Free Diabetes and 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).

Gaucher disease (GD) is characterized by a deficiency of the lysosomal enzyme glucocerebrosidase, resulting in the accumulation of sphingolipids throughout the body but most manifesting prominently in the bones. GD is subcategorized based on clinical features: type 1 GD is the non-neuronopathic form and affects mainly the inner organs, while types 2 and 3 are the acute and sub-acute neuropathic forms, whose pathology manifests predominantly within central nervous system. GD impacts about 1 in 75,000 births, making it one of the most common lysosomal storage diseases. One of the first of GD’s complications is the chronic anemia and a persistent bleeding risk. Another is the hepatosplenomegaly, which may be a part of the initial clinical presentation, as may the anatomical abnormalities of bone deformities and stunted growth.

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

• Describe the pathogenesis, clinical presentations, complications, and epidemiology of Gaucher disease including updated recently presented material
• Describe principles and problems regarding screening for and diagnosing Gaucher disease that can applied to patient cases
• Describe emerging therapies for Gaucher disease based on research recently presented
• Design and implement appropriate therapeutic plans for treatment of Gaucher disease based on research recently presented

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 Gaucher disease.