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EXCEMED Blended EducationCardiometabolic disorders in clinical practice:

a comprehensive updateHo Chi Minh City, Vietnam

8-9 September 2018

Dear Participants,

On behalf of EXCEMED, it is my pleasure to welcome you to the live intervention element of yourLearning Journey, Cardiometabolic disorders in clinical practice: a comprehensive update.

This face-to-face learning experience consists of five plenary sessions and one parallel session inworking groups with frontal lectures, interactive debates and clinical case discussions.

The learning continues after the live intervention.

Visit your Learning Journey page after the face-to-face meeting to access the in-depth interactivetutorials. Review key messages from the meeting with a concept map video and delve into bloodpressure targets after SPRINT with a video contribution by Prof. S. Taddei (Italy).We also welcome your presence in the private Facebook group which is accessible through yourpersonal Journey Page. Network with colleagues and discuss what you learned here in Ho ChiMinh City.Complete the entire journey – including the assessment surveys – and get access to a Diplomasigned by the Chairs as well as the final Outcomes & Feedback Report.

We look forward to seeing you in person and online!

Yours sincerely,

Alessia AddessiSenior Programme ManagerEXCEMED

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OverviewCardiometabolic disorders are the major cause of morbidity and mortality worldwide, and areintrinsically linked with diabetes, a devastating disease affecting more than 400 million people.Diabetes is the leading cause of cardiovascular disease, end-stage renal disease, blindness andnon-traumatic lower-limb amputation, as well as negatively affecting pregnancy outcomes andthe nervous system. However, diabetes and its complications can be avoided. A huge number ofpeople suffer from initial alterations in glucose metabolism, known as "pre-diabetes". Thesepeople are at higher risk of developing overt diabetes in the coming years, but evidence shows theprogression towards diabetes can be halted. Prompt intervention, with significant changes inlifestyle and/or implementation of appropriate pharmacotherapy, are effective strategies toprevent diabetes in at-risk people. To facilitate this, healthcare professionals should be updatedwith the most recent and compelling evidence about diabetes prevention. For those with overtdiabetes, relentless effort should be expended to avoid the debilitating complications of thedisease and to increase life expectancy. Knowledge and understanding of the complexpharmacological mechanisms and their clinical implementation will facilitate successfulmanagement of diabetes.

Like diabetes, thyroid disorders are among the most prevalent endocrine diseases that alsoimpact cardiovascular homeostasis. Unfortunately, a great number of patients with thyroiddiseases are undiagnosed, contributing to increased morbidity and reduced quality of life.Therefore, there is a need for clear recommendations allowing for effective and promptrecognition of the most frequent thyroid disorders in order to adequately treat patients and avoidadverse clinical outcomes.

Finally, hypertension is still the primary cause of death in the world and medicine is far fromestablishing adequate control of this cardiovascular risk factor. Recently, new aggressive targetsfor antihypertensive treatment were proposed, but it is not clear if scientific evidence justifies thistherapeutic strategy. Additional discussion surrounds the issue of applying the results ofcontrolled clinical trials to daily life. The role of combination treatment in hypertension and recentnovelties in the availability of fixed dose formulations will also be discussed.

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Cardiometabolic disorders in clinical practice: a comprehensive update

ONLINEPREPARATORYTUTORIALS

July 2018

LIVEINTERVENTION8-9 September 2018

ONLINEIN-DEPTHTUTORIALSOctober 2018

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An EXCEMED Learning JourneyEXCEMED is involved in a comprehensive educational blended journey to increase knowledge incardiometabolic diseases. This programme will address the most recent advancements ofresearch in the areas of cardiometabolic medicine and will discuss the best approaches forclinical management of the complex cardiometabolic patient in daily practice. A multistepapproach will be used, encompassing web-based and live activities. All activities – in-person andonline – will involve the full interactivity of learners.

Learning objectivesBy attending this programme, you will be able to: • Implement the most cost-effective strategies for diabetes prevention• Correctly diagnose thyroid disorders in the general population• Identify specific blood pressure targets for each patient with hypertension

Target audienceThis programme is designed for general practitioners, cardiologists, endocrinologists andinternists managing diabetes and cardiometabolic diseases in the Asia-Pacific region.

ChairsThy Khue NguyenUniversity of Medicine and PharmacyHo Chi Minh City, Vietnam

Ho Huynh Quang Tri Heart InstituteHo Chi Minh City, Vietnam

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ONLINE PREPA

RAT

ORY TU

TORIALS

ONLINE PREPARATORY TUTORIALSJuly 2018

CME ProviderEXCEMED is a non profit foundation dedicated, since the last four decades, to the development ofhigh-quality medical education programmes all over the world.

EXCEMED adheres to the guidelines and standards of the European Accreditation Council forContinuing Medical Education (EACCME®) which states that continuing medical education must bebalanced, independent, objective and scientifically rigorous.

EXCEMED - Excellence in Medical EducationSenior Programme Manager: Alessia AddessiT +39 06 420413 591 - F +39 06 420413 [email protected]

Medical Advisors: Ernesto Maddaloni and Stefano Taddei

EXCEMED adheres to the principles of the Good CME Practice group (gCMEp).

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This programme has been endorsed by the Vietnam National Heart Association (VNHA) of the HCMC Cardiology Association and the HCMC Association of Diabetes and Endocrinology.

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LIVE

INTE

RVE

NTION


July 2018



PREPARATORY INTERVIEWThe first exclusive tutorial is an interview with Prof P. Pozzilli (Italy) which highlights the importanceof diabetes prevention. This online educational tool is facilitated by the video-scribing techniqueand it enables to: • Understand the importance of an effective diabetes screening• Learn how to identify subjects at increased risk of diabetes

LIBRARYThe second exclusive tutorial helps illuminate the content of the live intervention, giving you thehead start you need to be fully engaged during the in-person learning. You are also able to shareyour research and publications with the rest of the community using the library platform, andsubmit questions directly to faculty ahead of the live intervention. You can look forward to yourquestion being addressed by faculty during theliv Q&A sessions.

Features of the interactive library: – Literature corner: summarises the key points and related publications for each of the lecturesbeing presented during the live intervention in Ho Chi Minh City.

– Publications exchange: contains a section for learners to share their research and publicationsrelated to your Learning Journey.

– Question time: a chance for leaners to submit a question for the faculty to answer during thelive intervention.

ONLINE PREPARATORY TUTORIALSJuly 2018

LIVE INTERVENTION8-9 September 2018

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The live component of the Learning Journey is a combination of frontal lectures followed byinteractive Q&A sessions, case-study-based debates, interactive clinical cases and working groups.You will be notified by email when the video lectures, slide kits and a scientific highlights publicationfrom the live intervention are available online.

LEARNING OBJECTIVESBy attending this live educational conference you will be able to:• Acquire knowledge about the obesity and pre-diabetes emergency• Personalize diabetes treatment• Manage most prevalent thyroid disorders• Tailor the appropriate treatment in hypertensive patients

VenueThis conference takes place at the:Intercontinental Saigon hotelHai Bà Trưng, Bến Nghé, Quận 1Ho Chi Minh City, Vietnam

LanguageThe official language of the live intervention is English.

For any logistic inquiry, please contact:Meridiano Congress InternationalEvent Manager: David H. SlangenT +39 06 88595 250 - F +39 06 88595 [email protected]

LIVE INTERVENTION8-9 September 2018


July 2018



Continuing medical educationThe “Cardiometabolic disorders in clinical practice: a comprehensive update”, Ho Chi Minh City,Vietnam, 08/09/2018 - 09/09/2018 has been accredited by the European Accreditation Council forContinuing Medical Education (EACCME®) with 9 (nine) European CME credits (ECMEC®s). Eachmedical specialist should claim only those hours of credit that he/she actually spent in theeducational activity.

Through an agreement between the Union Européenne des Médecins Spécialistes and theAmerican Medical Association, physicians may convert EACCME® credits to an equivalentnumber of AMA PRA Category 1 Credits TM . 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.

Live educational activities, occurring outside of Canada, recognised by the UEMS-EACCME® forECMEC®s are deemed to be Accredited Group Learning Activities (Section 1) as defined by theMaintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.

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Legend: L : Lecture CS : Case study : Case presentation : Discussion : Working groups

FACULTY

George J. KahalyDepartment of MedicineGutenberg University Medical CenterMainz, Germany

Ernesto MaddaloniUniversity Campus Bio-Medico (UCBM)Rome, Italy

Giuseppe ManciaUniversity of Milano-BicoccaMilan, Italy

Mafauzy MohamedUniversity Sains Malaysia Health Campus Kelantan, Malaysia

Thy Khue NguyenUniversity of Medicine and PharmacyHo Chi Minh City, Vietnam

Nemencio Almare Nicodemus JrDepartment of MedicineUniversity of the Philippines-College of MedicineManila, Philippines

Dang Van PhuocVietnam National UniversitySchool of MedicineHo Chi Minh City, Vietnam

Paolo PozzilliUniversity Campus Bio-Medico (UCBM)Rome, Italy

Ho Huynh Quang Tri Heart InstituteHo Chi Minh City, Vietnam

Kun-Ho YoonDepartment of Endocrinology & MetabolismSeoul St. Mary's HospitalSeoul, Korea

Saturday, 8 September 2018

08.45 Welcome and introductionN.T. Khue and H.H.Q. Tri (Vietnam)

Chairs: N.T. Khue and H.H.Q. Tri (Vietnam)

09.00 L1: The diabetes pandemic E. Maddaloni (Italy)

09.20 L2: Metabolic and clinical changes of pre-diabetes P. Pozzilli (Italy)

09.40 L3: How to recognize people with pre-diabetes K.H. Yoon (Korea)

10.00 Discussion

10.20 Coffee break


10.50 L4: Obesity – a contemporary issue creating future problems N.T. Khue (Vietnam)

11.10 L5: Keywords for pre-diabetes managementP. Pozzilli (Italy)

11.30 L6: Is treatment of pre-diabetes cost-effective?M. Mohamed (Malaysia)

11.50 Discussion

12.15 Lunch

Why you should worry about pre-diabetes, and how to recognize itSession I

Treating pre-diabetesSession II

PROGRAMME

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13.15 CS1: Newly diagnosed type 2 diabetes

Case presentation • Start with lifestyle intervention only K.H. Yoon (Korea)• Immediately start with drug therapy P. Pozzilli (Italy)

Discussion

14.15 CS2: Frail elderly patients with type 2 diabetes

Case presentation • Intensify monotherapyM. Mohamed (Malaysia)• Add-on therapy E. Maddaloni (Italy)

Discussion

15.15 Coffee break


15.45 CS3: Subclinical hypothyroidismG.J. Kahaly (Germany)

16.15 CS4: Hypothyroidism during pregnancyG.J. Kahaly (Germany)

16.45 CS5: Thyroid cancer N.A. Nicodemus Jr (Philippines)

17.15 End of the first day

Thyroid disorders: diagnosis is keySession IV

Diabetes treatment debate – different patients, different solutionsSession III

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Sunday, 9 September 2018

Chairs: D.V. Phuoc and H.H.Q. Tri (Vietnam)

09.00 L7: Blood pressure targets in hypertensive patients: European guidelinesG. Mancia (Italy)

09.20 L8: Are blood pressure targets proposed after the SPRINT study realistic in clinicalpractice?D.V. Phuoc (Vietnam)

09.40 L9: New possibilities for fixed-dose combination treatment in hypertensionH.H.Q. Tri (Vietnam)

10.00 Discussion

10.20 Coffee break

This session includes two different parallel workshops, each lasting 1 hour. Participants willbe divided into groups and will attend both workshops in rotation. By the end of the sessioneach participant will have attended both workshops.

WG1: Complex patient with hypertension: when a beta-blocker is neededH.H.Q. Tri (Vietnam)

WG2: Complex patient with hypertension: when combination therapy is neededD.V. Phuoc (Vietnam)

12.50 Back to plenary and take-home messages from the working groups

13.00 End of the live educational conference

Closing lunch

Management of hypertensionSession V

Working groups on hypertension management 10.50-12.50Session VI

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EXCEMED adheres to guidelines of the European Accreditation Council for Continuing MedicalEducation (EACCME®) and all other professional organizations, as applicable, which state thatprogrammes awarding continuing education credits must be balanced, independent, objectiveand scientifically rigorous. Investigative and other uses for pharmaceutical agents, medicaldevices and other products (other than those uses indicated in approved productlabelling/package insert for the product) may be presented in the programme (which may reflectclinical experience, the professional literature or other clinical sources known to the presenter).We ask all presenters to provide participants with information about relationships withpharmaceutical or medical equipment companies that may have relevance to their lectures. Thispolicy is not intended to exclude faculty who have relationships with such companies; it is onlyintended to inform participants of any potential conflicts so that participants may form their ownjudgements, based on full disclosure of the facts. Further, all opinions and recommendationspresented during the programme and all programme-related materials neither imply anendorsement nor a recommendation on the part of EXCEMED. All presentations represent solelythe independent views of the presenters/authors.

The following faculty provided information regarding significant commercial relationships and/ordiscussions of investigational or non-EMEA/FDA approved (off-label) uses of drugs:

George J. Kahaly Declared no potential conflict of interests.

Ernesto Maddaloni Declared receipt of grants and contracts from Astrazeneca and ofhonoraria and consultation fees from Merck.

Giuseppe Mancia Declared receipt of honoraria or consultation fees from: Boheringer,Daiichi Sankyo, Ferrer, Medtronic, Menarini, Merck, Novartis, Recordati,Servier.

Mafauzy Mohamed Declared receipt of grants and contracts from MSD, Boheringer, Abbvieand of honoraria or consultation fees from: Merck, Lilly, Pfizer, NovoNordisk, Novartis, Servier. He declared participation in a companysponsored speaker’s bureau: Merck, Lilly, Pfizer, Novo Nordisk, Novartis,Servier.

Thy Khue Nguyen Declared receipt of honoraria or consultation fees from: Astrazeneca,Boheringer, Merck, Novo Nordisk, Sanofi Aventis, Novartis, Servier.

FACULTY DISCLOSURES

Nemencio Almare Nicodemus Jr Declared no potential conflict of interests.

Dang Van Phuoc Declared no potential conflict of interests.

Paolo Pozzilli Declared receipt of grants and contracts from Astrazeneca andof honoraria and consultation fees from Ely Lilly.

Ho Huynh Quang Tri Declared receipt of honoraria or consultation fees from Merckand Menarini.

Kun-Ho Yoon Declared to be member of an Industry advisory board, board ofdirectors or other similar groups: MSD APAC, Sanofi, NovoNordisk. He declared also benefit from a relationship with acommercial enterprise: MSD APAC, Sanofi, Novo Nordisk, LG,Lilly, Astellas, Astra Zeneca, J&J, Hanmi, Takeda.

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BIOGRAPHIES

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Ernesto Maddaloni is a consultantendocrinologist at his home institution,Campus Bio-Medico University of Rome, Italy,were he graduated in Medicine in 2010 andcompleted his clinical fellowship inEndocrinology and Metabolic Disorders in2016. In 2014, he moved to Boston for a Post-Doctoral Research Fellowship at the VascularCell Biology Section of the Joslin DiabetesCenter (Harvard Medical School) focusing onthe study of aging adults with autoimmunediabetes and the interplay between vascularcomplications, bone health and autoimmunity.As a Mentee of the “European Foundation forthe Study of Diabetes (EFSD) Future LeadersMentorship Programme”, Dr Maddaloni hasjoined since 2017 the Diabetes Trial Unit of theUniversity of Oxford, Oxford Centre forDiabetes Endocrinology and Metabolism(OCDEM) where he is actually pursuing hisstudies on clinical diabetes and cardiovascularoutcomes.Dr Maddaloni has acted as study investigatorand coordinator in several national andinternational clinical trials and has publishedas leading author in several top-ranked peer-reviewed international medical journals.

His scientific achievements have beenrecognized with several awards, including the"2015 Albert Renold fellowship” of theEuropean Foundation for the Study ofDiabetes, the "2017 Young Investigator Award"of the Italian Society of Endocrinology (SIE)and the "2017 Early Investigator Award" of theEndocrine Society, USA.

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Ernesto Maddaloni

University Campus Bio-Medico (UCBM)Rome, Italy

George J. Kahaly, M.D., Ph.D. holds the rank ofProfessor of Medicine and Endocrinology /Metabolism and is chief physician of theendocrine outpatient clinic at the JohannesGutenberg University (JGU) Medical Center,Mainz, Germany. Dr. Kahaly chairs theORPHAN JGU expert center for Graves’orbitopathy and polyglandular autoimmunesyndromes.Dr. Kahaly directs the Molecular ThyroidResearch Laboratory of JGU and has authored247 original papers and reviews, coveringclinical and experimental aspects of endocrineautoimmunity, immunogenetics of thyroid andpolyglandular autoimmunity, as well ascardiovascular involvement of metabolicdisorders. Original papers and reviews havebeen published in the New England Journal ofMedicine, Lancet, Jama, Clinical Chemistry,the Journal of Autoimmunity, the Journal ofClinical Endocrinology and Metabolism, theJournal of Nuclear Medicine, Endocrinology,Thyroid, Endocrine Reviews, Nature Reviewsand Autoimmunity Reviews.Dr. Kahaly is Editor of the Journal of ClinicalEndocrinology & Metabolism, official Organ ofthe American Endocrine Society.

In the years 2009-2012, Dr. Kahaly served asAssociate Editor of the journal Thyroid, officialjournal of the American Thyroid Association(ATA). Dr. Kahaly is also member of theEditorial Board of the European ThyroidJournal, official journal of the EuropeanThyroid Association (ETA). Further, he iscurrently member of the scientific programorganizing committee (POC) of the 2020international thyroid congress.Dr. Kahaly served as Treasurer and principleofficer of the Executive Committee of the ETAbetween 2007 and 2016. He currently serveson the Public Health Committee of the ATA. Inthe years 2012-2015, Dr. Kahaly has beenactive member of the ATA ResearchCommittee, in 2007-2011, of the ATA Financeand Audit Committee, and in 2000-2006member of the ATA Membership andPublication Committees. Further, Dr. Kahaly isthe Treasurer of the European Group onGraves’ orbitopathy, official subgroup of theETA. In the years 2005-2011, he was memberof the Executive Committee of the GermanThyroid Board.

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George J. Kahaly

Department of MedicineGutenberg University Medical CenterMainz, Germany

Mafauzy Mohamed is currently a Professor ofMedicine and Senior ConsultantEndocrinologist in University Sains Malaysia.He was formerly the Assistant Vice-Cancellor,Director of Campus, Director of Hospital andDean of Medicine in the same university inKelantan, Malaysia. He obtained his M.B.B.S.from the University of Adelaide, Australia in1980. He was appointed as a Lecturer after hereceived his M.R.C.P (UK) in 1985. He alsoobtained his Masters of Medical Sciences fromUniversity of Sheffield in 1987. He waspromoted to Associate Professor in 1992. In1996, he was admitted as Fellow of RoyalCollege of Physicians (Edinburgh) and in 2000he was promoted as full Professor ofMedicine. He also received an HonoraryDoctor of Medicine degree from InternationalMedical University in 2017.He is actively involved in the field ofendocrinology and diabetes. He has alsoserved as an examiner for the Royal College ofPhysicians, United Kingdom and has beenappointed by several universities as ExternalExaminer for Professional Examinations atboth undergraduate and postgraduate levelsand also as Masters and PhD theses examiner.

Dr. Mafauzy is also actively involved in researchand has to date obtained over 110 researchgrants mainly in the field of diabetes,dyslipidemia and thyroid disorders includingmany clinical trials, including CV and renaloutcome trials, relating to diabetes andmetabolism. He has supervised over 25postgraduate students and has published over110 papers in national and internationalJournals, presented over 100 papers innational and international meetings and hasbeen invited to give over 500 lectures innational and international meetings. He hasbeen Chief Editor of the Malaysian Journal ofMedical Sciences, Journal of ASEANFederation of Endocrine Societies and Journalof Endocrinology and Metabolism. He is also aCouncil Member of the Malaysian MedicalCouncil and is actively involved in accreditationand recognition of medical programmes by theMalaysian Medical Council and MalaysianQualifications Agency.

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Mafauzy Mohamed

University Sains Malaysia Health Campus Kelantan, Malaysia

Giuseppe Mancia is Professor Emeritus of theUniversity Milano-Bicocca. He is also Presidentof the Italian Foundation on “Ricerca eInnovazione su Ipertensione e ProtezioneCardiovascolare” and of the Foundation of theEuropean Society of Hypertension(ESH) inZurich. He serves since 2008 as Chairman ofthe Joint Board of the Italian Scientific Societiesoperating in the area of cardiovascularprevention.He has served as President of the InternationalSociety of Hypertension, President of theEuropean Society of Clinical Investigation,Chairman of the Working Group onHypertension and the Heart of the ESC,member of the Executive Scientific Committeeof ESC, President of the Italian Society ofHypertension (1997-1999) and President ofESH. He has been member ex-officio (onlyEuropean) of the Executive Council of theAmerican Society of Hypertension, Officer forthe ISH Forum of National Societies, memberof the Committee on Cardiovascular Drugs andTherapy of the World Heart Federation andmember of the Writing Committee of the ESCguidelines on Prevention of CardiovascularDiseases, the WHO/ISH Guidelines on

Hypertension and the Guidelines onHypertension in the Elderly of the AmericanCollege of Cardiology. He has chaired theCommittee on the ESH-ESC guidelines onHypertension, the WHO/ISH LiaisonCommittee, and the Scientific and OrganisingCommittees of various ESH Meetings. He iscurrently Chairman of the Educational Board ofESH.His research interests focus on epidemiologypathophysiology, diagnosis and treatment ofhypertension, heart failure, and coronarydisease, as well as on the clinical aspects ofdiabetes, obesity and other metabolicabnormalities. His expertise includesambulatory blood pressure monitoring,neurohumoral control of the circulation, largeartery mechanics, hemodynamic changes ofcardiovascular drugs, cardiovascular regulationduring stress and sleep as well as epidemiologyand intervention trials in hypertension anddiabetes.

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Giuseppe Mancia

University of Milano-BicoccaMilan, Italy

Nemencio Almare Nicodemus Jr obtained hisdegree of Doctor of Medicine at the Universityof the Philippines - College of Medicine. Hesubsequently did his residency training inInternal Medicine and fellowship training inEndocrinology, Diabetes and Metabolism atthe Philippine General Hospital. Subsequently,he went to the Mayo Clinic in Rochester,Minnesota as part of the Visiting ClinicianProgram.He is a Professor at the University of thePhilippines - College of Medicine, Departmentof Biochemistry & Molecular Biology, wherehe was awarded the Most Outstanding MedicalTeacher in the Basic Sciences. He is also aClinical Professor at the Department ofMedicine of the Philippine General Hospitalwhere he was recognized by the University ofthe Philippines Medical Alumni Society inAmerica as Best Teacher.He is currently the Vice President of thePhilippine Society of Endocrinology, Diabetesand Metabolism (PSEDM), a director of thePhilippine Association For The Study ofOverweight and Obesity, Asian Alliance for theStudy of Neuroendocrine Tumors andPhilippine Thyroid Association.

He is the Associate Editor of the Journal of theASEAN Federation of Endocrine Societies(JAFES).

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Nemencio Almare Nicodemus Jr

Department of MedicineUniversity of the Philippines-College of MedicineManila, Philippines

Thy Khue Nguyen is Associate ProfessorEmeritus, Department of Endocrinology,University of Medicine and Pharmacy, Ho ChiMinh City. She is immediate Past President ofthe Vietnam Association of Diabetes andEndocrinology, President of HCMC Diabetesand Endocrinology Association, Vice Presidentof HCMC Medical Association, Member of TheEndocrine Society, United States, SeniorConsultant at Hospital 115 HCMC and Head ofEndocrinology Division at MEDIC HCMC. Her studies are mainly on Epidemiology ofdiabetes in South Vietnam diabeticnephropathy, lipid disorders in diabetes,hypoglycemia in DM, diabetic keto- acidosis,thyroid disorders in pregnancy.

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Thy Khue Nguyen

University of Medicine and PharmacyHo Chi Minh City, Vietnam

Paolo Pozzilli, MD trained in Medicine andspecialized in Endocrinology & MetabolicDiseases from Sapienza University of Rome,Italy, under the guidance of Professor DomenicoAndreani. He worked mainly in the field ofdiabetes with particular focus to type 1 diabetes(T1D) pathogenesis and prevention in Rome andin the UK, and in collaboration with severalinvestigators worldwide. Internationally he setup with others the EURODIAB study on theincidence of childhood T1D, that is the mostcomprehensive mapping of the incidence of T1Din Europe. He has been the regional P.I. forTRIGR, the longest trial for the primaryprevention of T1D. He established a jointinternational PhD program in diabetes including4 Universities (Barts & the London, Queen Mary,UK; University of Ulm, Germany; University ofBarcelona, Spain and University Campus Bio-Medico, Rome, Italy). The most relevantinternational studies where he acted as Leaderor regional P.I. include ENDIT, TRIGR, ActionLADA and more recently EMPAREG, EXSCEL,CANVAS and IN-TANDEM2 trials. Hiscollaborations with investigators in Europe, USand more recently China, have allowed him toimplement joint research programs for theidentification of T1D pathogenic mechanismsleading to beta cell destruction.

He is the Director of the Department ofEndocrinology & Diabetes, at University CampusBio-Medico in Rome and of the Post-GraduateSchool of Endocrinology and Metabolism at thesame University where he is also Coordinator ofthe PhD program in Integrated BiomedicalSciences and Bioethics. He was President of theItalian Society of Diabetes for Lazio and Romeregion, founder and Chairman in the late 80’s ofthe IMDIAB group (immunotherapy of T1D) withparticipation of several diabetes hospital centersin Rome, leading to the conduction of 13 clinicaltrials in the specific field. Currently is theCoordinator of the Italian Society ofEndocrinology for Lazio and Rome region.In the UK he has worked at the Centre ofDiabetes, St. Bartholomew’s and the LondonSchool of Medicine, Queen Mary, University ofLondon, initially under the guidance of the lateProfessor Andrew Cudworth at St.Bartholomew’s Hospital. He continued hisactivity at the Centre of Diabetes, BlizardInstitute, Queen Mary on projects on LatentAutoimmune Diabetes in Adults (LADA) beingDeputy leader of the EU funded programmeACTION LADA.

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Paolo Pozzilli

University Campus Bio-Medico (UCBM)Rome, Italy

Dang Van Phuoc is currently Professor andDean of the Faculty of Medicine – VietnamNational University HCM City and SeniorConsultant Cardiologist at the UniversityMedical Center / University of Medicine &Pharmacy Ho Chi Minh City. He earned hismedical degree from the Hanoi MedicalUniversity, completed his doctoral training incardiovascular medicine in Germany in 1975-1978 and a research fellowship in Germany in1987-1989. He went on to obtain a one-yearfellowship in interventional cardiology at theHouston’s Texas Medical Center, USA, in 1994.Professor Phuoc previously held the positionsof Chancellor and Dean of the Faculty ofMedicine of the University of Medicine andPharmacy of HCM City (2006 to 2011) as wellas Head of the Department of Cardiology, ViceDirector of Cho Ray Hospital HCM City (2004 to2011).Professor Phuoc is the President of the HeartAssociation of Ho Chi Minh City and Vice-President of the Viet Nam National HeartAssociation. He has served on the editorialboard of several academic journals of VietNam and published widely in the local medicalliterature.

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Dang Van Phuoc

Vietnam National UniversitySchool of MedicineHo Chi Minh City, Vietnam

Kun-Ho Yoon is Professor Department ofEndocrinology & Metabolism at Seoul StMary’s Hospital, and chief of Department ofMedical Informatics, Catholic UniversityMedical College, Korea. Prof Yoon graduatedwith his medical degree and also pursued hisPhD program at the Catholic UniversityMedical College. Prof Yoon also completed a 2-year stint as a visiting scholar with the Cellbiology and islet transplantation section inJoslin Diabetes Center of Harvard MedicalSchool, US at 1996~1998. Prof Yoon was the recipient of the KDAScientific Award three times. He washonoured with health technology Award byminister of Ministry of Health and Welfare andInnovative ICT and healthcare award bypresident. Prof Yoon has published more than200 articles in international peer-reviewedjournals with recent publications in Lancet,JAMA, Cell metabolism, Diabetes Care,Diabetes, and so on. His research has been focused on the beta-cell biology and improved diabetes patientscare using the mobile and internet platform.He also led the development of treatmentguideline of diabetes by KDA and he served asa vice president of KDA.

He had served as Executive Director, Bureauof HT R&D Planning and Budget Managementof Korea Health Industry DevelopmentInstitute for two years.

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Kun-Ho Yoon

Department of Endocrinology & MetabolismSeoul St. Mary's HospitalSeoul, Korea

Ho Huynh Quang Tri is the Chief of IntensiveCare Unit at the Heart Institute, Ho Chi Minhcity. A 1988 graduate of the Faculty of Medicine,University of Odessa, Ukraine, Dr Ho obtaineda fellowship in internal medicine at Nhan DanGia Dinh Hospital, Ho Chi Minh city, and afellowship in intensive care and cardiology atthe Heart Institute. He honed his skills incardiac intensive care during his 1-year-longresidency at Broussais Hospital in Paris,France. He was awarded the degree of PhD inMedicine and Cardiology in 2010 at theUniversity of Medicine and Pharmacy, Ho ChiMinh city.Dr Ho holds the position of Vice-President andSecretary-General of the Society of Cardiology,Ho Chi Minh city. He is also a member of the editorial board forthe society’s official journal. He has publishedwidely in the field of cardiology in Vietnameseand international journals including the AsianCardiovascular & Thoracic Annals and theJournal of Heart Valve Disease.Dr Ho is a visiting senior lecturer at theDepartment of Internal Medicine, Ho Chi Minhcity University of Medicine and Pharmacy.

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Ho Huynh Quang Tri

Heart InstituteHo Chi Minh City, Vietnam

LEARNING OBJECTIVES

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Learning objectives: • Describe mechanisms of insulin resistance • Illustrate mechanisms linking insulin resistance to end organ complications • Evaluate clinical consequences of insulin resistance in pre-diabetes

P. Pozzilli (Italy)L2Metabolic and clinical changes of pre-diabetes

NOTES

Learning objectives: • Describe the pandemic of diabetes and pre-diabetes• Illustrate the economic and health burden associated with the increasing prevalence ofdiabetes

• Discuss the clinical and pathophysiological heterogeneity of diabetes for a prompt recognitionof the disease

E. Maddaloni (Italy)L1The diabetes pandemic

NOTES

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Learning objectives:• Describe the growing epidemic of obesity• Identify obesity as a major driver of diabetes• Evaluate the consequences of obesity in terms of healthcare costs, morbidity and mortality

N.T. Khue (Vietnam)L4Obesity - a contemporary issue creating futureproblems

NOTES

Learning objectives:• Illustrate clinical features increasing the risk of pre-diabetes• Describe strategies for pre-diabetes screening• Evaluate the cost-effectiveness of pre-diabetes screening

K.H. Yoon (Korea)L3How to recognize people with pre-diabetes

NOTES

3332

Learning objectives:• Describe the costs associated with drug use for pre-diabetes• Illustrate the benefits in terms of preventing the complications of diabetes

M. Mohamed (Malaysia)L6Is treatment of pre-diabetes cost-effective?

NOTES

Learning objectives:• Describe the clinical trials supporting the ADA recommendations• Illustrate the lifestyle interventions as recommended by the ADA guidelines• Evaluate recommendation about pharmacotherapy in pre-diabetes

P. Pozzilli (Italy)L5Keywords for pre-diabetes management

NOTES

3534

Learning objectives: • Describe the relationship between frailty and diabetes

• Identify the challenges in diabetes management due to frailty

• Illustrate the impact of co morbidities in choosing anti-diabetic drugs

E. Maddaloni (Italy) and M. Mohamed (Malaysia)CS2Frail patients with type 2 diabetes

NOTES

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Learning objectives: • Illustrate ADA recommendations for initial treatment of diabetes

• Discuss lifestyle intervention to be implemented at the point of diabetes diagnosis

• Discuss whether metformin should be started at the point of diabetes diagnosis

P. Pozzilli (Italy) and K.H. Yoon (Korea)CS1Newly diagnosed type 2 diabetes

NOTES

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Learning objectives: • Grasp the consequences of hypothyroidism during pregnancy

• Discuss the most recent evidence about management of hypothyroidism and subclinicalhypothyroidism during pregnancy

• Discuss the necessity of L-thyroxin and understand when it should not be prescribed inpregnant women

G. Kahaly (Germany)CS4Hypothyroidism during pregnancy

NOTES

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Learning objectives: • Illustrate the prevalence of subclinical hypothyroidism

• Discuss when subclinical hypothyroidism should be screened

• Evaluate pros and cons of treating subclinical hypothyroidism

G. Kahaly (Germany)CS3Subclinical hypothyroidism

NOTES

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Learning objectives:• Grasp the new ESH/ESC guidelines• Detect blood pressure values which identify the presence of hypertension• Identify blood pressure targets that require antihypertensive treatment • Discuss results of controlled clinical trials which justify the choice of blood pressure targets

G. Mancia (Italy)L7Blood pressure targets in hypertensive patients:European guidelines

NOTES

41

Learning objectives: • Understand the prevalence of thyroid nodules and thyroid cancer

• Discuss the diagnostic stepwise approach to thyroid nodules

• Illustrate the ATA guidelines for differentiated thyroid cancer

N.A. Nicodemus Jr (Philippines)CS5Thyroid cancer

NOTES

40

Learning objectives: • Evaluate the difficulty of reaching blood pressure targets in hypertensive patients

• Grasp the pharmacological principles of combination therapy

• Illustrate the most important trials addressing the efficacy of different combination strategies

• Identify advantages of combinations not including RAS blockers

H.H.Q. Tri (Vietnam)L9New possibilities for fixed-dose combinationtreatment in hypertension

NOTES

43

Learning objectives: • Understand results of the SPRINT study

• Evaluate how such aggressive blood pressure control was achieved

• Illustrate possible biases of SPRINT study

• Predict implications of suggesting aggressive blood pressure control in clinical practice

D.V. Phuoc (Vietnam)L8Are blood pressure targets proposed after theSPRINT study realistic in clinical practice?

NOTES

42

Learning objectives: • Evaluate the clinical history of the patient

• Discuss whether high heart rate values might contribute to increasing a patient’scardiovascular risk

• Identify the rationale for combination therapy

• Understand whether it is appropriate to prescribe combination therapy including a beta-blocker

D.V. Phuoc (Vietnam)WG2Complex patient with hypertension: when combination therapy is needed

NOTES

45

Learning objectives: • Evaluate the clinical history of patients

• Define the cardiovascular risk of patients as well as the diagnostic procedures that should beperformed

• Illustrate possible options for pharmacological treatment

• Identify clinical differences among the various molecules within the beta-blocker class

H.H.Q. Tri (Vietnam)WG1Complex patient with hypertension: when a beta-blocker is needed

NOTES

44

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LIVE

INTE

RVE

NTION

ONLINE IN-DEPTH TUTORIALOctober 2018

ONLINE IN

-DEPTH

TUTO

RIALS

All EXCEMED programmes are organized solely to promote the exchange and dissemination of scientific andmedical information. No forms of promotional activities are permitted. There may be presentationsdiscussing investigational uses of various products. These views are the responsibility of the named speakers,and do not represent an endorsement or recommendation on the part of EXCEMED. This independentprogramme is made possible thanks to educational grants received from: Merck KGaA Darmstadt Germanyand San Raffaele Hospital Milan.

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July 2018



ONLINE IN-DEPTH TUTORIALOctober 2018

Continue your Learning Journey after the live intervention!

Online tutorials following the live intervention will help you delve deeper into content and put thekey messages of this Learning Journey into clinical practice.

CONCEPT MAPThis in-depth tutorial will help you summarize the key points of the Learning Journey and turnscientific concepts into a visual format.Concept mapping will be facilitated through the video scribing and will offer you a representativesummary of the entire learning path.

VIDEO-LECTUREThe final online tutorial is a video contribution by Prof. S. Taddei (Italy) on blood pressure targetsafter SPRINT study.

The following topics will be addressed in this talk:• Limitations of blood pressure targets in hypertension defined by Guidelines • Evidence in favour of lower blood pressure values • Strong and weak aspects of SPRINT

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