Today at MEDS
Clinician Reviews and the Primary Care Metabolic Group welcomed more than 300 NPs, PAs, RNs, CDEs, and other clinicians involved in the diagnosis and management of metabolic and endocrine disorders from across the United States and abroad to the 2018 Metabolic and Endocrine Disease Summit (MEDS). This annual conference, headed by Meeting Chair Scott Urquhart, PA-C, DFAAPA, and Co-Chair Christine Kessler, MN, ANP-BC, CNS, BC-ADM, FAANP, was held August 1-4, 2018, at the Wyndham San Diego Bayside in San Diego, California, providing the opportunity for attendees to earn up to 24.25 CE/CME credits.
View summaries from the event on the following pages.
Expert Tips on Evaluating Thyroid Nodules
Chris Sadler, MA, PA-C, CDE, DFAAPA, Janssen Pharmaceuticals, Inc.
In the United States, up to 68% of randomly selected adults have thyroid nodules. While most are benign, the number of those that are cancerous is increasing. To assist with determining which are malignant, Sadler provided insight on the clinical and ultrasound findings that suggest increased malignant potential. He also detailed an appropriate work-up, noting that ultrasound-guided fine needle aspiration remains the best means for evaluation.
Lifestyle Interventions: A New Narrative for Diabetes Management and Metabolic Health
Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, Pace University
Mandel discussed diabetes self-management education and support. She highlighted what works and what doesn’t among various diets, that sugar isn’t the only target, that dieting is only half the equation and must be coupled with physical activity (which is not the same as exercise), and that patient involvement in self-management correlates with greater long-term success.
Gut Grief: The Enteroendocrine Connection in Autoimmune Diseases
Christine Kessler, MN, ANP-BC, CNS, BC-ADM, FAANP, Metabolic Medicine Associates
“We need to look to the gut as the biggest player in chronic health and autoimmune disease,” said Kessler. Kessler went on to explain how altered gut flora impacts immune, endocrine, cardiovascular, neuropsychologic, reproductive, and metabolic health. She identified 12 endocrine-disrupting chemicals associated with autoimmunity. And she reviewed the causes of microbiome dysbiosis, the bidirectional nature of the gut-microbiome-brain axis, and strategies for promoting microbiome health.
Mind and Body: The Vicious Cycle of Depression in Diabetes and Chronic Illness
Ellen D. Mandel, DMH, MPA, MS, PA-C, RDN, CDE, Pace University
One in 4 American adults experiences mental illness in a year, and having a serious mental illness increases the risk of having a chronic medical condition. Because emotional well‐being is associated with positive diabetes outcomes, it’s imperative that diabetes self‐management education and support address psychosocial issues. It’s also important to screen for depression. To that end, Mandel shared a time-saving 2-question screening tool.
Cold Case Studies in Renal Medication Dosing: The Good, the Bad, and the Iatrogenic
Kim Zuber, PA-C, MS, American Academy of Nephrology PAs
Using actual cases of incorrect management, Zuber pointed out the most common medications taken by patients with chronic kidney disease (CKD) by disease stage and the most common errors made with those medications. She also reviewed the over-the-counter medications that can be dangerous for patients with CKD. When prescribing for patients with CKD, Zuber reminded, go low, go slow, and rerun lab tests often.
