Diabetes for the Internist
PRE 1001 Tuesday, 8:00 a.m.-5:00 p.m.
Harold E. Lebovitz, MD; Jay S. Skyler, MD, MACP; Lawrence A. Leiter, MD, FACP; Mary T. Korytkowski, MD, Member; Richard Kahn, PhD

The issues involved in the management of diabetes mellitus have become more complex and controversial as a result of several recently completed large clinical trials. It is becoming apparent that strategies for management should differ depending on the characteristics of the patients and the stage of their diabetes. This pre-course will provide the internist with the latest information about the abnormalities that underlie the development and progression of both type 1 and type 2 diabetes and how these abnormalities influence therapeutic decisions. It will emphasize the rationale and current controversies for the practical application of newer treatment strategies and pharmacologic agents. It will discuss the role of newer treatments as compared with older and cheaper generic treatments. The complex issue of prevention of diabetes, as well as the role of pharmacologic agents in decreasing ß-cell apoptosis or even increasing ß-cell mass, will be debated. The new field of matching genetic type with specific therapies will be presented. The emphasis throughout the course, where possible, will be on strategies to improve clinical outcomes rather than surrogate end points.

Learning Objectives:

1. Design glycemic treatment strategies on the basis of an analysis of the risk--benefit ratio of available pharmacologic agents presented by the newer clinical trials.
2. Effectively use available incretin mimetic and incretin-sparing therapies.
3. Develop insulin treatment programs that are appropriate for each individual patient and recognize the more recently appreciated dangers of severe hypoglycemia.
4. Use glucose-monitoring devices in a cost-effective manner.
5. Reduce clinical cardiovascular events by appropriately identifying and managing cardiovascular risk factors.