Medical Education Library

Type 2 Diabetes and Its Complications: A Focus on the Kidneys . . .


A CME-certified supplement to Family Practice News supported by an educational grant from Boehringer Ingelheim. Jointly sponsored by University of Louisville Continuing Health Sciences Education and Global Academy for Medical Education.

This activity was written from interviews with the faculty.

Click Here to view the supplement.


Yehuda Handelsman, MD–Chair
Medical Director
Metabolic Institute of America
Tarzana, CA

Stuart Shankland, MD
Belding H. Scribner Endowed Chair of Medicine
Head, Division of Nephrology
University of Washington School of Medicine
Seattle, WA

Dace Trence, MD
Assistant Professor of Medicine
Director, Diabetes Care Center
University of Washington School of Medicine
Seattle, WA

Virginia Valentine, NP
Clinical Nurse Specialist, Diabetes
CEO, Diabetes Network
Albuquerque, NM

Topic Highlights

  • Improving Screening and Diagnosis of Patients With Type 2 Diabetes Mellitus
  • Managing Patients With Type 2 Diabetes Mellitus: Tight Control Reduces Complications
  • Understanding Diabetic Kidney Disease: Current Insights
  • Clinical Pearls and Questions From the Diabetes Educator’s Office

Target Audience

This educational activity is designed for endocrinologists, primary care physicians, nurses, diabetes educators, and other clinicians who treat patients with type 2 diabetes mellitus.

Educational Needs

The burden of type 2 diabetes mellitus (T2DM), in terms of morbidity, mortality, complications, and economic burden, is high and is predicted to rise even further. According to estimates from the US Centers for Disease Control and Prevention (CDC), between 7% and 8% of the population has T2DM, but this is projected to increase to 30% of the population within the next 30 years. The greatest increases are estimated to occur in African Americans and Hispanics, and in women (regardless of race or ethnicity). In addition, although diabetes screening has long been recommended for individuals beginning at around 50 years of age, this is no longer the case. Given the changing—and already altered—demographics of T2DM, clinicians should be monitoring for the disease in all patients over 30 years of age. Both microvascular (retinopathy, neuropathy, and nephropathy) and macrovascular (cardiovascular diseases) complications are consequences of less-than-optimal control of several important clinical parameters in patients with existing T2DM. Therefore, it is crucial that health care providers focus not only on good control of serum glucose but also on blood pressure and lipids as well. This supplement is designed to provide needed updates in the identifi cation and treatment of patients with T2DM, in order to reduce complications and the societal/medical burden of this disease.

Learning Objectives

By reading and studying this educational supplement, participants should be able to:

  • Describe the potential for increased morbidity and accelerated mortality of suboptimally managed T2DM.
  • List the risk factors for T2DM and discuss the recommendations for the screening and diagnosis of this disease.
  • Discuss methods for identifying patients who may be at high risk for microvascular complications and explain the particular testing and treatment needs of patients who are at risk for renal impairment or failure.
  • Critically review and, as necessary, revise existing strategies for building a multidisciplinary, collaborative approach to enhance communication among colleagues, educate patients, and improve treatment, as well as to locate and use quality assessment tools and guidelines.
  • Demonstrate improved expertise in the management of patients with T2DM pharmacologic selection and explain the safety and efficacy profiles of antihyperglycemic agents when they are used in combination and/or with insulin.


Dr Handelsman has received grant/research support from Daiichi Sankyo, GlaxoSmithKline, Novartis, Novo Nordisk Inc., Takeda, sanofi - aventis, Tolerx, and XOMA. He has also received honoraria for being a consultant and/or serving on the speakers bureau for AstraZeneca, Bristol-Myers Squibb Company, Daiichi Sankyo, Gilead, Genentech, GlaxoSmithKline, Merck, Novartis, Takeda, Thetys, Tolerx, and XOMA.

Dr Handelsman is on the editorial advisory board of Clinical Endocrinology News.

Dr Trence has been a shareholder of Medtronic and sanofi -aventis.

Dr Shankland has no relevant financial relationships with any commercial interests.

Ms Valentine has received honoraria for being a consultant and/or serving on the speakers bureau and/or being a member of an advisory board for Amylin, Abbott Diabetes Care, Asante Solutions Inc., Boehringer Ingelheim, Calibra, Cequr, Dexcom, Intuity Medical, Eli Lilly and Company, Medtronic, F. Hoffman-La Roche Ltd., Pamlab, Takeda, and Tandem Pumps.

CHSE committee members have no relevant fi nancial relationships with any commercial interests: Carolyn Burns, MD; Dedra DeBerry, MA; Joyce Dunagan, MA, MSLS; Linda H. Freeman, DNS, RN; Terri Gipson, MSL; Ruth Greenberg, PhD; Lucy Juett, MS; Irene Litvan, MD; Loretta Maldaner; Mike Mansfi eld, DMD; Ashlee Melendez, RN, BSN; Lisa J. Pfi tzer, MD; Robert Sexton, MD; Uldis Streips, PhD; Kathy M. Vincent, MD; Lori Wagner, MD; Stephen Wheeler, MD; and Sharon Whitmer, EdD. CHSE offi ce staff members Jim Creg, Kim Moore, and Joyce Korfhage have no relevant relationships with any commercial interests.

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