Macro - and Microvascular Effects of Hyperglycemia: Addressing Issues and Controversies: VBWG Round Table

Presented By:		VBWG Roundtable, Video George L. Bakris, MD, FASN, FAHA University of Chicago Pritzker School of Medicine Chicago, Illinois Paresh Dandona, MBBS, DPhil, FRCP, FACP, FACC, FACE State University of New York at Buffalo Buffalo, New York Robert J. Chilton, DO, FACC, FACP The University of Texas Health Science Center San Antonio, Texas

Program Description:	This CME activity consists of a video and CME evaluation form. Estimated time to complete this activity, including review of materials, is 75 minutes.
General Information:	Requirements for Successful Completion: This CME activity consists of an educational component (ie, slides, audio lecture, newsletter) in an electronic format, which is followed by a CME evaluation form. There is no fee to participate in this CME activity or to receive CME credit. Certificates are awarded upon completion of the CME evaluation form. In order to receive credit, participants must watch the panel discussion in its entirety. Media: Internet Release Date:    October 7, 2009 Expiration Date:  October 6, 2011
Target Audience:	Clinical cardiologists, endocrinologists, certified diabetes educators, family/general physicians, internal medicine physicians, medical directors, nephrologists, nurse practitioners, primary care physicians, physician assistants, specialty physicians, nurses, pharmacists
Program Overview:	Concurrent cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) prevalence is high and increasing. Inadequate glycemic control in diabetes is a major health problem. The most consistent structural microvascular modification in hyperglycemia is the thickening of the capillary basement membrane. Hyperglycemia is responsible for endothelial microvascular dysfunction leading to neuropathy, retinopathy, nephropathy, and other vascular complications. Dysglycemia influences cardiac tissue beds and degree of coronary microangiopathy. Glucose-mediated metabolic pathways cause intracellular events resulting in tissue damage prior to hyperglycemia. Maintenance of A1C at or below 7% is needed to prevent the development and progression of T2DM and its comorbidities. Despite evidence supporting intensive and early glycemic control, an urgent need exists to close educational gaps for cardiologists, endocrinologists, and primary care physicians who manage hyperglycemia in patients with established and early diabetes to minimize macro- and microvascular complications.
Learning Objectives:	a. Discuss recently published data regarding the effects of intensive glycemic control on macro- and microvascular outcomes b. Select three key determinants of hyperglycemia complications and manage these risks appropriately through lifestyle modifications and pharmacologic therapy c. Modify glycemic goals for each patient, based on individual needs
Faculty Disclosure:	The University of Florida College of Medicine has a conflict of interest policy that requires course faculty to disclose any real or apparent commercial financial affiliations related to the content of their presentations/materials. It is not assumed that these financial interests or affiliations will have an adverse impact on faculty presentations; they simply are noted here to fully inform participants. Dr Bakris has indicated that he has a financial arrangement or affiliation with Abbott Laboratories, Boehringer Ingelheim, Daiichi Sankyo, Inc., Forest Laboratories, Inc., Gilead, GlaxoSmithKline, Juvenile Diabetes Research Foundation International, Merck & Co., Inc., NIH(NIDDK), Novartis, Takeda Pharmaceutical Company, and Walgreens (formulary committee). The types of affiliations/financial interests are grant/research support, consultant agreements, honoraria, and scientific advisory boards. Dr Dandona has indicated that he has a financial arrangement or affiliation with Abbott Laboratories, Allergan, Inc., Bristol-Myers Squibb, Centers for Disease Control & Prevention, Citrus Industry of Florida, ConjuChem, Inc., Daiichi Sankyo, Inc., Dainippon Sumitomo Pharma Co., Eli Lilly and Company, GlaxoSmithKline, John R. Oishei Foundation, Merck & Co., Inc, Millard Fillmore Foundation, Mitsubishi Tanabe Pharma Corporation, National Institutes of Health (NIH), Novartis, Novo Nordisk, P&G Pharmaceuticals, Quigley Pharma, Inc., sanofi-aventis U.S., Solvay Pharmaceuticals, Takeda Pharmaceutical Company, Tolerx, Inc., Transition Therapeutics Inc., and William G. McGowan Charitable Fund, Inc. The types of affiliations/financial interests are grant/research support and honoraria. Dr Chilton has indicated that he has a financial arrangement or affiliation with GlaxoSmithKline, Merck & Co., Inc., Pfizer Inc, and Takeda Pharmaceutical Company. The types of affiliations/financial interests are grant/research support, consultant agreements, and honoraria.
Continuing Medical Education Credit:
	Accreditation
	The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
	Credit
	The University of Florida College of Medicine designates this educational activity for a maximum of 1.25 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
	This continuing education activity was planned in accordance with the ACCME essentials and reviewed by Carl J. Pepine, MD, Program Chair.
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Commercial Support:	This CME activity is supported by an educational grant from sanofi-aventis U.S.
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CME Contact:	For any question regarding this Internet CME activity, please contact the Office of Continuing Medical Education at 352-265-8081.
	The University of Florida College of Medicine has received permission to use this copyrighted material within a CME activity on the internet.

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