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Multidimensional Outcomes in Type 2 Diabetes Looking Beyond Hemoglobin A1c

Christopher P. Cannon, MD; Serge A. Jabbour, MD, FACP, FACE; Stephen D. Wiviott, MD, FACC

This activity is jointly provided by Global Education Group and Integritas Communications.

 

This activity is supported by an independent educational grant from AstraZeneca.

 

Faculty

Christopher P. Cannon, MD
Education Director, Cardiovascular Innovation
Preventive Cardiology Section
Brigham and Women’s Hospital
Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Serge A. Jabbour, MD, FACP, FACE
Professor of Medicine
Director, Division of Endocrinology, Diabetes and Metabolic Diseases
Sidney Kimmel Medical College
Thomas Jefferson University
Philadelphia, Pennsylvania

Stephen D. Wiviott, MD, FACC
Executive Director, Clinical Trials Office
Partners HealthCare
Senior Investigator
Thrombolysis in Myocardial Infarction (TIMI) Study Group
Cardiovascular Division, Brigham and Women's Hospital
Associate Professor of Medicine
Harvard Medical School
Boston, Massachusetts

Target Audience

The educational design of this activity addresses the needs of cardiology, endocrinology, and diabetology clinicians involved in the treatment of patients with type 2 diabetes mellitus (T2DM).

Educational Objectives

After completing this activity, the participant should be better able to:

  • Describe the pathophysiologic relationships between T2DM and cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD), including implications for antihyperglycemic treatment
  • Compare the designs and results of large-scale cardiovascular outcomes trials with sodium-glucose cotransporter-2 (SGLT2) inhibitors for T2DM
  • Discuss the mechanistic profiles, evidence for clinical benefits, and safety concerns associated with SGLT2 inhibitors as treatment options for patients with T2DM
  • Collaborate with other clinicians to treat patients with T2DM based on cardiovascular and renal risks, recent guideline recommendations, and other clinical parameters

Program Overview

Diabetes disorders afflict more than 30 million Americans, while another 84 million adult Americans have prediabetes.1 Multisystem consequences of T2DM include CVD, HF, and CKD. The pathophysiologic mechanisms underlying T2DM, CVD, HF, and CKD share common characteristics: metabolic changes, a proinflammatory state, and oxidative stress.2 Following several cardiovascular outcomes clinical trials with SGLT2 inhibitors, the American Diabetes Association recommends incorporating these agents (and other antihyperglycemic classes, such as glucagon-like peptide-1 receptor agonists), into treatment regimens for T2DM, particularly when CVD risks are elevated.3 The established relationships among T2DM, CVD, HF, and CKD necessitate individualized treatment to avoid or mitigate hyperglycemia and these common comorbidities. Cardiologists, in particular, must be knowledgeable about how updates to guidelines outside of the cardiology space have evolved, allowing them to contribute to multidisciplinary best-practices for the treatment of patients with T2DM and common comorbidities. This enduring Interactive Exchange™ program addresses these topics to ensure participants understand the role of maladaptive glucose reabsorption in T2DM, the benefits SGLT2 inhibitors may have on common comorbidities associated with T2DM, and the role the cardiologist plays in diabetes management.

References

  • Centers for Disease Control and Prevention. National diabetes statistics report. 2017; https://www.cdc.gov/diabetes/data/statistics/statistics-report.html. Accessed November 15, 2018.
  • Kovacic JC, Castellano JM, Farkouh ME, Fuster V. The relationships between cardiovascular disease and diabetes: focus on pathogenesis. Endocrinol Metab Clin North Am. 2014;43(1):41-57.
  • American Diabetes Association. Standard of Medical Care in Diabetes – 2019. Diabetes Care. 2019;42(suppl 1):S1-S193.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Christopher P. Cannon, MD
Consultant/Independent Contractor: Aegerion Pharmaceuticals, Inc., Alnylam Pharmaceuticals Inc., Amarin Corporation, Amgen Inc., Applied Therapeutics, Inc., Asendia USA, Boehringer-Ingelheim, Bristol-Myers Squibb, Corvidia Therapeutics Inc., HLS Therapeutics Inc., Innovent Biologics, Inc., Janssen Pharmaceuticals, Inc., Kowa Pharmaceuticals America, Inc., Merck & Co., Inc., Pfizer Inc., sanofi-aventis U.S. LLC; Grant/Research Support: Amgen Inc., Boehringer-Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo Company, Limited, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Pfizer Inc.

Serge A. Jabbour, MD, FACP, FACE
Consultant/Independent Contractor: AstraZeneca; Speakers Bureau: Janssen Pharmaceuticals, Inc.

Stephen D. Wiviott, MD, FACC
Consultant/Independent Contractor: Arena Pharmaceuticals, Inc., AstraZeneca, Aegerion Pharmaceuticals, Inc., Allergan, Inc., Angel Medical Systems, Inc., Boehringer Ingelheim, Boston Clinical Research Institute, Bristol-Myers Squibb Company, Daiichi Sankyo Company, Limited, Eisai Inc., Eli Lilly and Company, ICON plc, Janssen Therapeutics, Lexicon Pharmaceuticals, Inc., Merck & Co., Inc., Servier Pharmaceuticals LLC, St. Jude Medical, Inc., Xoma Biotechnology; Grant/Research Support: Amgen, Arena Pharmaceuticals, Inc., AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo Company, Limited, Eisai Inc., Eli Lilly and Company, Janssen Therapeutics, Merck & Co., Inc., sanofi-aventis U.S. LLC; Other: Spouse is an employee of Merck & Co., Inc.

The following planners and managers reported that neither they nor their spouses/life partners have financial relationships or relationships to products or devices with commercial interests related to the content of this CME activity:

Lindsay Borvansky, Andrea Funk, Liddy Knight, Ashley Cann, Gena Dolson, Celeste Collazo, Jim Kappler, PhD

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global and Integritas Communications do not recommend the use of any agent outside of the labeled indications. 

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Instructions to Receive Credit

In order to receive credit for this activity, the participant must complete the posttest and program evaluation. Your posttest will automatically be graded. If you successfully complete the posttest (score of 80% or higher), your statement of participation will be made available immediately. Click on the View Statement of Participation link and print the statement for your records. If you receive a score lower than 80%, you will receive a message notifying you that you did not pass the posttest. You will have 2 opportunities to pass the posttest.

For information about the accreditation of this program, please contact Global at 303-395-1782 or cme@globaleducationgroup.com.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Click "Begin Activity" to acknowledge that you have reviewed the preamble information for this activity.

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credit amount 1.00

credit type CME

release 01/15/2020

expiration 01/15/2021

type Webcast