Activity 1: Type 2 Diabetes 2009

Program Overview

More than 23 million Americans, or nearly 8 percent of the population, have diabetes. (1) A total of 1.6 million new cases of diabetes were diagnosed in people ages 20 years or older in 2007. (1) Diabetes and its complications are major causes of morbidity and mortality in the United States. However, it is not inevitable that more Americans develop type 2 diabetes, nor is it inevitable that people with diabetes experience the long-term complications such as lower limb amputations, kidney failure, and premature death. There are successful interventions for delaying and potentially preventing the development of type 2 diabetes, managing type 2 diabetes effectively, and preventing complications responsible for diminished quality of life and shortened life expectancy. Family physicians largely determine the quality of diabetes care in the United States and, as such, are instrumental in proving primary prevention and risk reduction efforts.

1. National diabetes statistics, 2007. National Diabetes Information Clearinghouse,, National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/DM/PUBS/statistics/#allages. Accessed April 29, 2009.

Intended Audience

This continuing medical education program is intended for family practitioners and other healthcare professionals who manage type 2 diabetes.

Learning Objectives (Diabetes Tract)

The Type 2 Diabetes subtract will deliver educational programming over the year designed to help family physicians to:

• Identify patients at risk for type 2 diabetes and implement recommended risk reduction strategies
• Put evidence-based treatment recommendations into practice
• Apply appropriate strategies for maintaining optimal glycemic control
• Identify challenges and barriers to the prevention/management of type 2 diabetes and implement effective solutions

Learning Objectives (Activity 1)

• Explain the epidemiology of diabetes and the impact of lifestyle and obesity
• Relay the importance of a multifactorial intervention strategy to reduce the incidence of microvascular and macrovascular disease in diabetes
• Relate the recommended standards of care for continuous comprehensive diabetes management, including coronary risk prophylaxis
• Provide the definition and prevalence of pre-diabetes as well as the recommended options for treatment
• State glycemic goals and the rational for these goals for patients with diabetes including patients with recently diagnosed diabetes and elderly diabetic patients with multiple co-morbid illness
• Implement the American Diabetes Association treatment recommendations for selecting agents to manage elevated blood glucose levels

Faculty

Neil Skolnik, MD
Professor of Family and Community Medicine
Temple University School of Medicine
Associate Director, Family Medicine Residency Program
Abington Memorial Hospital
Abington, PA

Planning Committee

Neil Skolnik, MD
Professor of Family and Community Medicine
Temple University School of Medicine
Family Medicine Residency Program
Abington Memorial Hospital
Abington, PA

Serena Cardillo, MD
Assistant Professor of Medicine
Hospital of the University of Pennsylvania
Philadelphia, PA

Frances Love, MSN, RN, CDE, BC-ADM
Clinical Nurse Specialist/Diabetes Education Coordinator
PENN Rodebaugh Diabetes Center, Univ of Pennslyvania
Philadelphia, PA

John Russell, MD
Associate Director of Family Medicine Residency
Abington Memorial Hospital
Clinical Associate Professor of Family and Community Medicine
Temple University School of Medicine

CME Accreditation

This activity has been reviewed and is acceptable for up to 2.0 Prescribed credit(s) by the American Academy of Family Physicians. Of these credits, 1.0 conforms to the AAFP criteria for evidence-based CME clinical content. CME credit has been increased to reflect 2 for 1 credit for only the EB CME portion. AAFP accreditation begins 5-1-09. Term of approval is for two year(s) from this date with the option of yearly renewal. When reporting AAFP credit, claim total Prescribed and Elective credit for this activity. It is not necessary to label credit as evidence-based CME for reporting purposes.

The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since some clinical research is ongoing, the American Academy of Family Physicians recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this education activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Agenda

Introduction and Opening Remarks
Module 1: Epidemiology, Screening, and Diagnosis of Diabetes and Pre-Diabetes
Module 2: Glycemic Goals and Risk Factor Management
Module 3: Treatment of Type 2 Diabetes
Closing Remarks

Disclosures:

It is the policy of the AAFP that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interests and, if identified, they are resolved prior to confirmation of participation. Only these participants who have no conflict of interest or who agree to an identified resolution process prior to their participation were involved in this CME activity.

The AAFP and MedEd Architects staffs have indicated that they have no relationships to disclose relating to the subject matter of the activity. Drs. Skolnik, Cardillo, Love, and Russell have returned a disclosure form indicating that she/he have no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material.

Please note that faculty is required to disclose all relevant relationships prior to the beginning of the activity.