Friday, January 27, 2023
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Professor of Medicine
University of Barcelona
Barcelona, Spain
This activity has been peer reviewed and the reviewer has no relevant financial relationships.
Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™
This educational activity is intended for an international audience of non-US and non-UK primary care physicians, cardiologists, and other HCPs involved in the management of patients with T2D.
The goal of this activity is for learners to improve their ability to manage patients with T2D using glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and other cardiorenal protective agents.
Upon completion of this activity, participants will:
Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.
Disclosures for additional planners can be found here.
Professor of Medicine
University of Barcelona
Barcelona, Spain
This activity has been peer reviewed and the reviewer has no relevant financial relationships.
Medscape, LLC designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability
and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those
credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the
activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.
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CME Released: 11/11/2022
Valid for credit through: 11/11/2023
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The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.
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Leo is a 48-year-old barkeeper. After being diagnosed with diabetes 4 years ago, he is concerned about his health. He comes to the primary care office today for his annual checkup and to review his recent laboratory results. He tells you that he cut back to only smoking cigarettes in the mornings and on nights that he works, and he only has a drink or 2 after work on the weekends. Because he works nights and odd hours at the bar, he eats most of his meals on the go, and he asks for advice on losing some weight.
Leo's medical history and the results of his physical exam and laboratory tests are shown in Table 1. He does not have overt cardiovascular disease (CVD). You note that his blood pressure (BP) is 145/94 mm Hg despite adherence to an angiotensin-converting enzyme (ACE) inhibitor and a beta-blocker. His glycated hemoglobin (HbA1c) is 7.4% on metformin.
| History | Findings |
|---|---|
| Medical | T2D × 4 years, hypertension × 10 years, dyslipidemia × 8 years, and obesity |
| Current medications | Metformin 1000 mg twice daily, lisinopril 20 mg/d, metoprolol 100 mg twice daily, simvastatin 20 mg/d |
| Social/Occupational | Barkeeper, single; divorced, lives with dog; smoker × 30 years, recreational drinker; has 2 adult sons. Sedentary lifestyle. High-fat diet; poor intake of fruit, vegetables, and whole grains |
| Physical Exam | Findings |
| Vital signs | BP: 145/94 mm Hg Heart rate: 78 bpm |
| Body measurements | Weight 96 kg, waist circumference 112 cm, BMI 35.5 kg/m2; class 2 obesity |
| Extremities | No edema |
| Neck | No distended neck veins |
| Lungs | No rales |
| Abdomen | Soft, nontender |
| CBC | Results |
| Normal | |
| Metabolic Panel | Results |
| FPG | 122 mg/dL |
| HbA1c | 7.4% |
| Lipid panel | LDL 75 mg/dL, HDL 35 mg/dL, TG 170 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; LDL, low-density lipoprotein; TG, triglyceride; UACR, urine albumin-to-creatinine ratio
