The Meaning of Health

Episode 130 – Diabetes Medication to Prevent Heart Problems with Dr. Juliana De Oliveira Costa

In this episode, Craig chats with Dr Juliana de Oliveira Costa, Research Fellow at the Medicines Intelligence Research Program, UNSW Sydney. Juliana is a pharmacist and pharmacoepidemiologist who uses big health data to study and improve medicine use across populations.

They discuss SGLT2 inhibitors and GLP-1 receptor agonists—modern type 2 diabetes medicines now known for heart, kidney, and weight-loss benefits. Juliana explains how cardiovascular benefits were discovered by accident, leading to major changes in treatment guidelines and PBS (Pharmaceutical Benefits Scheme) access.

Topics include how these medicines work, recent PBS changes enabling earlier use in high-risk patients to be cheaper for patients, medication costs, private prescribing, and research showing underuse—especially in older adults—despite strong evidence of benefit. They also touch on safety concerns, long-term use, and the value of real-world data in guiding policy and practice.

Learn more about Juliana’s work here and get contact details for the cardio-metabolic team: https://www.unsw.edu.au/medicine-health/our-schools/population-health/research/transforming-health-systems/medicines-intelligence/cardiometabolic-medicines

Learn more about Juliana: https://www.unsw.edu.au/staff/juliana-de-oliveira-costa

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