration in sudomotor function. By facilitating easy, daily screening, it helps care teams to track patients’ risk of diabetic peripheral neuropathy, allowing for early intervention with coaching, diet and exercise changes, medications, vitamin prescriptions, and other measures to slow and hopefully prevent complications. 

Similarly, if a patient has already been diagnosed with peripheral autonomic neuropathy, the device can help in the follow-up by monitoring disease progression or improvement. Patients can follow their own progress as well, helping to motivate them to continue making lifestyle changes to reduce their chances of complications.  

Improving patient outcomes

Body Pro 2’s ability to support healthcare professionals better care for patients with diabetes is a major turning point for the healthcare industry. Electrochemical Skin Conductance is a breakthrough measurement that provides physicians access to the health data they need to make critical decisions about their patient’s health. Body Pro 2 will transform a traditionally underdiagnosed condition to one that can be regularly monitored from the patient’s home. 

As further modules are released, care teams will be able to gain a holistic view of patients for better disease management and improved patient outcomes. 

[post_title] => Pioneering Real Change in Diabetes Care [post_excerpt] => Up to 70% of people with diabetes will be affected by diabetic peripheral neuropathy, and nearly half have no symptoms to alert them that it’s happening. This often silent condition increases the risk of foot ulcers and potential amputations. Patients with diabetic foot ulcers have a two-fold greater increase in mortality. [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => pioneering-real-change-in-diabetes-care-body-pro-2 [to_ping] => [pinged] => [post_modified] => 2024-06-27 09:48:20 [post_modified_gmt] => 2024-06-27 09:48:20 [post_content_filtered] => [post_parent] => 0 [guid] => https://withingshealthsolutions.com/?p=1032 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 4 [filter] => raw ) [comment_count] => 0 [current_comment] => -1 [found_posts] => 3 [max_num_pages] => 1 [max_num_comment_pages] => 0 [is_single] => [is_preview] => [is_page] => [is_archive] => [is_date] => [is_year] => [is_month] => [is_day] => [is_time] => [is_author] => [is_category] => [is_tag] => [is_tax] => [is_search] => [is_feed] => [is_comment_feed] => [is_trackback] => [is_home] => 1 [is_privacy_policy] => [is_404] => [is_embed] => [is_paged] => [is_admin] => [is_attachment] => [is_singular] => [is_robots] => [is_favicon] => [is_posts_page] => [is_post_type_archive] => [query_vars_hash:WP_Query:private] => fad837d62e54fc8e3d9a93c236689846 [query_vars_changed:WP_Query:private] => [thumbnails_cached] => [allow_query_attachment_by_filename:protected] => [stopwords:WP_Query:private] => [compat_fields:WP_Query:private] => Array ( [0] => query_vars_hash [1] => query_vars_changed ) [compat_methods:WP_Query:private] => Array ( [0] => init_query_flags [1] => parse_tax_query ) )
Article

Pioneering Real Change in Diabetes Care

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Part 1: Supporting Safe and Sustainable Weight Loss With GLP-1s – Finding the right remote health technologies

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Part 2: Supporting Safe and Sustainable Weight Loss With GLP-1s – Why body composition matters

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