The Journal of family practice
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A Elbow and forearm with erythematous, well-demarcated, pink plaques with mild micaceous scale in a 42-year-old White woman. B Elbow and forearm with violaceous, well-demarcated plaques with micaceous scale and hyperpigmented patches around the active plaques in a 58-year-old Black man.
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• Type 1 diabetes (T1D) is an autoimmune disease that progresses through 3 distinct stages. • T1D can be diagnosed at any age, with a peak incidence at 10-14 years of age. • The incidence of T1D in the United States is rising. • Screening for T1D autoantibodies has positive clinical consequences, including reduction of diabetic ketoacidosis events, improved glycemic control, and positive impact on short- and long-term complications. • Primary care clinicians can play a critical role in promoting islet autoantibody screening.
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• Chronic kidney disease (CKD) is common, occurring in 1 of 7 adults in the United States. • 9 out of 10 adults with CKD are unaware of it. • People with CKD have the same risk for cardiovascular (CV) death as people with known atherosclerotic heart disease. • The risk for CV events and death increases with worsening albuminuria and estimated glomerular filtration rate (eGFR). • Patients with risk factors for CKD (hypertension, diabetes, family history of CKD, or advancing age) should be screened by measuring both eGFR and urinary albuminto-creatinine ratio. • Sodium-glucose cotransporter-2 inhibitors are first-line agents for treatment of patients with type 2 diabetes mellitus and CKD or a history of atherosclerotic CV disease. • Dapagliflozin has demonstrated equivalent efficacy for reducing kidney events in patients with CKD irrespective of diabetes status, and a similar, ongoing trial with empagliflozin may provide potential confirmation.
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At the end of the activity, participant will be able to: • Identify patients who could benefit from continuous glucose monitoring (CGM) vs fingerstick blood glucose monitoring. • List the types of information provided by CGM systems. • Interpret CGM data using the ambulatory glucose profile (AGP) to assess if the patient is achieving targets established by the International Consensus on Time in Range. • Modify the treatment plan based on CGM data to improve patient outcomes.
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At the end of the activity, participants will be able to: • Recognize obesity as a chronic, relapsing, serious disease warranting long-term management and early intervention to minimize disease burden and decrease associated morbidity and mortality. • Destigmatize obesity to initiate and enhance patient engagement. • Apply guideline-recommended care for screening, diagnosis, and individualized treatment of adults and others with obesity. • Incorporate practical practice management strategies.