Endocrinology CME

Activity Description / Statement of Need:

In this online, self-learning activity:

Mucopolysaccharidoses (MPS) are a group of genetic diseases characterized by a deficiency of lysosomal enzymes responsible for the hydrolysis of glycosaminoglycans (GAGs), resulting in a variety of clinical manifestations in patients presenting with MPS. MPS has several subcategories, and MPS type I (MPS I) arises from the inheritance of an alteration in the IDUA gene, which encodes for alpha-L-iduronidase. Affecting an estimated one in 100,000 live births, MPS I is categorized as either attenuated MPS I (also known as Scheie or Hurler-Scheie syndromes) or severe MPS I with cognitive impairment (also known as Hurler syndrome).

Progressive in nature, MPS I is associated with multi-organ complications and sequelae. Patients exhibit a spectrum of clinical presentations, including facial deformities, organomegaly, cognitive impairments, upper airway obstructions, skeletal deformities, and cardiomyopathy. The burden of MPS I is considerable, with reports of caregivers contributing 51 hours per week on average to help patients perform daily activities of living. Quality of life for patients and their caregivers is significantly reduced with MPS I, affecting the social, emotional, and financial well-being of a family. It is reported that parents fear for their child’s delayed language acquisition, ability to fit in amongst peers and the society, fear of the expense for the necessary care, and fear for the death of a child from obstructive sleep apnea.

This learning activity has been designed to bring HCPs’ knowledge of the strategies for treatment and management of MPS I up to date and to improve their competence and performance in treating it.

Target Audience:

The following HCPs: Pediatricians, neurologists, endocrinologists, genetic disease specialists; physician assistants, nurse practitioners, and pharmacists in the aforementioned areas of specialty; and any other HCPs with an interest in or who may clinically encounter patients with MPS I.

Activity Description / Statement of Need:

In this online, self-learning activity:

Osteoporosis is a disease common among elderly patients and is increasing in frequency as senior citizens begin to represent a larger share of the US population. In the US, fragility fractures are associated with 1.7 million hospitalizations, and the number of annual of osteoporotic fractures is expected to rise to three million annually in the next few years, with annual treatment costs expected to be $25.3 billion. Despite the morbidity and mortality associated with osteoporosis, practice gaps related to suboptimal screening, risk assessment, and management practices have led to underdiagnosis and undertreatment of this condition. Osteoporosis screening may identify people at increased risk of low-trauma fracture who may benefit from interventions to minimize risk. The USPSTF recommends screening for osteoporosis with BMD testing in all women 65 years or older and in postmenopausal women younger than 65 years but at increased risk of osteoporosis. However, the literature has consistently illustrated underutilization of screening and diagnostic measures. About 60% of women for whom the USPSTF recommends screening do not receive BMD testing,  with some patient populations more likely than others to miss out on screening and care. Clinicians should be aware that prior fragility fracture is sufficient for diagnosis of osteoporosis, and yet only one-quarter of patients with a prior fragility fracture were aware they had this condition. Underdiagnosis therefore represents a compelling safety consideration, as 20% of patients become dependent on long-term care after a hip fracture, and 20% die within a year from related complications.

Target Audience:

HCPs specializing in: endocrinology, internal medicine, geriatrics, and women’s health; physician assistants, nurse practitioners, and pharmacists who practice in those areas of specialty; and those who otherwise commonly care for or clinically encounter patients with postmenopausal osteoporosis.

Activity Description / Statement of Need:

In this online, self-learning activity:

Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. While there are many complications resulting from this disease, this CME proposal focuses on treating diabetic foot ulcers that occur in the setting of peripheral neuropathy. Diabetic foot complications are the most common cause of non-traumatic foot injuries leading to amputation, and are also the most frequent reason for hospitalization in patients with diabetes in the United States Diabetic wound care treatments are varied with mixed results, and all current methods require some degree of medium to long-term follow-up and management by an interdisciplinary team which is costly and a significant burden to both the patients and the healthcare system as a whole.

A single treatment with an ultrasonic probe has demonstrated a high rate of complete healing with low recurrence and complication rates. Using these types of devices are relatively inexpensive when compared to more extensive and complex wound care regimens and are easily learned by those experienced in managing this condition. The treatment of diabetic foot ulcers with ultrasonic probes is an evolving standard of care and is becoming an alternative to traditional treatments. This treatment involves fragmenting, emulsifying, and removing thickened scar tissue beneath the wound crater, as well as removing osseous prominences to decrease pressure on the wound bed and promote healing.

There have been recent developments in the available treatments for diabetic foot ulcers. Communicating related information to HCPs, including recent guideline updates, is a demonstrated need.

Target Audience:

The following HCPs who specialize in diabetic care: Endocrinologists, podiatrists, foot and ankle surgeons, primary care physicians, physician assistants, nurse practitioners, and wound care RNs.

Activity Description / Statement of Need:

In this online, self-learning activity:

Acromegaly is an endocrine disorder characterized by dysregulated hypersecretion of growth hormone (GH), usually caused by a GH-secreting, pituitary adenoma and leading to an overproduction of insulin-like growth factor 1 (IGF-1). Estimated at between 40 and 240 people per million, is not as high as other endocrine disorders, acromegaly has a significant impact on patient quality of life. Approximately 25 percent of people with acromegaly have elevated blood pressure, and 50 percent have evidence of insulin resistance, putting them at risk of developing type 2 diabetes in future. The mortality rates of acromegaly patients are three times higher than the general population, with most dying from respiratory or cardiac complications.

Target Audience:

HCPs including: endocrinologists and primary care providers; physician assistants, nurse practitioners, and pharmacists who specialize in endocrinology; and any other healthcare professionals with an interest in or who clinically encounter patients with acromegaly.