Collective Clinical Forum

5 Case Studies will be presented in an interactive format with a faculty member leading each case. Below are the topics/patients that will be addressed.
9:00 am Case 1: 50-year-old white male with a ten year history of type 2 diabetes	9:40 am Case 2: 35-year-old Mexican female diagnosed one and a half years ago with diabetes	10:35 am Case 3: 77-year-old white female with a 3 year history of diabetes	11:15 am Case 4: 16-year-old male is referred for diabetes	11:55 am Case 5: 54-year-old white male recently diagnosed with diabetes

Overview • A1c 8.4 • Obese • Inactive • Decreased vibratory sensation in both feet Objectives: • Appreciate the difficulties in achieving optimal glucose control • Summarize the major clinical recommendations for the care of T2DM • Discuss therapy treatment options currently available for the management of T2DM	Overview • Random BS 289 • A1c 11.4 • Weight 142, Height 5' 0” • Refuses waist measurement Objectives: • Appreciate the difficulties in achieving optimal glucose control. • Differentiate what type of diabetes she has. Is it important? • Discuss pharmacologic treatments you would consider. • Consider what advice would you give her.	Overview • Admitted to short term stay after suffering a mild left-sided CVA • Thin elderly lady who is mildly confused Objectives: • Distinguish what type of diabetes she has. • Discuss alternatives you consider in her treatment. • Understand the rationales behind choices of care.	Overview • 75 pounds weight gain in the past 2 years, from 185 to 250 pounds • Drinks as much as two 2-liter bottles of Coke daily • Urinating at least 3 times at night • Lost 10 pounds recently Objectives: • Understand maturity onset diabetes of the young (MODY) • Rationalize between use of oral agents, incretin mimetics or insulin if control remains poor	Overview • Symptoms consisting of fatigue • Weight loss of 14 pounds over about • Avid exerciser, competing successfully for age group in triathelons • FPG 185 mg/dl, HbA1c 11.5%, TG 670 mg/dl Objectives: • Diagnose and confirm the kind of diabetes he has. • Understand what his prognosis is—short term and long term. • Describe how to initiate therapy. • Discuss continuing therapy scenarios.

CHAIRPERSON

Christopher Saudek, MD
Hugh P. McCormick Family Professor of Endocrinology and Metabolism
Director, Johns Hopkins Diabetes Center
Program Director, General Clinical Research Center
Johns Hopkins University School of Medicine

FACULTY

Neil Brooks, MD
Past President, American Academy of Family Physicians
AAFP Representative-Relative Value Update Committee
Medical Director, Vernon Manor Health Care Center

Vivian Fonseca, MD
Professor of Medicine
Director, Diabetes Program
Tullis-Tulane Alumni
Chair in Diabetes
Tulane University Medical Center

Anne Peters, MD
Professor of Clinical Medicine
University of Southern California
Keck School of Medicine
Director, Los Angeles County-USC Diabetes Program
The Westside Center for Diabetes

CME INFORMATION

Intended Audience:
This activity is designed for primary care physicians. There are no prerequisites for attendees.

Credit Designation Statement:
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 4.0 AMA PRA
Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Accreditation Statement:
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Policy on Faculty and Provider Disclosure:
It is the policy of the Johns Hopkins University School of Medicine that the faculty and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the course handout materials.

Americans With Disabilities Act:
The Johns Hopkins University School of Medicine fully complies with the legal requirements of the ADA and the rules and regulations thereof. Please notify us if you have any special needs.

WHAT IS THE COLLECTIVE CLINICAL FORUM?

"An important aim of continuing education is to improve professional practice so that patients can receive improved health care."

In 2005, the Cochrane Database of Systemic Reviews published a study on the educational impact of different CME meeting formats. In assessing the effects of educational meetings on professional practice and health care outcomes, the researchers concluded that "interactive" workshops can result in moderately large changes in professional practice. Didactic sessions alone are unlikely to change professional practice." By providing a unique meeting format combining video case studies, audience interactivity, didactic presentations, and faculty debate, our goal is to create positive change in physician practice and impart critical insights into the diagnosis and management of type 2 diabetes.

Clinical manifestations of type 2 diabetes include hyperglycemia, hypertension, and hyperlipidemia, and are among the highest risk factors for the development of macro and microvascular complications. In clinical practice, establishing adequate therapy is complex. Although providers agree that maintaining glucose, lipid and blood pressure at target ranges is important; practice habits are inconsistent with this belief.

Due to lack of services in some regional areas, gaps exist between the state of the art in diabetes care management and current practices in the primary care setting related to insulin therapy. Primary Care Physicians encounter many barriers that prevent them from achieving established treatment goals, including time constraints during office visits and increased costs of medical care.

The clinical content of this program will provide PCPs with strategies they can use in practice today to overcome these very barriers.

The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

Presented By:

This program is supported by an educational grant from Eli Lilly and Company.