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CME: Reducing vascular events and disease progression in type 2 diabetes (T2DM) and optimizing delivery of care

Activity Description / Statement of Need:

In this online, self-learning activity:

Cardiovascular (CV) disease (CVD) is the leading cause of mortality and morbidity in adults worldwide, accounting for around one-third of mortality in the United States. High blood pressure, diabetes, and obesity are health conditions that can increase the risk of heart disease, and over half of American adults have at least one major risk factor for adverse cardiovascular events. In particular, T2DM is a risk factor, with CV events implicated in the mortality of two-thirds of patients with T2DM. About one and a half million new cases of diabetes mellitus are diagnosed in in the United States each year, and the incidence of T2DM is increasing owing in part to Western-style diets, sedentary lifestyle, and changing demographics, and the disease is the largest contributor to a number of vascular outcomes, including end-stage chronic kidney disease (CKD) and blindness in individuals under age 75. CKD is itself a major CVD risk factor and affects millions, yet the literature shows that patients with CKD are underserved with respect to CV risk reduction efforts.

This activity has been proposed to enhance the knowledge, competence, and performance of several members of HCPs in mitigating heart and kidney disease risk in patients with T2DM while addressing barriers to optimal care.

Target Audience:

The following HCPs: Endocrinologists, nephrologists, cardiologists, and primary care physicians; certified diabetes educators, physician assistants, nurse practitioners, nurses, and pharmacists who practice in diabetes and endocrinology; and any other HCPs with an interest in or who clinically encounter patients with diabetes.


Commercial Support Disclosure: This program is supported by an educational grant from Bayer.

This activity is free of charge.


Release Date: December 16, 2021 -- Expiration Date: December 16, 2023

Faculty: Matt Budoff, M.D., FACC -- Joshua Kaplan, MD, FASN

Agenda

Faculty introduction, disclosures

T2DM, vascular risk, and heart and kidney disease

  • Epidemiology of cardiovascular outcomes in T2DM
  • Relationship between T2DM, vascular outcomes, and kidney disease

Treatment of diabetes

  • Beneficial effects of drug therapy for diabetes apart from absolute blood glucose thresholds, associated pathophysiology, and which agents affect which values

· Guideline-directed therapy and the role of novel agents for the treatment of patients with T2DM and established or at risk of:

· Sodium-glucose cotransporter 2 inhibitors (SGLT2is), glucagon-like peptide-1 receptor agonists (GLP-1 RAs)

· Cardiovascular disease: heart failure (preserved and reduced ejection fracture), major adverse cardiovascular events

· Rational for use, including mechanisms

· Outcomes: major adverse cardiovascular events, heart failure hospitalizations

· Chronic kidney disease

· Rational for use

· Outcomes

· Vascular event and kidney disease clinical trial data

· Emerging therapy: Finerenone

· Rational for use: Mineralocorticoid receptor antagonism

· Outcomes: Albuminuria, fibrosis as a key driver of disease progression, hyperkalemia

· Adverse effect profiles

· Novel therapies and their place within the context of comprehensive diabetes, vascular risk, and kidney disease management

  • Barriers to care

· Age-, sex-, race-, and ethnicity-related healthcare disparities

· Adherence

· Treatment in the COVID-19 era

  • Patient case(s)

Summary, conclusions, and best practice recap

Learning Objectives

By the end of the session the participant will be able to:

  • Recall the interrelationship between T2DM and: vascular risk factors; major adverse cardiovascular events; and kidney disease.
  • List safe, effective, and emerging pharmacotherapeutic risk mitigation strategies for heart and kidney diseases in patients with T2DM and formulate a care plan based on those strategies.
  • Summarize scientific evidence and professional guidelines aimed at effective management of cardiovascular and renal risk in patients with T2DM.
  • Recognize the benefits of comprehensive management of diabetes, cardiovascular risk, and kidney disease by members of a multidisciplinary healthcare team.
  • Describe the following changes strategies to reducing vascular and kidney disease risk in patients with T2DM: Adherence and the role socioeconomic, race, ethnic, and sex play in healthcare disparities.

Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

CME-MOC_badge

ABIM MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.5 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

PhysiciansFor maintenance of certification (MOC) credit, you must enter your board certification ID # and birth date correctly. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC credit for this activity. Please note: Not all activities on this site provide MOC credit. If this activity does not specify that it provides MOC credit in this section, then it does NOT provide MOC credit.

Pharmacists

ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.5 contact hours (0.15 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-21-039-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.  ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.


Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved thru content review ScientiaCME.

Faculty Disclosure:

Matthew Budoff, MD, FACC, FAHA, Professor of Medicine, UCLA School of Medicine, has received financial compensation for research and speaker's bureau from Novo Nordisk.

Faculty will not discuss off-label use of a commercial product.

Joshua Kaplan, MD, Associate Professor of Nephrology and Hypertension, Rutgers University has received financial compensation as a consultant and/or speaker, and is a stockholder of Aurinia, Fibrogen, Akebia, and Vertex.

Faculty will be discussing off-label use of a commercial product.

 

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Bayer.

Instructions

  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowedge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Take the post-test
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural and Linguistic Competence

System Requirements

PC
Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
MAC
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version


Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.


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