Preventive Cardiovascular Nurses Association

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Reducing Cardiovascular Risk in the Insulin Resistant Patient
Module 2: Assessment & Diagnosis of Insulin Resistance
1 CE Credit
Release Date: January 2007
COURSE OVERVIEW:
Insulin Resistance Syndrome (IRS) affects more than 1 in 5 adults in the US, and prevalence is expected to increase as the epidemic of overweight, obesity, and inactivity continues. Insulin Resistance (IR) provides a broad umbrella for the clustering of abnormal insulin mechanisms, metabolic syndromes, and certain clinical outcomes. It is important to perform a focused history and physical examination to diagnose IR/dysmetabolic syndrome and to document evaluation of patients in accordance with the International Classification of Disease-10th revision (ICD-9).
PRESENTER:
Joanna D. Sikkema, MSN, ARNP
Director, Acute Care Nurse Practitioner Program, University of Miami
Clinical Nurse Practitioner,
Whole Health Management
Miami, FL
PRESENTER BIO:
Joanna Sikkema is the Director of the Acute Care Nurse Practitioner Program at the University of Miami and also currently is employed as a clinical nurse practitioner for Whole Health Management providing employee primary health care and wellness at Florida Power and Light Corporation. She was previously the Director of Cardiovascular Prevention Services and the Women’s Heart Program at the Cardiovascular Center of South Florida. She has also served as Director of Non-invasive Services for the Miami Vascular Institute of Baptist Health System where she managed multiple departments including the Cardiac Rehabilitation Center, Echocardiography, Peripheral Vascular Laboratory, Cardiovascular Prevention Center, and Research and Outcomes Management. Joanna currently serves as President-Elect on the board of directors of the Preventive Cardiovascular Nurses Association.

COURSE EDITORS:
Joanna D. Sikkema, MSN, ARNP
Carol M. Mason, ARNP, FAHA
CE Course Outline

Print slides/handouts (pdf)

Step 1: Take Course
Step 2: Take CE Exam
Step 3: Quick Evaluation
Step 4: Print CE Certificate


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EDUCATIONAL OBJECTIVES:
Upon completion of this program, participants will be able to:
  1. Discuss co-morbid disease conditions and pharmacotherapy that may contribute to the development of insulin resistance syndrome
  2. Identify components of a focused history and physical exam to be included in order to support the diagnosis of insulin resistance
  3. List items of documentation for the IR patient evaluation that must be included in accordance with the International Classification of Disease - 10th revision (ICD-9) codes for reimbursement
AUDIENCE:
The audience for this course consists of nurses and nurse practitioners specializing in cardiovascular disease prevention and management.

PRESENTER DISCLOSURES:
The presenter has no commercial relationships to disclose.

SPONSOR/ACCREDITOR:
This activity is sponsored by the Preventive Cardiovascular Nurses Association (PCNA). PCNA is approved as a provider of nurse practitioner continuing education by the American Academy of Nurse Practitioners (AANP) - provider number 030602. PCNA will provide 1 contact hour of continuing education for this program.

GRANTOR:
This continuing education activity is supported by unrestricted educational grants from KOS Pharmaceuticals and Cholestech Corporation.

COST:
This online educational activity is offered free of charge.

PARTICIPATION IN THE ACTIVITY AND RECEIPT OF CERTIFICATE OF CREDIT:
Complete the online course, online exam, and the evaluation form; and submit your results electronically. Exams will be graded and results displayed instantaneously. Participants who receive a passing score of 80% or higher will receive an electronic, printable certificate of completion following the exam. Participants will have 2 opportunities to successfully complete the exam.

MODULE 2 REFERENCES:
  • American Medical Association. International Classification of Disease: Physician ICD-9_CM2006; Chicago, IL: AMA Press 2006. Vol 1.
  • Grundy, S, Hanson B, Smith S, Cleeman J, Kahn R AHA/NHLBI/ADA Conference Proceedings: Clinical Management of the Metabolic Syndrome. Circulation. 2004; 109:551-556.
  • Haffner S. Position Statement from the American Diabetes Association- Diagnosis and Classification of Diabetes Mellitus. Diabetes Care {series on line} 2004: 27:55.
  • Executive Summary of the Adult Treatment Panel III. JAMA 2001; 287:2486-2497.
  • ACE Recommendations from the American College of Endocrinology Conference on Insulin Resistance Syndrome Endocrine Practice {serial online} 2003;9:240-272.
  • American Diabetes Association. position statement Standards of medical care in diabetics: Diabetes Care 2004;27:515-535.
  • Pritchett, AM, Foreyt, JP. Treatment of the metabolic syndrome: the impact of lifestyle modification. Curr. Atherosclerosis Rep. Mar. 2005 7 (2): 95-102. Medline.
  • Pasquali, R., Patton L. Metabolic alteration and cardiovascular risk factors in polycystic ovary syndrome. Minerva Gynecology Feb 2005; 57 (1) 79-85 Medline.
  • Federal Register. Rules and Regulations Medicare Program; Revision of Payment Policies and adjustments to the Relative Value Units under the Physician fee Schedule for Calendar Year 1999. November 2, 1998; 63 (211): 58863-58912. Available on line at: http//www.nurse.net/medicare/regs/fedreg.58863.html. Accessed October 2006.
  • Current Procedural Terminology (CPT) 2006. American Medical Association Press. 2005.

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