Society Recommends UNIVERSAL DIABETES TESTING AT FIRST PRENATAL VISIT
The Society was encouraged by the recommendation from the U.S. Preventative Services Task Force (USPSTF) when it released its recommendations in January calling for expectant mothers to be tested for gestational diabetes after 24 weeks of gestation. While the Society applauds the USPSTF, it recommends going a step further to identify undiagnosed type 2 diabetes cases before harmful pregnancy complications can develop.
The Society agrees that pregnant women who have not previously been diagnosed with overt or gestational diabetes should be tested at this stage of pregnancy. However, the Society also recommends universal diabetes testing for women at the first prenatal visit in its Diabetes and Pregnancy Clinical Practice Guideline published in the November 2013 issue of the Society’s Journal of Clinical Endocrinology and Metabolism. The test should be done before 13 weeks’ gestation or as soon as possible thereafter.
“Given that many cases of type 2 diabetes are undiagnosed, it’s important to ascertain early in pregnancy whether women have this condition,” says Ian Blumer, MD, of the Charles H. Best Diabetes Centre in Whitby, Ontario, Canada, and chair of the task force that authored the guideline. “Untreated diabetes poses serious risks to the mother and the fetus, so it is important to reduce the chance of complications through early diagnosis and treatment.”
As many as one in five women may develop gestational diabetes — a form of diabetes that has its onset during pregnancy. However, traditional testing strategies only identify about 25% of the cases. Women who go undiagnosed are at an increased risk of having an overly large baby, which can complicate delivery.
When pregnant women are screened for gestational diabetes at 24 to 28 weeks gestation, the Society recommends using a one-step testing approach in line with the consensus panel of the International Association of the Diabetes and Pregnancy Study Groups’ protocol. This involves pregnant women taking a 75-g oral glucose tolerance test, which is more sensitive and can help physicians diagnose more cases. This differs from the 50-g oral glucose challenge test, which is commonly used in the U.S. As the USPSTF noted in its statement, many pregnant women receive this test and are only given the oral glucose tolerance test if the first test yields abnormal results.
“The Society’s task force felt the overriding concern of pregnant women was to avoid complications that can harm the fetus,” Blumer says. “Using the more sensitive, one-step test supports the goal of early diagnosis and treatment.”
Other members of the Society task force that developed the Diabetes and Pregnancy Clinical Practice Guideline include: Eran Hadar of Helen Schneider Hospital for Women in Petach Tikva, Israel; David R. Hadden of Royal Victoria Hospital in Belfast, Northern Ireland; Lois J. Jovanovic of Sansum Diabetes Research Institute in Santa Barbara, Calif.; Jorge H. Mestman of the University of Southern California in Los Angeles; M. Hassan Murad of the Mayo Clinic in Rochester, Minn.; and Yariv Yogev of Helen Schneider Hospital for Women.
New from the Network — HYPOPITUITARISM
Visit www.hormone.org to download the Network’s latest fact sheet, Hypopituitarism, and help your patients learn more about this rare but treatable condition. The fact sheet defines hypopituitarism, lists its causes and symptoms, and describes the functions of various pituitary hormones. Patients are counseled that, while they may need life-long medication to replace the hormones they’re missing, they can still live long, healthy lives. Brief definitions and a list of suggested questions help patients have more informed conversations with their doctors.
ABIM NEW MOC Requirements
The American Board of Internal Medicine’s (ABIM) revised requirements for Maintenance of Certification (MOC) went into effect at the beginning of this year, bringing to fruition the new “continuous” MOC model that began transition in 2010.
The American Board of Medical Specialties (ABMS) — of which ABIM is a member — and ABIM believe that a more continuous MOC program helps physicians keep pace with the changes in the science of medicine and assessment. Beginning in January, ABIM is requiring more frequent participation in MOC and will be publicly reporting whether board certified physicians are “Meeting MOC Requirements,” regardless of initial certification date.
In order to continue to be reported as “Meeting MOC Requirements,” all ABIM Board Certified physicians wishing to maintain their certification need to complete an MOC activity by Dec. 31, 2015 and every two years thereafter. By Dec. 31, 2018 and every five years thereafter, to continue to be reported as “Meeting MOC Requirements,” all physicians will need to have earned 100 MOC points with at least 20 points in medical knowledge and 20 points in practice assessment. In addition, by Dec. 31, 2018 and every five years thereafter, physicians will need to fulfill a patient safety and a patient survey requirement. Every 10 years, physicians will also need to pass a secure exam in each certification area they choose to maintain. The points earned every two years will count toward the five-year requirement and also count toward the milestones for the certifications being maintained.
Physicians initially certified before 1990, the so-called “grandfathers” and “grandmothers,” are not required to participate in MOC to maintain certification, but in order to be publicly reported as “Meeting MOC Requirements,” they will need to enroll and engage in MOC. This includes participating in the requirements outlined above and taking a MOC exam by Dec. 31, 2023 and every 10 years thereafter.
“The Endocrine Society is committed to meeting the educational needs of its members … while helping them maintain their professional identity as diplomates of the ABIM,” says Graham McMahon, MD, Endocrine Society member and Clinical Endocrine Education Committee chair. “We’ve developed educational products for endocrinologists by endocrinologists to meet these needs; they are designed specifically to make the process as efficient, as effective, and as rewarding as possible,” he says.
Visit MOC2014.abim.org for more information about the new MOC program requirements. Contact the Endocrine Society at [email protected] and visit https://www.endocrine.org/education-and-practicemanagement/moc for help and information on available Medical Knowledge and Practice Assessment activities.
A WORLD OF OPPORTUNITY Awaits You at ICE/ENDO 2014
ENDO has always been an event with global significance — but the 2014 meeting promises to raise the bar to a new level.
For the first time in nearly 20 years, the Endocrine Society and the International Society of Endocrinology (ISE) are joining forces to host ICE/ENDO 2014, an extraordinary summit on hormone research and clinical practice.
Over 10,000 attendees are expected to arrive in Chicago in June — making it the world’s largest gathering of endocrinologists ever. This is truly a can’t miss event for anyone in the field — and a rare opportunity to interact with, collaborate with, and showcase your work to the widest audience of colleagues possible.
Making History — and Science and Geography, Too
All the best of ENDO — its bounty of abstracts, workshops, symposia, meet-the-professor, and master clinician sessions — are amplified with this collaboration. The inherent international nature of ENDO is augmented with an even broader array of speakers, topics, and global perspectives.
Founded in 1960, ISE represents a strategic network of 70 international endocrine societies that stimulates borderless cooperation, coordinates scientific discourse, and provides strategic support to member societies in developing nations. Each of the ISE regions — the Americas, Europe, Africa, Asia, and Oceania — will be represented at ICE/ENDO 2014.
The flagship of ISE remains its International Congress on Endocrinology (ICE), which is held every two years with one of its member societies around the world. Since the first ICE in 1960, Denmark, Mexico, Germany, Australia, Japan, Portugal, and the U.S. have all hosted the Congress.
ICE facilitates global perspectives on the clinical issues that endocrinologists deal with every day — such as management of gestational diabetes, metabolic bone disease, and the evaluation of thyroid nodules — as well as the diagnosis and treatment of rare disorders such as acromegaly, Cushing syndrome, and disorders of sexual development.
ICE in the Americas
The last joint meeting of ICE and ENDO on U.S. soil took place in 1996 in San Francisco. It was the 10th anniversary of the prestigious gathering and the second time ICE had come to the U.S. Now this truly global event returns to the U.S. at McCormick Place West in Chicago — home of the Willis (née Sears) Tower, second-tallest building in the U.S., Wrigley Field, and thriving arts and culinary communities.
“We’re excited to bring ICE to the Americas,” says Paul M. Stewart, secretary treasurer of ISE. “The Endocrine Society delivers an outstanding cutting-edge conference, and the partnership with ISE will provide the global endocrine community with the biggest and hopefully the best ICE ever!”