STATEMENT OF NEED

Type 2 diabetes (T2D) is closely linked with heart failure (HF) and chronic kidney disease (CKD), which may develop early, progress concurrently, and substantially increase risks for hospitalization, cardiovascular events, kidney failure, and mortality. However, HF and CKD are often underrecognized in patients with T2D, particularly when symptoms are subtle or absent. Timely risk assessment is essential to identify disease progression and intervene before irreversible organ damage occurs (Pop-Busui et al, 2022; KDIGO, 2024). The therapeutic landscape for cardiorenal risk reduction in T2D has evolved rapidly. Nonsteroidal mineralocorticoid receptor antagonists (MRAs), sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists provide important benefits across cardiovascular and kidney outcomes. Emerging evidence supports combination therapy for patients with cardiorenal risk (Neuen et al, 2024; Valente et al, 2026). To optimize outcomes, the multidisciplinary team must be equipped to identify HF and CKD early, select and sequence evidence-based therapies, mitigate treatment-related risks, and tailor care to patients’ individual needs. This Interactive Case Consult features Silvio Inzucchi, MD; Erin D. Michos, MD, MHS; and Matthew R. Weir, MD, as they explore strategies for improving the prevention, diagnosis, and management of cardiorenal comorbidities in patients with T2D. 

TARGET AUDIENCE

Cardiologists, endocrinologists, nephrologists, hospitalists, primary care physicians, and advanced practice providers involved in the care of patients with type 2 diabetes (T2D) with or at risk for concurrent heart failure (HF) and/or chronic kidney disease (CKD).

LEARNING OBJECTIVES

Upon completion of this activity, participants should be able to

• Describe risk factors and assessments that can enable prompt diagnosis and identification of disease progression for HF and CKD in patients with T2D

• Evaluate the mechanism of action, safety, and efficacy of new and emerging agents for the management of HF or CKD in patients with T2D

• Appraise strategies to optimize treatment selection and implementation for individual patients with T2D and concurrent HF and/or CKD

REGISTRATION

There is no fee to participate in or claim CME/AAPA credit for this activity.

PROVIDED BY

JOINTLY ACCREDITED PROVIDER

In support of improving patient care, i3 Health is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

PHYSICIANS

i3 Health designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

By providing this information, participants are agreeing to allow i3 Health to share this information with the ACCME.

Physician Assistants

i3 Health has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.25 AAPA Category 1 CME credits. Approval is valid until 8/4/27. PAs should only claim credit commensurate with the extent of their participation.

Nurse Practitioners

The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.

DISCLOSURE OF RELEVANT FINANCIAL INFORMATION WITH INELIGIBLE COMPANIES

i3 Health endorses the standards of the ACCME that require everyone in a position to control the content of a CME activity to disclose all financial relationships with ineligible companies that are related to the content of the CME activity. CME activities must be balanced, independent of commercial bias, and promote improvements or quality in health care. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession.

A conflict of interest is created when an individual has an opportunity to affect CME content about products or services of an ineligible company with which he/she has a financial relationship, which therefore may bias their opinions and teaching. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, stocks, or other financial benefits.

i3 Health will identify, review, and mitigate all relevant financial relationships that speakers, authors, or planners disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. i3 Health does not endorse any products or services.

Relevant financial relationships exist between the following individuals and ineligible companies:

The i3 Health planners, reviewers, and managers have nothing to disclose.

Silvio Inzucchi, MD, discloses that he has served on an advisory board or panel for AstraZeneca, Bayer, Boehringer Ingelheim, Madrigal, and Novo Nordisk.

Erin D. Michos, MD, MHS, discloses that she has served as a consultant for Arrowhead, AstraZeneca, Bayer, Boehringer Ingelheim, Edwards Lifesciences, Eli Lilly, Ionis, Merck, Mineralys, NewAmsterdam, Novartis, Novo Nordisk, and Pfizer​.

Matthew R. Weir, MD, discloses that he as served on an advisory board or panel for AstraZeneca, Bayer, Boehringer Ingelheim, Corcept, CSL Vifor, Idorsia, Mineralys, Novo Nordisk, and Vera.

i3 Health has mitigated all relevant financial relationships.

INSTRUCTIONS TO RECEIVE CREDIT

In order to receive credit for this activity, participants must watch the video and submit a completed evaluation at the end of the activity.

TECHNOLOGY REQUIREMENTS FOR VIRTUAL CME ACTIVITIES

For virtual (asynchronous, archived live, home study; synchronous webinars) CME activities, include access to system requirements:

• The Internet browser(s) supported and minimum versions of each required by the learner to complete the online activity.

• The minimum memory, storage, processor, and Internet speeds require by the learner to complete the online activity.

UNAPPROVED USE DISCLOSURE

i3 Health requires CME faculty (speakers) to disclose to attendees when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved), as well as any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty may discuss information about pharmaceutical agents that is outside of U.S. Food and Drug Administration approved labeling.

This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

DISCLAIMER

The information provided at this CME activity is for continuing education purposes only and is not meant to substitute for the independent medical/clinical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition.

COMMERCIAL SUPPORT

This activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc

CONTACT INFORMATION

Technical queries or questions regarding activity credit should be directed to i3 Health at support@i3health.com.