Mini-modules: Diabetes guideline update
Maximum: 1 CME cr.
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This program is composed of three mini-modules, with an estimated duration of around 10-15 minutes each.

1. Understand how KDIGO guideline are developed and introduce the new KDIGO format

2. Understand how to monitor HbA1c and what the glycemic targets should be in patients with diabetes and chronic kidney disease (CKD)

3. Understand the role of lifestyle modification and anti-hyperglycemic therapies, including novel therapies like SGLT2 inhibitors and GLP-1 receptor agonists, in patients with diabetes and CKD

4. Understand the approaches to care in patients with diabetes and CKD, including comprehensive care, self-management education, and team care

1. IDF Atlas 2017. http://www.diabetesatlas.org/IDF_Diabetes_Atlas_8e_interactive_EN/
(Accessed March 12, 2018)

2. American Diabetes A. 10. Microvascular Complications and Foot Care: Standards of
Medical Care in Diabetes-2018. Diabetes Care 2018; 41:S105-S18.

3. Villar E, Chang SH, McDonald SP. Incidences, treatments, outcomes, and sex effect on
survival in patients with end-stage renal disease by diabetes status in Australia and New
Zealand (1991 2005). Diabetes Care 2007; 30:3070-6.

4. USRDS 2013 Annual Data Report: Atlas of Chronic Kidney Disease and End Stage Renal
Disease in the United States 2013. at http://www.usrds.org/2013/pdf/v2_ch12_13.pdf.)

5. Ninomiya T, Perkovic V, de Galan BE, et al. Albuminuria and kidney function independently
predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20:1813-
21.

6. Toyama T, Furuichi K, Ninomiya T, et al. The impacts of albuminuria and low eGFR on the
risk of cardiovascular death, all-cause mortality, and renal events in diabetic patients:
meta-analysis. PloS one 2013; 8:e71810.

7. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention
on mortality in type 2 diabetes. N Engl J Med 2008; 358:580-91.

8. Gregg EW, Li Y, Wang J, et al. Changes in diabetes-related complications in the United
States, 1990-2010. N Engl J Med 2014; 370:1514-23.

9. Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular
outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345:861-
9.

10. Lewis E, Hunsicker L, Bain R, Rhode R. The effect of angiotensin-converting-enzyme
inhibition on diabetic nephropathy. N Engl J Med 1993; 329:1456-62.

11. Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor
antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med
2001; 345:851-60.

12. Marso SP, Daniels GH, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes
in Type 2 Diabetes. N Engl J Med 2016; 375:311-22.

13. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and
Mortality in Type 2 Diabetes. N Engl J Med 2015; 373:2117-28.

14. Mann JFE, Orsted DD, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2
Diabetes. N Engl J Med 2017; 377: 839-48.

15. Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and Progression of Kidney Disease in
Type 2 Diabetes. N Engl J Med 2016; 375:323-34.

16. Wanner C, Inzucchi SE, Zinman B. Empagliflozin and Progression of Kidney Disease in Type
2 Diabetes. N Engl J Med 2016; 375:1801-2.

17. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events
in Type 2 Diabetes. N Engl J Med 2017; 377:644-57.

18. Ruospo M, Saglimbene VM, Palmer SC, et al. Glucose targets for preventing diabetic
kidney disease and its progression. Cochrane Database of Systematic Reviews 2017, Issue
6. Art. No: CD010137. DOI: 10.1002/14651858.CD010137.pub2.

Satisfactory Completion
Learners must complete an evaluation form to receive a certificate of completion. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your licensing/certification requirement.

The ISN Academy, made available on https://academy.theisn.org and organized by International Society of Nephrology (ISN), is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to provide the following CME activity for medical specialists.

Each medical specialist should claim only those credits that he/she actually spent in the educational activity. The EACCME is an institution of the European Union of Medical Specialists (UEMS). Only those e-learning materials that are displayed on the UEMSEACCME website have formally been accredited.

Through an agreement between the European Union of Medical Specialists (UEMS) and the American Medical Association (AMA), physicians may convert EACCME credits to an equivalent number of AMA PRA Category 1 CreditsTM. Information on the process to convert EACCME credit to AMA credit can be found at www.ama-assn.org/education/earn-credit-participation-international-activities.

Date of Release
01/31/2020

Date of Expiry
​10/01/2021

There are significant financial interests or financial benefits directly related to the author's work for The International Society of Nephrology:
Consulting for Boehringer-Ingelheim, George Clinical, Goldfinch Bio, and Ironwood. Equipment and supplies for research donated by Medtronic and Abbott.

Mini-modules: Diabetes guideline update

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