SGLT-2 Inhibitors for Type 2 Diabetes: Renal and Urinary Issues

Over the past 2 decades, increased clinical research has been focused on the sodium-glucose co-transporter 2 (SGLT-2) inhibitors for the management of type 2 diabetes mellitus (T2DM).
Over the past 2 decades, increased clinical research has been focused on the sodium-glucose co-transporter 2 (SGLT-2) inhibitors for the management of type 2 diabetes mellitus (T2DM).

This activity is provided by Haymarket Medical Education.

Faculty

George L. Bakris, MD, Professor of Medicine, Director, ASH Comprehensive Hypertension Center, Chicago, IL

David Cherney, MD CM, PhD, FRCP(C), Associate Professor of Medicine - University of Toronto, Clinician Scientist - Division of Nephrology, University Health Network, Toronto, Ontario, Canada

Release Date: December 10, 2015
Expiration Date: December 10, 2016
Estimated time to complete the educational activity: 60 minutes

Statement of Need: Over the past 2 decades, increased clinical research has been focused on the sodium-glucose co-transporter 2 (SGLT-2) inhibitors for the management of type 2 diabetes mellitus (T2DM). These medications target renal glucose reabsorption to reduce hyperglycemia. This unique mechanism of action allows for antihyperglycemic effects in combination with other oral antidiabetic medications, as well as with insulin. Potential benefits beyond glycemic control include weight loss and blood-pressure reduction; recent data show that these agents may actually reverse β-cell dysfunction and insulin resistance.

The safety of SGLT-2 inhibitors in T2DM patients with chronic kidney disease has remained questionable since the first agent in the class was approved. While initial studies have been reassuring in regard to renal safety, long-term data have been in short supply. In addition, it is well documented that the glycosuria that results from the use of these agents may result in a higher frequency of urinary infections and genital fungal infections.

This educational activity will provide learners with an improved understanding of the mechanism of action of the SGLT-2 inhibitor drug class; relay the differences in the various agents within the class; provide an update on safety and efficacy data; interpret the most recent information on potential benefits and risks; and illustrate practical treatment strategies to prevent and mitigate adverse events while maximizing the potential benefits.

Target Audience: Nephrologists and urologists who co-manage the care of patients with T2DM; primary care clinicians who treat patients with T2DM.

Learning Objectives: After completing the activity, the participant should be better able to:

  • Examine how individual patient characteristics may influence response to SGLT-2-inhibitor therapy
  • Assess data from recent clinical trials for potential renal benefits of SGLT-2 inhibitors
  • Formulate treatment plans to prevent/mitigate potential renal/urinary adverse events in patients with T2DM

Commercial Supporter

Supported by AstraZeneca, LP

Accreditation Statements

Physician Credit: Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical ­education for physicians.

Credit Designation: Haymarket Medical Education designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Academy of Physician Assistants (AAPA)

The AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a ­maximum of 1.00 hour of Category I credit for completing this program.

Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, HME requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs.

The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this CME/CE activity:

Faculty Disclosures

Name of Faculty Financial Relationship
George L. Bakris, MD

Dr. Bakris has received consulting fees from Boehringher Ingelheim, AbbVie, Takeda, Bayer, Relypsa, and Arbor.

David Cherney, MD CM, PhD, FRCP(C) Dr. Cherney has received consulting fees from Boehringher Ingelheim, Janssen, AstraZeneca, and Merck.


Staff/Planners' Disclosures

The planners and managers for this program reported the following ­financial relationships with commercial interests whose products or services may be related to the content of this CME activity: HME staff, planners, and reviewers have no relevant financial relationships to disclose.

Disclosure of Unlabeled Use

This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. Haymarket Medical Education does not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Haymarket Medical Education. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Method of Participation: There are no fees for participating in and receiving CME/CE credit for this activity. During the period of December 10, 2015, through December 10, 2016, participants must:

  1. Read the learning objectives and faculty disclosures;
  2. Complete the pre-assessment test;
  3. Study the educational activity;
  4. Submit the post-test online (clinicians may register at www.mycme.com);
  5. Complete the evaluation form online

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.

Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities


HOW TO TAKE THE POST-TEST: Click here after reading the article to take the post-test on myCME.com. To claim credit, you must complete the pre-assessment test, review the article, and complete the post-test and evaluation.

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