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Multifactorial management in 15 min
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Multifactorial management in 15 min

0.25 hours

This content was released on 28/08/2019 and will expire on 28/08/2020.

These five 3-minute videos summarise the role of primary care services in helping people with diabetes achieve multifactorial health. This includes foot care, kidney health, eye care, mental health and diet

Animated storyboard: The importance of early intensive therapy
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Animated storyboard: The importance of early intensive therapy

This content was released on 18/08/2020 and will expire on 18/08/2021.

In type 2 diabetes, there is often the perception that poor outcomes only happen later on in the disease, and people can gradually get their blood sugar under control. However, the truth is far more severe: delaying treatment intensification by just 1 year is linked to a 62% higher lifetime risk of cardiovascular outcomes such as heart attack and stroke.

This 5-minute video, steered by Tina Vilsbøll of the Steno Diabetes Center in Copenhagen, describes the pathophysiology that leads to this higher lifetime risk, the importance of early intensive therapy, and how you can work in partnership with your patient to implement this vital regimen.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change

 

Animated storyboard: Navigating the EASD-ADA algorithm
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Animated storyboard: Navigating the EASD-ADA algorithm

This content was released on 20/08/2020 and will expire on 20/08/2021.

While lifestyle interventions are the cornerstone of type 2 diabetes management, antihyperglycaemic medications remain an important part of disease management. However, given the wide range of available agents, how can we select between the available options?

This 5-minute video, steered by Dr Kevin Fernando of the North Berwick Health Centre UK, guides you though a simplified version of the EASD/ADA algorithm, most recently updated in December 2019.

Moving through the algorithm, it includes clear discussion of when to initiate dual therapy, key information on the importance of cardiorenal status, and guidance on how to match specific drug classes to individual patients based on their profile.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change

Animated storyboard: Spotlight on GLP-1 RAs
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Animated storyboard: Spotlight on GLP-1 RAs

This content was released on 20/08/2020 and will expire on 20/08/2021.

GLP-1 RAs are associated with a number of multifactorial effects, including reduction in weight, protection against cardiovascular events, and improvements in HbA1c. Given their indications in type 2 diabetes, this class of agents can be particularly suited to helping specific patient presentations. But how do they work?

This 5-minute video, steered by Carel le Roux, examines the mechanism of action of GLP-1 RAs, including their effects on glucose, cardiovascular disease, and the neurohormonal system. It also discusses injectable and oral formations and strategies for discussing the therapeutic class with your patients to help them overcome fears and understand the benefits of this treatment.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change

Explainer video: John Buse explains The 2019 changes to the ADA‑EASD consensus on management of hyperglycaemia
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Explainer video: John Buse explains The 2019 changes to the ADA‑EASD consensus on management of hyperglycaemia

This content was released on 20/08/2020 and will expire on 20/08/2021.

Though generally the American Diabetes Association and European Association for the Study of Diabetes (ADA EASD) guidance on management of hyperglycaemia statement has been updated every three years, 2019 was a year packed full of very important studies that resulted in two key overarching changes to guidelines.

The committee felt that, though the 2018 document was still relatively new, an update was required.

In this 6-minute video, lead author Dr John Buse explains the important new recommendations on cardiorenal protective agents, when to offer dual therapy, and how to select between GLP-1 RAs and SGLT2is in patients with established cardiovascular disease.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change

Animated storyboard: Cardiovascular and Diabetes Guidelines in Practice
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Animated storyboard: Cardiovascular and Diabetes Guidelines in Practice

This content was released on 24/09/2020 and will expire on 24/09/2021.

Cardiovascular disease and diabetes often co-occur in patients, presenting a challenge for both diabetologists and cardiologists: given numerous targets (from blood sugar to blood lipids), how can both conditions be managed concurrently?

This 5-minute video, steered by Professor Lars Rydén, succinctly summarises relevant guideline recommendations surrounding cardiovascular disease and diabetes, including appropriate blood pressure targets, individualised lipid targets, and how to select antihyperglycaemic agents that offer additional cardioprotective effects. By using these recommendations, you will be able to tailor treatment to an individual patient's personal presentation, which will help to optimise their cardiovascular outcomes.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change

Animated storyboard: New Targets for insulin-treated patients
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Animated storyboard: New Targets for insulin-treated patients

This content was released on 24/09/2020 and will expire on 24/09/2021.

HbA1c has been the main target used to assess success or failure of treatment in diabetes. However, this metric has its own limitations - for example, while it is useful in assessing a 3-month average of glucose exposure, it cannot provide any specific information on day-to-day variability or within-day hyper- or hypoglycaemia.

With this in mind, technologies such as continuous glucose monitors and flash glucose monitors have allowed for the development of new metrics in diabetes: time in range and glycaemic variability. 

This 5-minute video, steered by Professor Dr Thomas Danne, summarises the role of these new metrics, and their role in setting new targets in patients receiving insulin.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change.

Animated storyboard: GLP-1 RAs for cardiologists: cardiovascular protection and their role in therapy
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Animated storyboard: GLP-1 RAs for cardiologists: cardiovascular protection and their role in therapy

This content was released on 30/09/2020 and will expire on 30/09/2021.

GLP-1 receptor agonists have an increasing wealth of clinical trial data supporting the class’ use as a cardioprotective agent in people with type 2 diabetes. EASD/ADA guidelines now recommend their use in all T2D patients with cardiovascular disease or multiple risk factors – but what do those in the cardiology community need to know about this class?

This 5-minute video, designed by Dr. Naveed Sattar, summarises all the pertinent information that cardiologists, cardiology nurses and other related HCPs need to know about this class of medications.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change.

 

Explainer video: Mansoor Husain explores the results and implications of PIONEER 6, the CVOT for oral semaglutide
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Explainer video: Mansoor Husain explores the results and implications of PIONEER 6, the CVOT for oral semaglutide

This content was released on 20/10/2020 and will expire on 20/10/2021.

The PIONEER 6 trial was a large-scale, randomised, controlled, cardiovascular outcomes trial evaluating the cardiovascular effects of oral semaglutide. While the primary outcome just missed out on significant risk reduction, the results are still highly informative for both semaglutide and the wider GLP-1 receptor agonist class.

Join principal investigator Dr Mansoor Husain for a 5-minute summary of the trial’s key findings, and find out what he and his fellow investigators concluded from the study.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change.

Animated storyboard: Strategies to reduce hypoglycaemia risk – lifestyle, technology, and selection of insulin analogue
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Animated storyboard: Strategies to reduce hypoglycaemia risk – lifestyle, technology, and selection of insulin analogue

This content was released on 06/01/2021 and will expire on 06/01/2022.

Hypoglycaemia is a risk for anyone taking insulin, and can be difficult to balance against efforts for glycaemic control due to the various overlapping factors that can lead to an episode.

This 5-minute video, steered by Professor Simon Heller of the University of Sheffield, presents the key elements in reducing the risk of hypoglycaemia, including selection of insulin analogue, glucose monitoring, lifestyle behaviours, and education for patients and their families.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change.

Animated storyboard: Treating MAFLD/NASH – current best practice approaches in comorbid patients
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Animated storyboard: Treating MAFLD/NASH – current best practice approaches in comorbid patients

This content was released on 18/08/2020 and will expire on 18/08/2021.

With no pharmacotherapies currently approved to treat NASH, management of this condition is a complicated issue. Furthermore, NASH typically presents alongside comorbidities, so how can we best manage it?

This 5-minute video, steered by Dr. Stephen Harrison, discusses guideline recommendations for treating NASH through a multifactorial approach, the evidence for different strategies, and how to integrate this with management of type 2 diabetes and obesity.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change.

Explainer video: Sérgio Vencio presents a secondary analysis of the CAPTURE study: diabetes medications with CV benefit
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Explainer video: Sérgio Vencio presents a secondary analysis of the CAPTURE study: diabetes medications with CV benefit

This content was released on 26/01/2021 and will expire on 26/01/2022.

CAPTURE was a non-interventional, cross-sectional study that assessed the prevalence of cardiovascular disease in people with type 2 diabetes; a pre-specified secondary analysis evaluated the use of glucose-lowering agents with a proven cardiovascular benefit.

Join principal investigator Dr Sérgio Vencio for a 5-minute summary of this analysis, presented in a poster at the EASD 2020 annual meeting.

The information and data provided in this program was updated and correct at the time of the program development, but may be subject to change.

Animated storyboard: What is NASH? An overview of steatohepatitis and metabolic liver disease
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Animated storyboard: What is NASH? An overview of steatohepatitis and metabolic liver disease

This content was released on 18/02/2021 and will expire on 18/02/2022.

The prevalence of metabolic-associated fatty liver disease (MAFLD) is estimated to be 80-90% among people with obesity, diabetes and metabolic syndrome. A notable proportion of these will progress to non-alcoholic steatohepatitis (NASH), which increases the risk of fatal and non-fatal cardiorenal disease, and is a leading indication for liver transplantation. It is therefore essential to consider MAFLD and NASH among people with metabolic diseases, including obesity and diabetes.

This 5-minute video, steered by Professor William Alazawi, summarises the pathophysiology of NASH, its links with metabolic diseases, and how it progresses to poor outcomes.

Explainer video: Professor Tina Vilsbøll presents a post-hoc analysis of DUAL V and DUAL VII
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Explainer video: Professor Tina Vilsbøll presents a post-hoc analysis of DUAL V and DUAL VII

DUAL V and DUAL VII investigated the safety and efficacy of IDegLira in participants with insufficiently controlled type 2 diabetes. The results showed that IDegLira improved glycaemic control, and compared to insulin therapy alone, reduced the risk of weight gain and hypoglycaemia.

In this 5-minute video, Professor Tina Vilsbøll presents a post-hoc analysis aiming to answer two outstanding questions. Firstly, for those participants taking a higher dose of insulin before switching to IDegLira, did glycaemic control decline before it improved? And secondly, did the pre-trial insulin dose influence the effects of IDegLira?

Animated Storyboard: Glycaemic variability and hypoglycaemia in type 2 diabetes: associations with outcomes
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Animated Storyboard: Glycaemic variability and hypoglycaemia in type 2 diabetes: associations with outcomes

HbA1c is the traditional primary metric for monitoring glycaemia, but it does not give us a full picture of glycaemic control. Does shorter-term glycaemic variation have an impact on outcomes? Does longer-term fluctuation in HbA1c affect the disease course?

This 5-minute video, steered by Professor Dace Trence, outlines the outcomes associated with both short- and longer-term glycaemic variability in type 2 diabetes.

Animated storyboard: Spotlight on SGLT2 inhibitors
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Animated storyboard: Spotlight on SGLT2 inhibitors

SGLT2 inhibitors are a class of antihyperglycaemic agents that have been found to also offer cardiovascular and renal benefits. But how do they work and how are they used in clinical practice?

Steered by Professor Hiddo Lambers Heerspink, this video summarises their mode of action,  clinical considerations for initiating therapy, and monitoring for adverse events.

Animated storyboard: How to identify NASH through non-invasive investigations and risk stratification
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Animated storyboard: How to identify NASH through non-invasive investigations and risk stratification

It is estimated that up to 90% of people with obesity, diabetes and metabolic syndrome are living with NAFLD, around 1 in 5 of whom will progress to NASH. Currently, the only way to confirm a diagnosis of NASH is through liver biopsy, so how can we best identify patients at high risk?

This 5-minute video is steered by Professor Arun Sanyal, and provides an overview of best-practice screening approaches for identifying patients at higher risk of NASH.

Funding information is available at the beginning of each activity. All content has been developed by Liberum IME in conjunction with an independent steering committee; financial supporters have had no influence on the content of this education.

The American Medical Association has an agreement of mutual recognition of Continuing Medical Education (CME) credits with the European Union of Medical Specialists (UEMS), the accreditation body for European countries.Physicians interested in converting AMA PRA Category 1 Credit™ to UEMS-European Accreditation Council for Continuing Medical Education CME credits (ECMEC®s) should contact the UEMS at mutualrecognition@uems.eu