Diagnosis of thyroid disease is primarily a laboratory diagnosis. When the TSH is elevated and thyroid hormone levels low, or when TSH is suppressed and the thyroid hormone levels are high, it is trivial to diagnose hypo- and hyperthyroidism, respectively. In such cases, the treatment is relatively straightforward as well. However when the tests are not straightforward, one is unable to initiate treatment until the diagnosis is certain. Two major conundrums faced by physicians caring for thyroid patients are when 1) the levels of TSH and thyroid hormone are not complementary or 2) when the thyroid hormone levels don’t match the clinical symptoms. This presentation will unravel the seeming contradictions between clinical presentation and laboratory analysis of such thyroid tests.
In this Clinical Coffee Break, Dr. Anne Peters of Keck School of Medicine at the University of Southern California discusses the rationale and role of combining GLP-1 receptor agonists and basal insulin for the treatment of type 2 diabetes. She will also review the safety and efficacy of emerging fixed-ratio formulations of GLP-1 RAs and insulin.
Depending on whether you count all insulins as one or count them as multiple classes, there are now between 13 and 19 classes of antihyperglycemic agents that have been approved by the US FDA for the treatment of people with type 2 diabetes mellitus (T2DM). Insulin remains the most effective antihyperglycemic agent, and many, if not most, patients with T2DM will eventually require treatment with one or more of the increasing insulin therapy options. In this case compendium, Lawrence Blonde, MD, discusses patients at different stages of T2DM to illustrate how clinicians can better utilize insulin therapy options to attain glycemic control and improve the overall health outcomes of patients with T2DM
The primary goal of this integrated, multi-interventional curriculum of both live and online activities is to provide an educational initiative for primary care physicians, physician assistants (PAs) and nurse practitioners (NPs) on the advantages and disadvantages of prandial insulin, the clinical profiles of GPL-1 receptor agonists, and the benefits of combining GLP-1 receptor agonists with basal insulin.
In this Virtual Expert Roundtable, moderator Mary Lindholm, MD, of UMass Medical Center, along with faculty Intekhab Ahmed, MD, FACE, FACP, of Thomas Jefferson University, and Felice Caldarella, MD, FACE, FACP, CDE, of Hunterdon Medical Center, discuss how and when providers should consider adding a GLP-1 receptor agonist to basal insulin for the treatment of type 2 diabetes. They will discuss the differences between short-acting and long-acting GLP-1 receptor agonists and the practical aspects of adding a GLP-1 receptor agonist to basal insulin therapy, as well as the latest data on emerging fixed-ratio formulations of GLP-1 receptor agonists and basal insulin.
Highlights from the recent AACE/ATA hypothyroidism guidelines are reviewed in this activity.
Given the high percentage of diabetic patients who are not achieving ADA/AACE glycemic goals, it is imperative that appropriate diabetes treatment regimens are initiated and intensified in a timely manner. Even with the addition of basal insulin, only about 40% of patients achieve an A1C target of <7% and in some patients hyperglycemia persists despite reaching an A1C <7%. With the continued loss of beta cells and subsequent decline of insulin secretory capacity, postprandial hyperglycemia becomes the dominant glycemic control target. In this activity, learn more about the clinical profiles of the different GLP-1 receptor agonists (GLP-1 RAs), the differences in guideline recommendations regarding use of GLP-1 RAs and their role in combination with basal insulin for reducing postprandial glucose. Dr. Fonseca will take you through frequently asked questions regarding use of GLP-1 RAs in clinical practice and their impact on postprandial hyperglycemia.
In this activity, Dr. Richard Pratley, a world-renowned diabetologist, will provide evidence-based practical approaches to attaining glycemic control in patients with type 2 diabetes. He will outline strategies for setting glycemic targets, monitoring treatment, and intensifying treatment when glycemic targets are not met. The efficacy and safety of newer antidiabetic agents will be highlighted.
Type 2 diabetes is marked by progressive beta cell dysfunction requiring progressive pharmacological therapy to maintain glucose control. In this Clinical Coffee Break, Dr. James R. Gavin III of Emory University discusses the timely intensification of antihyperglycemic therapy including the initiation of insulin, pharmacologic and clinical differences between currently available basal insulins, and the role of new ultralong-acting basal insulins. He will also discuss how to devise insulin regimens that are specific to the patient needs while minimizing hypoglycemia risk.