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Welcome to the October meeting issue of Metabolic and Endocrine eNews! This month we talk to some of the faculty for the upcoming Metabolic & Endocrine Disease Summit Fall (MEDS), which is being held in-person from October 12-14, 2023 in Orlando, Florida. MEDS Fall will bring you the latest cutting-edge knowledge and clinical breakthroughs in metabolic and endocrine diseases—diabetes, thyroid and adrenal disorders, obesity, and everything in between, to make a lasting difference in your patients’ lives!

Read on for candid insights from these faculty and tidbits from the upcoming MEDS Fall! Last month we spoke with Rick Pope on all things osteoporosis and rheumatology. If you missed it, click here!

Thank you to these thought leaders featured in this issue for their time and effort. Please contact me at colleen@cmhadvisors.com with comments or suggestions. Don’t forget to register and attend--MEDS is a one-stop shop to get you up to speed with CME, with an emphasis on interactivity via panel discussions, Q&A, and case studies. Hope we see you there!—Colleen Hutchinson

What’s Hot at MEDS Fall!

Faculty and participant affiliations can be found by clicking here.

Can you share takeaways from your MEDS 2023 presentation topic?

Wendy Wright/Hypertension: Resistant or Not?: Resistant hypertension is present in about 17% of all hypertensive patients in primary care. They are at a substantial risk for target organ damage. Getting their blood pressure to goal is a challenge. My biggest pearl for all of our attendees is: When you have used 3 medications and they are still not at goal, it is time to obtain metanephrines, aldosterone and plasma renin activity. These labs can dictate your next steps in controlling their blood pressure. 

David Doriguzzi/ Case Presentations in Thyroiditis: Thyroid disorders are not always what they appear to be. Sometimes the best treatment is just time.

Ashlyn Smith/ Adrenal Insufficiency Response: One of the biggest teaching points about adrenal insufficiency is the judicious use of testing. We see many folks inappropriately tested with random cortisol levels and subsequently inappropriately treated for adrenal insufficiency. Another area of concern is treatment for adrenal fatigue, which is not a supported diagnosis and treatment can have damaging long-term effects. I will also highlight the connection between adrenal insufficiency and a hot topic in medicine: immunomodulator therapy. 

Hypercalcemia Response: Calcium disorders can be particularly challenging to providers for a variety of reasons. We will review when “normal doesn’t mean normal” in hypercalcemia workup and when imaging is appropriate and when it is not. This will assist the clinician in making an appropriate timely diagnosis and avoid unnecessary studies (which equal additional cost and anxiety for the patient).

Christine Kessler/ Obesity Treatment: Who Should Take the Lead and How?: There are 4 primary takeaways from this session:

  1. Obesity/ overweight (adiposity) is a chronic, progressive, relapsing, multifactorial, inflammatory disease; overeating does not cause obesity—obesity causes overeating! (So stop the “blame & shame game.”) 
  2. The goal of weight loss is not reducing numbers on a scale, but improving metabolic health.
  3. Current pharmacotherapy and metabolic bariatric surgery (appropriately applied) are effective for weight loss—but lifestyle changes are foundational for the long term success of these weight loss interventions. 
  4. If not broached by the patient, the HCP should take the lead in initiating adiposity management, but implementation and maintenance of the weight loss journey must be a shared responsibility (both patient and provider).

Amy Butts: Insulin Options: Proper Utilization Through Case Studies?: Insulin use can seem overwhelming to both patients and providers. However, due to the progression of beta cell decline at the pancreas, insulin is a part of the treatment plan for those living with diabetes. This program will help providers initiate and titrate insulin in a step-wise, systematic way. The goal is for providers return home from the conference feeling confident about utilizing insulin in their practice.

Kim Zuber/ Diabetes and CKD Screening and Treatment: Who, When, Why?:

Hopefully everyone understands the importance of urine. It is a very missed lab, gives a lot of information, is prognostic in CKD and DKD, is non-invasive and costs next to nothing!

Joyce Ross/ Key Aspects of Metabolic Syndrome: What You Need to Know & Reaching the Heights of Optimal Cholesterol Management: Metabolic syndrome is a pervasive problem in our country today. It is not a disease but a syndrome that tells us about the metabolic condition of a person. Five important components are found in the syndrome but any three may be present for a person to have it. They are common and sometimes often neglected lab results, especially since many people today do not get regular physical exams that might disclose the syndrome. They are: elected glucose > 100 mg/dL, TGs > 150, HDL < 30 mg/dL in men and < 50 mg/dL in women, blood pressure > 130/>85 or person talking blood pressure medications, and elevated waist circumference > 40 “ in a man and > 35 inches for women. Often identification of this syndrome is the heralding event that causes a person to seek medical attention, which might consist of lifestyle management or lifestyle management and medications. Identifying these problems can well be instrumental in keeping a patient from developing diabetes mellitus. Annual physical exams as well as appropriate laboratory studies may be the most important key in prevention of diabetes and cardiovascular disease.

How would you describe the MEDS meeting to those who have not attended? For whom would this meeting and agenda be helpful?

Wendy Wright: This meeting delivers the latest in evidence-based practice guidelines to primary care providers by the nation’s leading NPs and PAs. It is a conference planned and delivered by NPs and PAs. Those who attend will be able to walk out of this meeting and translate what they have learned in their next clinic day. The speakers are the best of the best. It is a can’t miss meeting.

Ashlyn Smith: MEDS was created for PAs and NPs by PAs and NPs. MEDS is one of the only conferences that has true clinically relevant endocrine content for busy clinicians who are interested in, are new to, or want a refresher in endocrinology and diabetes.

David Doriguzzi: MEDS is a down-to-earth conference designed to help healthcare providers in a wide range of clinical settings become more current on endocrine-related topics. It’s hosted by normal people who happen to specialize in endocrine disease states, which creates a very approachable and relatable learning environment. Primary care, endocrinology, nephrology, urgent care, emergency medicine, and cardiology PAs & NPs would all find the MEDS conference uniquely beneficial.

Christine Kessler: This program generally targets primary care providers, who are the “tip of the spear” for identifying and initiating treatment of most endocrine disorders. This conference, taught by their peers in endocrinology, provides clinically useful tips to help them effectively and safely handle these challenging patients. It is also hoped to increase interest in, and preparation for, working in the intriguing field of endocrinology.

Amy Butts: MEDs is a very comprehensive meeting with speakers who have expertise on treating metabolic disorders. Metabolic and endocrine disorders are very common. Advanced practice providers in primary care, internal medicine, endocrinology, nephrology, and cardiology will all benefit from the lectures provided at this conference.

Kim Zuber: It is concentrated medicine of very common diseases taught by incredible speakers. It is the PA/NP experts teaching each other. We know what you need to know and what you already do know! And it is a great chance to ask all those questions you have wondered about…or get a curbside consult.

Joyce Ross: An amazing opportunity to meet with peers and discuss primary care concerns with leaders in the PA and NP space.