Martin Visit 1: A 51-year-old man with recent history of weight gain

Title:	Martin Visit 1: A 51-year-old man with recent history of weight gain
Topic:	Endocrinology
Relevant Terms:	Hypertension; Obesity; Dyslipidemia; Diabetes
Primary Audience:	Primary care providers (MDs/ DOs/ NPs/ PAs)
Launch Date:	01-Nov-12
Credits:	0.5 AMA PRA Category 1 Credit™
Expiration Date:	31-Oct-13
Curriculum Name:	Managing patients with hyperglycemia and other risk factors

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Learning Objectives

After completing this activity, the participant will demonstrate the ability to:

Demonstrate the ability to identify people who are at increased risk for the development of pre-diabetes, diabetes, and other cardiometabolic risk factors through appropriate screening methods.
Demonstrate the ability to set individualized glycemic control goals
Demonstrate the ability to design a glycemic control program using antidiabetes medications and/or insulin in a manner that balances underlying pathophysiology with patient-specific considerations
Demonstrate the ability to recognize markers of increased risk for development of diabetes-related complications, and initiate office-based complication monitoring and early intervention programs

Faculty

Edward S. Horton, MD
Professor of Medicine
Harvard Medical School
Senior Investigator
Joslin Diabetes Center
Boston, MA

Edward S. Horton, MD Edward S. Horton, MD, received his medical degree from Harvard Medical School in 1957. Following an internship in surgery at Johns Hopkins Hospital, Baltimore, Maryland, he performed part of his residency in pathology at Dartmouth Medical School, Hanover, New Hampshire, and the remainder in medicine at Duke University Medical Center, Durham, North Carolina. After completing his residency in 1964, Dr. Horton remained at Duke while serving in various fellowship positions in endocrinology. In 1967, he joined the staff at the University Of Vermont College Of Medicine and the Medical Center Hospital of Vermont, Burlington, Vermont, where he worked for twenty-six years primarily as Director of Endocrinology and Metabolism and then later as Chairman of the Department of Medicine and Chief of the Medical Service. In 1993, he was appointed Professor of Medicine at Harvard Medical School, Chief of the Division of Endocrinology and Metabolism at Deaconess Hospital and Medical Director for the Joslin Diabetes Center in Boston, Massachusetts. Currently he is Professor of Medicine at Harvard Medical School and a Senior Investigator at the Joslin Diabetes Center.

His major interests include obesity and insulin resistance as they relate to diabetes mellitus and cardiovascular disease; the regulation of energy balance and metabolic fuel homeostasis; the regulation of glucose transport and metabolism in skeletal muscle and adipose tissue; and the effects of exercise and physical training on insulin sensitivity. Dr. Horton has over 300 publications to his credit. He is also the recipient of several awards and distinctions, including the Banting Medal for Distinguished Service awarded by the American Diabetes Association, the American Society for Clinical Nutrition's Robert H. Herman Award, the Mizuno Award and Lectureship, the International Diabetes Federation John A. Galloway Award and Lectureship, the ADA Outstanding Physician Educator Award and the Distinguished Physician Award from the Endocrine Society. He has served as Associate Editor of Diabetes, Diabetes Care, Obesity Research and the American Journal of Physiology and on the editorial boards of numerous other journals including the Journal of Clinical Endocrinology and Metabolism.

Dr. Horton is past president of the American Diabetes Association and the American Society for Clinical Nutrition. He has also served as Chairman of the National Diabetes Advisory Board.

Jacqueline Shahar, MEd, RCEP, CDE
Manager, Exercise Services
Clinical Exercise Physiologist
Certified Diabetes Educator
Joslin Diabetes Center
Boston, MA

Jeanne Spellman, RD, LDN
Research Dietitian
Joslin Diabetes Center
Boston, MA

Planning Committee

Richard S. Beaser, MD*

Associate Clinical Professor of Medicine

Harvard Medical School

Medical Executive Director

Professional Education

Joslin Diabetes Center

Boston, MA

Julie Brown*

Director

Professional Education

Joslin Diabetes Center

Boston, MA

Karen Kuc*

Assistant Director

Professional Education

Joslin Diabetes Center

Boston, MA

James Neighbours, Med*

Associate Director
Education Design

Professional Education

Joslin Diabetes Center

Boston, MA

Kenneth J. Snow, MD, MBA*
Assistant Professor of Clinical Medicine
Harvard Medical School
Director, Medical Programs, Strategic Initiatives
Senior Physician, Adult Diabetes Section
Joslin Diabetes Center
Boston, MA

*Also on CME Advisory Committee

CME Advisory Committee

Enrique Caballero, MD
Director, Medical Affairs
Professional Education
Director, Latino Diabetes Initiative
Joslin Diabetes Center
Boston, MA

Jerry Cavallerano, OD, PhD

Optometrist

Beetham Eye Institute

Joslin Diabetes Center

Boston, MA

A. Patrick Egan, MD

Family Practice
Internal Medicine Specialist

Dorchester House Multi-Service Center

Boston, MA

Ann E. Goebel-Fabbri, PhD

Instructor in Psychiatry

Harvard Medical School

Psychologist

Behavioral and Mental Health Unit

Joslin Diabetes Center

Boston, MA

Osama Hamdy, MD, PhD, FACE

Assistant Professor of Medicine

Harvard Medical School

Medical Director, Obesity Clinical Program

Joslin Diabetes Center

Boston, MA

Robert C. Stanton, MD

Associate Professor of Medicine

Harvard Medical School

Chief of Nephrology

Joslin Diabetes Center

Boston, MA

Howard Wolpert, MD

Assistant Professor of Medicine

Harvard Medical School

Director, Insulin Pump Program

Senior Physician

Joslin Diabetes Center

Boston, MA

DISCLOSURE POLICY STATEMENT

As part of its accreditation with the Accreditation Council for Continuing Medical Education, Joslin Diabetes Center, Boston, must disclose to the audience of a Joslin continuing medical education activity the existence of any relevant financial relationships between Joslin and/or its planning committee members, speakers, and their spouses/partners and commercial entities. Joslin and its planning committee members and speakers must disclose any relationships they and their spouses/partners have or have had in the prior 12 months with proprietary entities producing healthcare goods or services with the exception of nonprofit or government organizations and non–healthcare-related companies, which are exempt.

Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fees, honoraria, ownership interests (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds) or other financial benefit in any amount. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected.

If a faculty or planning committee member has no information to disclose, this information will also be provided. If a faculty or planning committee member refuses to disclose, he/she will not be able to participate in the planning, management, presentation, or evaluation of any Joslin Diabetes Center CME activity. In addition, faculty has been asked to disclose when a product or device is not labeled for the use under discussion. The opinions and comments expressed in this program are those of the speakers and should not be considered the opinions or comments of the Joslin Diabetes Center.

Faculty

Dr. Frederick L. Dunn received grant/research support from Merck & Co., Inc., and is a consultant for Lilly USA LLC. Dr. Dunn's spouse receives grant/research support from GlaxoSmithKline, Lilly USA LLC, Novo Nordisk Inc., and Sanofi USA LLC, and is a consultant for Merck & Co., Inc., and Novo Nordisk Inc.

Dr. David Erani is on the speaker's bureau for Amylin Pharmaceuticals, Inc., and Sanofi USA LLC.

Dr. Edward S. Horton is a consultant for Amarin Pharmaceuticals, Inc., Amylin Pharmaceuticals, Inc., Gilead Sciences, Inc., Janssen Pharmaceuticals, Inc., and Merck Research Laboratories, Inc.; serves on the data safety monitoring board for GI Dynamics, Inc., Theracos, Inc., and Takeda Pharmaceuticals, Inc.; receives grant/research support from Amylin Pharmaceuticals, Inc., and Eli Lilly and Company; and is on the speakers bureau for Merck & Co., Inc.

Jacqueline I. Shahar has no relevant financial relationships.

Jeanne Spellman has no relevant financial relationships.

Dr. Robert C. Stanton has no relevant financial relationships.

Planning Committee

Dr. Richard S. Beaser, Medical Executive Director, Professional Education, Joslin Diabetes Center, is a consultant for AstraZeneca/Bristol-Myers Squibb Company and CeQur Ltd.

Julie A. Brown, Director, Professional Education, Joslin Diabetes Center, is a consultant for Bristol-Myers Squibb Company.

Karen J. Kuc, MPH, Assistant Director, Grants and Projects, Joslin Diabetes Center, has no relevant financial relationships.

James E. Neighbours, Associate Director, Education Design, Professional Education, Joslin Diabetes Center, has no relevant financial relationships.

Dr. Eyiuche Okeke has no relevant financial relationships.

CME Advisory Committee

Dr. Richard S. Beaser, Medical Executive Director, Professional Education, Joslin Diabetes Center, is a consultant for AstraZeneca/Bristol-Myers Squibb Company and CeQur Ltd.

Julie A. Brown, Director, Professional Education, Joslin Diabetes Center, is a consultant for Bristol-Myers Squibb Company.

Dr. Enrique Caballero, Director, Medical Affairs, Professional Education, Director, Latino Diabetes Initiative, Joslin Diabetes Center, is a consultant and on the speakers bureau and scientific advisory board for Amylin Pharmaceuticals, Inc., AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Daiichi Sankyo, Inc., and Eli Lilly and Company.

Dr. Jerry Cavallerano, Optometrist, Beetham Eye Institute, Joslin Diabetes Center, has no relevant financial relationships.

Dr. A. Patrick Egan, Family Practice, Internal Medicine Specialist, Dorchester House Multi-Service Center, has no relevant financial relationships.

Anne E. Goebel-Fabbri, Psychologist, Behavioral and Mental Health Unit, Joslin Diabetes Center, has no relevant financial relationships.

Dr. Osama Hamdy, Medical Director, Obesity Clinical Program, Joslin Diabetes Center, is on the speakers bureau for Amylin Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Merck & Co., Inc., Novo Nordisk Inc., sanofi-aventis U.S., and Takeda Pharmaceuticals North America, Inc.

Karen J. Kuc, MPH, Assistant Director, Grants and Projects, Joslin Diabetes Center, has no relevant financial relationships.

James E. Neighbours, Associate Director, Education Design, Professional Education, Joslin Diabetes Center, has no relevant financial relationships.

Dr. Robert C. Stanton, Chief of Nephrology, Joslin Diabetes Center, has no relevant financial relationships.

Dr. Howard A. Wolpert, Director of the Insulin Pump Program and Senior Physician, Joslin Diabetes Center, is a consultant for Abbott Diabetes Care; Becton, Dickinson and Company; Insulet Corporation; and Novo Nordisk, Inc.

ACCREDITATION STATEMENT

The Joslin Diabetes Center, Boston, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CREDIT DESIGNATION

Joslin Diabetes Center designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

To Obtain CME Credits

Read the learning objectives and faculty disclosures.
Participate in the activity.
Complete the posttest and activity evaluation.
Physicians who successfully complete the posttest and evaluation will receive CME credit.
You must score 65% or higher on the posttest to receive credit for this activity.
All other participants who successfully complete the posttest and evaluation will receive a certificate of participation.

COURSE VIEWING REQUIREMENTS

Google Chrome for Windows, Mac, or Linux

Internet Explorer 7.0+ for Windows

Mozilla 1.4+ for Windows, Mac, or Linux

Firefox 3.5+ for Windows, Mac, or Linux

Safari 4.0+ for Mac

Release Date: November 1, 2012

Expiration Date: October 31, 2013

ACKNOWLEDGEMENT

This activity is sponsored by Joslin Diabetes Center.

This activity is supported by educational grants from Daiichi Sankyo, Inc., Novo Nordisk Inc., sanofi-aventis U.S.

If you have any questions regarding this activity, send an email to profedweb@joslin.harvard.edu.

Copyright © 2012 by Joslin Diabetes Center, Inc. All rights reserved. These materials may be used for personal use only. Any rebroadcast, distribution, or reuse of this presentation or any part of it in any form for other than personal use without the express written permission of Joslin Diabetes Center is prohibited.

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