Free Endocrinology CME

Primary care clinicians and endocrinologists play a critical role in identifying and managing metabolic dysfunction-associated steatohepatitis (MASH) before it progresses. Results from a Med-IQ survey, however, revealed that approximately half of the respondents screen only 50% or fewer of their patients with obesity or type 2 diabetes. Patients with these conditions or other risk factors, such as metabolic syndrome, dyslipidemia, or elevated liver enzymes, should be screened using noninvasive tools like FIB-4, transient elastography (FibroScan), ELF, or VCTE.

Although lifestyle modification remains the cornerstone of treatment, pharmacologic options such as GLP-1 receptor agonists, pioglitazone, and resmetirom may be appropriate based on individual risk profiles. Most patients can be effectively managed in primary care or endocrinology settings, with hepatology referral recommended for patients with a high risk of advanced fibrosis.

Activity Description / Statement of Need:
In this online, self-learning activity:

Familial chylomicronemia syndrome (FCS) is an ultrarare genetic disease characterized by the buildup of chylomicrons – the largest lipoprotein – as a result of loss of function of one of five genes responsible for lipolysis. Its estimated prevalence is one in one million people and affects patients of all ages. The clinical presentation of FCS varies but includes patients with triglyceride (TG) levels over 10 times and up to a hundred-fold times the upper limit of normal. Complications include eruptive xanthomas on the trunk and extremities, lipemia retinalis, recurrent abdominal pain, hepatosplenomegaly, fatigue, cognitive disorientation, organ failure, necrosis, and pancreatitis, the latter of which is associated with a five- to 30-percent mortality rate in patients affected by FCS. Unfortunately, due in part to the rarity of the condition, patients are commonly undiagnosed, even by endocrinologists.

Target Audience:
HCPs including: endocrinologists, cardiologists, and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in the aforementioned areas of specialty; and those who otherwise have an interest in or commonly care for or clinically encounter patients with FCS.

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 to have a prevalence of 2.8 to 13.7 cases per 100,000, acromegaly is not as common as other endocrine disorders. However, its incidence is increasing, and it has a significant impact on patient quality of life, with clinical features that include: acral enlargement; facial feature and oral changes; headache; significant fatigue, including daytime sleepiness; hyperhidrosis; oily and thicker skin; weight gain; and arthralgia. 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.