Endocrinology CME

In this online CME self-learning program: Mucopolysaccaridoses (MPS) are group of genetic disease characterized by a deficiency of lysosomal enzymes responsible for the hydrolysis of glycosaminoglycans (GAGs), whose manifold biological roles resulting in a variety of clinical manifestations in patients presenting with MPS. MPS has seven different subcategories, of which Hunter syndrome is MPS II. A deficiency in iduronate 2-sulfatase results in relatively high levels of the GAGs heparan and dermatan sulfate, resulting in physical signs similar to MPS I with the addition of aggressive behavior and developmental delay. Hunter syndrome is an X-linked recessive genetic disease, with males more likely to develop disease and females more likely to be carriers

Target Audience:

The following healthcare professionals: Pediatricians, neurologists, endocrinologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists; and any other healthcare professionals with an interest in or who may clinically encounter patients with Hunter syndrome.

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

• Determine the likelihood of a Hunter syndrome diagnosis using established diagnostic methods, given a patient case.
• Describe current and investigative options available for management of Hunter syndrome, and design a medical plan to treat a patient with Hunter syndrome.
• Describe present barriers to care in the treatment of patients with Hunter syndrome.
• Describe the clinical outcomes associated with Hunter syndrome treatment.
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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, osteoporosis is associated with about 2 million broken bones each year, leading to over 500,000 hospitalizations, 800,000 emergency room visits, and 200,000 nursing home placements. By 2040, osteoporosis is expected to cause 3.2 million fractures per year in the United States at a cost of over $95 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 US Preventive Services Task Force (USPSTF) recommends screening for osteoporosis with bone mineral density (BMD) testing in all women 65 years or older and in postmenopausal women younger than 65 years but at increased risk of osteoporosis. Risk for osteoporosis should be determined by a formal clinical measurement tool, such as FRAX™, which assesses 10-year fracture risk.

Target Audience:

HCPs specializing in endocrinology, internal medicine, 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.

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

• Recall how the results of diagnostic imaging and pertinent past medical history to determine risk of fracture.
• List the criteria for initiation of pharmacotherapy for postmenopausal osteoporosis treatment and prevention and apply them to a patient case.
• Describe challenges associated with treating patients with postmenopausal osteoporosis, focusing specifically on the risks of the agents used to treat and prevent osteoporosis, and apply the information to optimize patient care in a patient case.
• Identify recently approved and emerging pharmacotherapeutic treatments for management of postmenopausal osteoporosis, and describe their mechanisms of action.

Hypoparathyroidism is a rare disorder characterized by decreased function of parathyroid glands resulting in low levels of parathyroid hormone (PTH). There are a variety of causes, including autoimmune disease, congenital defects, unintended parathyroid removal during thyroidectomy, or damage caused by radiation therapy. In a normal functioning parathyroid gland, PTH is secreted in response to low serum-ionized calcium. According to one study, nearly 60,000 people in the United States have been diagnosed with the disorder, with about 73% caused by surgery. Another study estimated the prevalence of primary hypoparathyroidism at 40 per 100,000 people in the United States.

Target Audience:

The following healthcare professionals: endocrinologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in endocrinology and internal medicine; and any other healthcare professionals with an interest in or who clinically encounter patients with hypoparathyroidism.

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

• Describe the pathophysiology and manifestations of hypoparathyroidism and discuss how they may have relevance to treatment targets.
• Define patient-specific goals, identify treatments directly treating hypoparathyroidism, and incorporate both in the development of a treatment plan in patient cases.
• Describe goals and mainstays of supportive care in hypoparathyroidism and apply them to patient cases.
• Describe barriers to care in the optimal treatment of hypoparathyroidism and suggest strategies for ameliorating them.

The Evolution of Insulin Replacement Therapy consists of 4 presentations with discussion:
• Session 1: Insulin Options for Diabetes: Update on their Evolution
• Session 2: Advancing to Insulin Therapy for Type 2 Diabetes: The Impact of the New Insulin Options
• Session 3: Physiologic Insulin Replacement: Practical Approaches for the Primary Care Provider
• Session 4: The Evolution of Glycemic Monitoring and Insulin Delivery Devices: Why the Primary Care Provider Should Understand the Options

At the conclusion of The Evolution of Insulin Replacement Therapy, you will be able to:
• Identify clinically relevant pharmacokinetic and pharmacodynamic properties of the new insulins and insulin combinations
• Discuss the clinical importance of similarities and differences between a biosimilar insulin and a reference insulin
• Recognize the indications for advancement to insulin replacement therapy for people with T2DM
• Identify clinically relevant pharmacokinetic and pharmacodynamic properties of the new insulins and insulin combinations
• Describe initiation and titration methods for new insulin-based therapies to optimize achievement of glycemic goals while minimizing adverse effects
• Discuss strategies to overcome patient and clinician barriers to the successful initiation and utilization of insulin therapy in the context of the new insulin-based therapies, and monitoring and delivery devices

Target Audience:
This program is intended for US-based primary care providers, clinical endocrinologists/diabetologists, nephrologists, cardiologists, emergency department specialists, pharmacists, and other clinicians caring for patients with type 2 diabetes mellitus (T2DM).

About 50 activities on various aspects of diabetes. Not all activities offer Physician CME, so be sure to check the type of CME offered before you start. The actual content is located at PRESENTdiabetes.com, but this site (Diabetes in Control) is easier to navigate.

Target Audience: Diabetes professionals

Eleven activities covering various endocrine topics; the most recent are:
• Above and Beyond Glycemic Control
• Above and Beyond Glycemic Control: Reducing the Risk of Cardiovascular Disease
Before the Breaking Point: Reducing the Risk of Osteoporotic Fracture
• Practical Lipidology: Best of Lipid Forum
• Managing the Full Spectrum of Cardiovascular Risk Factors: A Closer Look at GLP-1 Agonists
• The New Treatment Paradigm in Obesity: Proper Patient Selection, Assessment of Comorbidities, and Stepped Interventions
• Dialogues in Diabetes: Volume 2, Number 1
• Growth Hormone Deficiency and Other Causes of Short Stature: Trends in Diagnosis, Evaluation, and Treatment in Children and Adults
• GLP-1 Agonists: Examining New Data on Cardiovascular Risk Reduction, Combination Insulin Therapy, and Adherence
• Weighing in on the Beneficial Effects of GLP-1 Agonists: Assessing Cardiovascular Risk Reduction, Combination Therapy and Adherence
• Cardiovascular Risk Reduction

Target Audience: Physicians specializing in Endocrinology

Two activities at present:

Obstructive Sleep Apnea and the Cardiometabolic Syndrome: Clinical Perspectives and Interrelationships “will teach you to recognize the sometimes subtle, nonspecific symptoms and clinical presentation of obstructive sleep apnea, and why you should refer both patients with suspected OSA and patients with cardiometabolic syndrome to a sleep specialist for evaluation and intervention.”

Handling the Hand-off: Transitioning from Pediatric to Adult Diabetes Care “was developed from presentations made at the live symposium titled Handling the Hand-off: Transitioning from Pediatric to Adult Diabetes Care that took place on August 6, 2010, in San Antonio, TX, as part of the AADE’s Annual Meeting.

Target Audience: Physicians specializing in Endocrinology

CME activities of special interest to endocrinologists. Medscape contains a variety of educational formats:

CONFERENCE COVERAGE – Reports of advances presented at major medical conferences; typically includes several tracks with news stories, expert interviews, and in-depth topic overviews.

CLINICAL UPDATE – Comprehensive original review article on scientific advances in a clinical topic.

FAST TRACK CLINICAL UPDATE – Narrowly focused original review article on scientific advances in a clinical topic.

CME-LIVE – Real-time online events with streaming video, synchronized visuals, and interactive questions and answers; archived for 1 year.

CLINICAL BRIEFS – Daily reports of major current medical research articles; 0.25 credits each

JOURNAL CME – Articles selected from a wide selection of peer-reviewed journals.
SPECIAL REPORT CME – Topic-based monthly email newsletter distributed to Medscape’s professional member database by specialty.

INTERACTIVE PATIENT CASES – Original CME activity presented to the physician in an interactive, clinical case-based format. (See especially eMedicine CME Case Presentations.)
CME CIRCLE – Multimedia content certified by other accredited professional education providers, typically from live symposia or monographs, and then posted on Medscape and archived for one year.

Target Audience: Physicians specializing in Endocrinology

New perspectives in diabetes offers knowledge, competency, and practice improvements in the diagnosis, management, and treatment of patients with type 2 diabetes mellitus. The following topics are discussed:
• The Role of the Kidney in Glucose Homeostasis
• Prevention of CVD Events in Diabetes
• The Role of SGLT2 Inhibition in T2DM
• Improving Patient-Provider Communication Techniques
• The Value of Managing the ABCs: A1C, blood pressure, and Cholesterol
• When Should We Use SGLT2 Inhibitors?
• Emerging T2DM Therapies Targeting the Kidney
• Interactive Case : Patient with inadequate control of A1C levels currently on metformin
• Interactive Case : Type 2 Diabetes Mellitus with CV Risk
• Summaries of recently published articles with expert perspective on how results can be applied in clinical practice

Target Audience: Physicians focusing on Endocrinology

Activity Description / Statement of Need:

In this online, self-learning activity:

Growth hormone deficiency (GHD) is characterized by inadequate secretion of growth hormone by the pituitary gland. The condition may arise from a variety of causes, including tumors, radiation, medications, traumatic brain injury, or genetic defects. In children, GHD is characterized by pronounced short stature, defined as 2 or more standard deviations from the mean based on age and sex. Because short stature may be caused by a variety of other factors, including genetics, hypothyroidism, and Turner syndrome, estimating the prevalence of GHD in the pediatric population is challenging. Studies suggest that GHD may occur in 1 out of every 4,000 children. There are also related conditions whose features overlap, including idiopathic short stature (ISS), and primary insulin-like growth factor-I deficiency (PIGFD), complicating diagnosis.

This program has been designed to bring HCPs’ knowledge of the rationale behind management of pediatric GHD up to date and to enhance their competence and practice in caring for pediatric patients with GHD. Topics addressed will include: clinical presentation, diagnostic tests, and safety and efficacy of present and emerging therapy, including dose selection, monitoring, transition into adulthood, and providing patient-centered care.

Target Audience:

The following HCPs: Endocrinologists, pediatricians, and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in endocrinology; and any other HCPs with an interest in or who clinically encounter patients with GHD.