CME Information

Patients with diabetes mellitus, obesity and atherogenic dyslipidemia have an increased risk for coronary heart disease (CHD). Appropriate evaluation and intervention can decrease a person’s lifetime risk for CHD. Additionally, oral therapies for diabetes mellitus are expanding, and a clear understanding of the risks and benefits to these medications is essential to the appropriate diagnosis and management of diabetes mellitus.  Healthcare professionals need to be aware of the most recent guidelines for the management of diabetes, dyslipidemia, and obesity. The purpose of this review is to highlight the methods for risk stratification in the setting of diabetes and dyslipidemia, as well as address the recent advances in oral therapies for diabetes mellitus.

At the conclusion of this activity, the participant should be able to:

• Discuss the guidelines for optimal management of diabetes mellitus, according to the American Diabetes Association

• Describe the relationship of diabetes to coronary heart disease

• Discuss the guidelines for management of dyslipidemia, according to CHD risk

• Describe the critical role of therapeutic lifestyle change in the management of metabolic derangements (diabetes mellitus, dyslipidemia, obesity)

• Describe the relationship of weight change and oral therapies for diabetes mellitus

This CME activity is designed to meet the educational needs of cardiologists, endocrinologists, primary care physicians, and other physicians caring for patients at risk for cardiovascular disease.

This clinical case is in text format accompanied by references linked to PubMed.

To receive a maximum of 0.5 AMA PRA Category 1 Credit(s)™ you should:

• View the presentations in this CME activity and evaluate the content presented

• Complete and submit the posttest, CME registration and activity evaluation forms

The estimated time to complete this activity, including review of the materials, is 0.5 hour(s).

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.    

ACCME accredited providers may issue credit to both U.S. and international physicians for any activity that has been designated for AMA PRA Category 1 Credit(s)™ in accordance with PRA requirements.

December 2007 through December 2008. Original release date: December 2007

In November 2007, this continuing medical education activity was reviewed by Madhuri Vasudevan, MD, MPH, Clinical Endocrinology and Atherosclerosis Fellow, Center for Cardiovascular Disease Prevention and Division of Endocrinology, Baylor College of Medicine, Houston, Texas. In order to ensure the continued scientific relevance of this enduring material it will be reviewed again December 2008.

Disclosure: Nothing to disclose.

Christie M. Ballantyne, MD
Professor of Medicine
Associate Chief and Clinical Director, Section of Atherosclerosis and
Lipoprotein Research
Department of Medicine
Baylor College of Medicine
Houston, Texas

Director, Center for Cardiovascular Disease Prevention
Methodist DeBakey Heart Center
Co-Director, Lipid Metabolism and Atherosclerosis Clinic
The Methodist Hospital
Houston, Texas

Disclosure: non-public support of research – AstraZeneca, GlaxoSmithKline, KOS, Merck, Merck/Schering-Plough, Novartis, Pfizer, Sankyo, sanofi-aventis, Schering, Takeda; speakers bureau member – AstraZeneca, Merck, Merck/Schering-Plough, Pfizer, Reliant, Schering; advisory committee member – AstraZeneca, KOS, Merck/Schering-Plough, Reliant, sanofi-aventis, Schering; consultant – AstraZeneca, GlaxoSmithKline, Merck, Merck/Schering-Plough, Pfizer, Reliant, sanofi-aventis, Schering; honorarium recipient – AstraZeneca, GlaxoSmithKline, KOS, Merck, Merck/Schering-Plough, Pfizer, Reliant, sanofi-aventis, Schering.

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Christie M. Ballantyne, MD, Activity Director: non-public support of research – AstraZeneca, GlaxoSmithKline, KOS, Merck, Schering, Novartis, Pfizer, Sankyo, sanofi-aventis, Merck/Schering-Plough, Takeda; speakers bureau member – AstraZeneca, Merck, Schering, Pfizer, Reliant, Merck/Schering-Plough; advisory committee member – AstraZeneca, KOS, Reliant, Schering, sanofi-aventis, Merck/Schering-Plough; consultant – AstraZeneca, GlaxoSmithKline, Merck, Pfizer, Reliant, Schering, sanofi-aventis, Merck/Schering-Plough; honorarium recipient - AstraZeneca, GlaxoSmithKline, KOS, Merck, Pfizer, Reliant, Schering, Merck/Schering-Plough, sanofi-aventis.

Peter H. Jones, MD, Contributor: non-public support of research – Abbott, AstraZeneca;  advisory committee member – Abbott, AstraZeneca, Pfizer; consultant – GlaxoSmithKline; honorarium recipient – Abbott, AstraZeneca, Merck/Schering-Plough.

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Madhuri Vasudevan, MD, MPH, Peer Reviewer: nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

This CME activity is supported by an educational grant from sanofi-aventis.