Sunday, December 3, 2023
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Head of Department
Unit of Endocrinology and Nutrition
Hospital Universitario Fundación Alcorcón
Madrid, Spain
None of the nonfaculty planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
This educational activity is intended for an international audience of non-US and non-UK primary care physicians, cardiologists, diabetologists, and endocrinologists.
The goal of this activity is to advance the guideline-endorsed principle of personalized management of patients with type 2 diabetes (T2D) in primary care.
Upon completion of this activity, participants will:
WebMD Global requires each individual who is in a position to control the content of one of its educational activities to disclose any relevant financial relationships occurring within the past 12 months that could create a conflict of interest.
Head of Department
Unit of Endocrinology and Nutrition
Hospital Universitario Fundación Alcorcón
Madrid, Spain
None of the nonfaculty planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.
This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.
The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 0.75 continuing professional development credits (CPD).
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CPD Released: 12/9/2021
Valid for credit through: 12/9/2022, 11:59 PM EST
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Benjamin is a 58-year-old government official with a 2-year history of type 2 diabetes (T2D) and stable angina after a myocardial
infarction (MI) 4 years ago which required a stent in the anterior descending coronary artery. He has come to the primary
care office today for his annual check-up and to review his recent laboratory results. His medical history and the results
of his physical exam and laboratory tests are shown in Table 1.
You note that his blood pressure (BP) is 148/98 mmHg despite adherence to an angiotensin converting enzyme inhibitor and beta-blocker.
His glycated hemoglobin (HbA1c) is 6.8% on metformin. His kidney function is good, with no sign of albuminuria.
Table 1. Benjamin’s Medical Record
|
History |
Findings |
|---|---|
|
Medical |
T2D x 2 years, stable angina from MI 4 years ago, HTN x 10 years, dyslipidemia x 7 years, and obesity |
|
Current medications |
Metformin 1000 mg twice daily, lisinopril 20 mg/d, metoprolol 100 mg twice daily, simvastatin 20 mg/d, ezetimibe 10mg/d, acetylsalicylic acid 100 mg/d |
|
Social/occupational |
Government official, married, lives with wife and dog; non-smoker, non-drinker; has 2 adult sons. Sedentary lifestyle. High-fat diet, poor intake of fruit, vegetables, and whole grains |
|
Physical Exam |
Findings |
|
Vital signs |
BP: 148/98 mmHg HR: 78 bpm |
|
Body measurements |
Weight: 85.2 kg, waist circumference: 108 cm, BMI: 32 kg/m2; class 1 obesity |
|
Extremities |
No edema |
|
Neck |
No distended neck veins |
|
Heart |
LVEF: 60% |
|
Lungs |
No rales |
|
Abdomen |
Soft, nontender |
|
CBC |
Results |
|
|
Normal |
|
Metabolic Panel |
Results |
|
FPG |
122 mg/dL |
|
HbA1c |
6.8% |
|
Lipid panel |
LDL: 75 mg/dL; HDL: 35 mg/dL, TG: 155 mg/dL |
|
eGFR |
91 mL/min/m2 |
|
UACR |
9 mg/g |
BMI, body mass index; CBC, complete blood count; eGFR, estimated glomerular filtration rate; FPG, fasting plasma glucose; HDL, high density lipoprotein; HTN, hypertension; HR, heart rate; LVEF, left ventricular ejection fraction; LDL, low density lipoprotein; TG, triglycerides; UACR, urine albumin-to-creatinine ratio.
