Intended Audience

This complimentary CME educational activity is designed for all cardiology-focused physicians, nurses, NPs, academicians, pharmacists, researchers, investigators, and program directors managing, referring, and/or consulting on patients with atrial fibrillation, with a focus on stroke prevention. We welcome diabetes-focused clinicians with a medical and educational needs in the fields of diabetology, endocrinology, internal medicine, primary care, and other providers that are part of the multidisciplinary team caring for patients with these and related conditions, including:

• Diabetologists
• Endocrinologistss
• Primary care physicians
• Internal medicine specialists
• Diabetic nurse practitioners NPsn
• Related practitioners

Registration

Participation in this iQ&A interactive Medical Intelligence Zone for Type 2 Diabetes is complimentary, and clinicians are invited to view this CME-certified program and/or share this invitation with other colleagues, departmental staff members, and healthcare professionals.

Method of Physician Participation Utilized in Learning Process

There are no fees for participating and receiving CME credit for this activity. During the period November 18, 2011 through November 18, 2013 participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity, and are expected to view all 86 segments totaling 2 hours and 20 minutes to successfully complete the activity and earn CME credit;; 3) register and complete the evaluation form and post-test; 4) score 100% on the post-test; and 4) print out CME certificate

Course Overview

In this web-based program, physicians will learn how recent advances in basic and clinical research have helped to advance the understanding of treatment advances in the management of Type 2 diabetes.

Release Date

November 18, 2011

Expiration Date

November 18, 2013

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Massachusetts Medical School Office of Continuing Medical Education (UMMS-OCME) and CMEducation Resources, LLC. The UMMS-OCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

The University of Massachusetts Medical School designates this enduring activity for a maximum of 2.5 AMA PRA Category 1 Credits(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

Estimated Time to Complete Educational Activity

2.5 hours

Grantor Support

Supported by an educational grant from Bristol-Myers Squibb and AstraZeneca



Policy on Faculty & Provider Disclosure

It is the policy of the University of Massachusetts Medical School to ensure fair balance, independence, objectivity and scientific rigor in all activities. All faculty participating in CME activities sponsored by the University of Massachusetts Medical School are required to present evidence-based data, identify and reference off-label product use and disclose all relevant financial relationships with those supporting the activity or others whose products or services are discussed. Faculty disclosure will be provided in the activity materials.

Policy on Faculty & Provider Disclosure

It is the policy of the University of Massachusetts Medical School to ensure fair balance, independence, objectivity and scientific rigor in all activities. All faculty participating in CME activities sponsored by the University of Massachusetts Medical School are required to present evidence-based data, identify and reference off-label product use and disclose all relevant financial relationships with those supporting the activity or others whose products or services are discussed. Faculty disclosure will be provided in the activity materials.

Program Faculty and Disclosure

Clifford J. Bailey, PhD, FRCP, FRCPath
UK Diabetes Research
Aston Pharmacy School
School of Life and Health Sciences Triangle
Aston University
Birmingham , UK

Advisor or consultant: AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; GlaxoSmithKline; Merck Sharp & Dohme Corp.; Novo Nordisk; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.
   
George L. Bakris, MD, FAHA, FASN
Professor of Medicine
Director, Hypertensive Diseases Unit
University of Chicago School of Medicine
Chicago, Illinois

Consultant/Principal Investigator: Medtronic, Johnson & Johnson, Abbott, Takeda,

John Buse, MD, PhD
Director, Diabetes Care Center
Chief, Division of Endocrinology
Executive Associate Dean for Clinical Research
University of North Carolina School of Medicine
Chapel Hill, North Carolina


Served as a director, officer, partner, employee, advisor, consultant, or trustee for: Amylin Pharmaceutical, Inc. Andromeda, Bayhill Therapeutics, Biodel, Boehringer Ingelheim, Catabasis, Diartis, Elcelyx, Eli Lilly and Co., Exsulin, GI Dynamics, Halozyme, Inc., Hoffman-LaRoche Inc., Johnson & Johnson, Lexicon, LipoScience, Medtronic MiniMed, Inc., Merck, Metabolon, Novan, Novo Nordisk Pharmaceuticals, Inc., Osiris Therapeutics, Inc., Orexigen, Pfizer, Inc., sanofi-aventis, Tolerex, Transition Therapeutics, TransPharma

Professor Bernard H. Charbonnel, MD
Professor of Endocrinology and Metabolic Diseases
University of Nantes
Nantes, France

Advisor/Consultant: AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; Boehringer Ingelheim Pharmaceuticals, Inc.; GlaxoSmithKline; Eli Lilly and Company; Merck Sharpe & Dohme Corp.; Novartis Pharmaceuticals Corporation; Novo Nordisk; Roche; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.
Speaker: AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; Boehringer Ingelheim Pharmaceuticals, Inc.; GlaxoSmithKline; Eli Lilly and Company; Merck Sharpe & Dohme Corp.; Novartis Pharmaceuticals Corporation; Novo Nordisk; Roche; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.

Ralph A. DeFronzo, MD
Professor of Medicine
School of Medicine
Diabetes and Metabolic Disorders (DMD) Track
Diabetes Research Unit
Barter Research Unit, UTHSCSA
UTHSCSA Graduate School of Biomedical Sciences
San Antonio, Texas

Consultant: Amylin, Eli Lilly, Takeda, Bristol-Myers Squibb, Astra Zeneca, J&J, Novartis, Merck
Grants: Amylin, Eli Lilly, Takeda, Bristol-Myers Squibb

Professor Stefano Del Prato, MD
Department of Endocrinology and Metabolism
Section of Metabolic Disease and Diabetes
University of Pisa
Pisa, Italy

Research Support: Merck & Co., Inc.; Novo Nordisk; sanofi-aventis
Advisor/Consultant: Bristol-Myers Squibb Company; Merck & Co., Inc.; Novartis Pharmaceuticals Corporation; Novo Nordisk; Pfizer Inc.; Roche
Speaker: GlaxoSmithKline; sanofi-aventis

Vivian A. Fonseca, MD, FRCP
Professor of Medicine and Pharmacology
Tulis-Tulane Alumni Chair in Diabetes
Chief, Section of Endocrinology
Tulane University Health Sciences Center
New Orleans, Louisiana

Grants/Research Support: Daiichi Sankyo, Inc.; Eli Lilly and Company; Halozyme Therapeutics; Novo Nordisk; Pamlab, L.L.C.; Reata Pharmaceuticals, Inc.; sanofi-aventis
Advisor/Consultant: AstraZeneca Pharmaceuticals LP; Daiichi Sankyo, Inc.; Eli Lilly and Company; GlaxoSmithKline; Novo Nordisk; Pamlab, L.L.C.; sanofi-aventis; Takeda Pharmaceuticals North America, Inc.; XOMA (US) LLC

Professor Markolf Hanefeld, MD, PHD
Centre for Clinical Studies,
Dresden Technical University
Dresden, Germany

Nothing to disclose

Silvio E. Inzucchi, MD
Professor of Medicine (Endocrinology)
Clinical Director, Section of Endocrinology
Director, Yale Diabetes Center
Director, Endocrinology & Metabolism Fellowship
Director, Yale Affiliated Hospitals Program
New Haven, Connecticut

Consultant: Takeda, Amylin, Merck, Boehringer-Ingelheim

Lawrence A. Leiter, MD, FRCP(C), FACP?
Professor, Departments of Medicine and Nutritional Sciences
Head of the Division of Endocrinology and Metabolism
Director of the Lipid Clinic
Associate Director
Clinical Nutrition and Risk Factor Modification Centre
St. Michael’s Hospital
University of Toronto
Toronto, Ontario

Speaker/Advisory Board Honoraria: AstraZeneca Pharmaceuticals, Boehringer-Ingelheim GmbH, Eli Lilly and Company, GlaxoSmithKline, Novartis AG, Novo Nordisk A/S, sanofi-aventis U.S. LLC., and Pfizer Inc.
Grants/Research Support/Consultant: AstraZeneca Pharmaceuticals, Eli Lilly and Company, GlaxoSmithKline, Merck & Co., Inc., Novartis Pharmaceuticals, Novo Nordisk Pharmaceuticals Inc., Roche Pharmaceuticals, sanofi-aventis, Servier Pharmaceuticals.

Dr. Juris J. Meier, MD
St Josef-Hospital
Klinikum der Ruhr-Universität Bochum
Bochum, Germany

Nothing to disclose

Michael A. Nauck, MD
Head of Diabetes Center
Head Physician, Diabeteszentrum
Bad Lauterberg, Germany

Grants/Research Support: Amylin Pharmaceuticals, Bayer Vital, Berlin-Chemie/Menarini, Eli Lilly and Company, Novartis, Novo Nordisk, Probiodrug, Restoragen Inc., Sanofi-Aventis; Consultant: AstraZeneca, Bayer Vital, Berlin-Chemie/Menarini, Biovitrum, ConjuChem, Inc., Eli Lilly and Company, Hoffmann-La Roche, Merck & Co., Inc., MSD, Novartis, Novo Nordisk, Pfizer Inc., Probiodrug, Restoragen Inc., Sanofi-Aventis, Takeda Pharmaceuticals Inc.; Advisory Boards: Amylin Pharmaceuticals, ConjuChem, Inc., Eli Lilly and Company, GlaxoSmithKline, Hoffmann-La Roche, Novartis, Novo Nordisk, Probiodrug, Restoragen Inc., Sanofi-Aventis

Anne Peters, MD, FACP, CDE
Professor of Medicine
Director of the USC Clinical Diabetes Program
Director, USC Westside Center for Diabetes
Beverly Hills, California

Advisory Board: Amylin, Lilly, Novo Nordisk
Speaker’s Bureau: Amylin, Lilly, Novo Nordisk, Boehringer Ingelheim, Takeda, sanofi aventis

Steven Shoelson, MD
Section Head, Cellular & Molecular Physiology
Joslin Diabetes Center
Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Nothing to disclose

Professor Krzysztof Strojek, MD
Department of Internal Diseases, Diabetology, and Nephrology
Medical University of Silesia
Katowice, Poland

Advisory Board: Eli Lilly and sanofi-aventis
Speaker Fees: Eli Lilly and sanofi-aventis

Alexander Turchin, MD, MS
Assistant Professor
Harvard Medical School
Brigham and Women's Hospital
Boston, Massachusetts

Nothing to disclose

Mark E. Williams, MD, FACP, FASN
Associate Professor of Medicine
Harvard Medical School
Co-Director of Dialysis
Beth Israel Deaconess Medical Center
Senior Staff Physician, Joslin Diabetes Center
Boston, Massachusetts

Consultant: sanofi-aventis

Vincent Woo, MD
Endocrinology Section
Department of Internal Medicine
University of Manitoba
Health Sciences Centre Diabetes Research Group
Winnipeg, Canada

Nothing to disclose

Carol Wysham, MD
Clinical Associate Professor of Medicine
University of Washington School of Medicine
Section Head, Rockwood Center for Diabetes and Endocrinology
Spokane, Washington

Advisory Board: Amylin, Eli Lilly, sanofi-aventis, Boehringer Ingelheim
Speaker: Amylin, Eli Lilly, sanofi-aventis, Boehringer Ingelheim, Merck, Novo Nordisk

Program Managers and Web Editor Disclosure Program Manager Gideon Bosker, MD has nothing to disclose.

Program Reviewers Denise Leary and Richard Aghababian, MD have nothing to disclose.


Educational Objectives

Upon completion of this activity, participants will be able to:

• Explain interventions that currently are deployed for T2D and that have been shown to be helpful for glycemic regulation in T2D; and, the impact of successful glycemic management of T2D on microvascular and macrovascular complications.
• Detail advances in therapeutic strategies based on new mechanisms, involving SGLT2 inhibitors (encoded by the SLC5A2 gene), and their impact on glucose homeostasis; and, the effects these agents may have on cardiometabolic markers, including lipids, insulin resistance, HA1c, glucose levels, and microvascular/macrovascular disease.
• Describe the mechanisms underlying, and the clinical implications of, SGLT2 inhibition and its potential for shifting the glucose “reabsorption/excretion” threshold to the left, thereby introducing a physiological basis for reducing plasma glucose in patients with T2D.
• Describe recent advances in our scientific understanding of mechanisms of action of targeted agents that affect glucose reabsorption in the kidney, the rationale for such agents, and how their actions can produce improvements in HA1c target levels and other goals identified by such national organizations as ADA and AACE
• Detail the relationship between T2DM and atherosclerosis, and how emerging therapies might affect signaling and inflammatory signals, including cytokines, inflammation, and insulin resistance, and the vasculopathic cascade that characterizes T2DM and its adverse thrombovascular sequelae.
• Apply evidence from landmark trials, national guidelines from the ADA and AACE to the clinical challenge of multidimensional therapeutic interventions for T2D; and understand how emerging therapies aimed at inhibiting glucose reabsorption in the kidney may one day play a role as monotherapy, or in combination with established agents for diabetes, for managing patients with T2D.
• Stratify patient populations and clinical profiles with T2D that are likely to be the most suitable candidates for and respond optimally to treatment with drugs affecting renal-mediated glucose homeostasis, including: Treatment-naïve, newly diagnosed patients with T2D; Patients with T2D on concomitant, first-line metformin or sulfonylurea treatment; Patients who are on incretin-based therapy; and Patients on insulin.
• Understand the rationale, indications, sequencing, and combination strategies that can be deployed using a glucosuric agent in combination with established platform agents for T2D, including metformin, sulfonylureas, IBTs, and insulin.
• Detail, based on well-conducted clinical studies, what the possible safety issues are, or might be, with agents that impair glucose reabsorption in the kidney, and how to manage such side effects, if they occur.

Hardware and Software Requirements:

To participate in this program, viewers must have a PC or Macintosh computer that has active, ongoing internet access for the duration of the program, as well as a compatible Flash-viewer. An email address is required for registration, and a printer is required to print out the CME certificate..

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Copyright © 2011 by Pharmatecture, LLC and CMEducation Resources, LLC All rights reserved.

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