COURSE GUIDE LONDON JUNE

Transcription

1 2016 School COURSE GUIDE LONDON JUNE

2 WELCOME SCOPE School 2016: London SPECIALIST CERTIFICATION OF OBESITY PROFESSIONAL EDUCATION (SCOPE) SCOPE is the official education programme of World obesity developed by global obesity experts to educate health professionals. Registration is free and it provides: / Knowledge of obesity from leading obesity experts / The only internationally-recognised qualification in obesity management / CPD and CME points for continued professional development What s included? / Over 35 e-learning modules / Evidence-based content on obesity management across all disciplines / Recognition as a SCOPE Certified health professional upon completion of the course which includes a certificate and listing on our website / Free obesity resources including exclusive World Obesity journal articles, data maps, podcasts and exclusive offers to global obesity conferences / We have Spanish, French and Portuguese learning portals Endorsements / 53 national obesity organisations representing 55 countries endorse SCOPE / SCOPE is accredited by the CPD and CME service / SCOPE is accredited by the Association for Nutrition / NHS commissioning guidelines on severe and complex obesity 2012/13 and 2013/14 endorse SCOPE / SCOPE is recommended for further study by the Royal College of GP s / SCOPE was shortlisted for best e-learning/online education by the International Association Awards Dear Colleagues, Joe Proietto Chair of Clinical Care On behalf of the World Obesity Federation (formerly IASO), we are delighted to welcome you to the thirteenth SCOPE School. SCOPE (the Specialist Certification of Obesity Professional Education) is the internationally recognised standard of excellence in obesity prevention and management. SCOPE helps health professionals understand, treat, manage and prevent obesity. We have brought together a faculty of internationally recognised experts in different areas of obesity treatment. They will explore different approaches to diabetes and obesity management, including diet adaptations, meal replacement strategies, exercise and surgery. We create an environment in which you can engage with experts and colleagues and take home knowledge that will transform your patient outcomes. Healthcare professionals and patients need to work together effectively, in order to manage excess weight and its associated conditions - this SCOPE School will equip you with the knowledge, skills and techniques to do so. To qualify for SCOPE Certification, you must earn 12 SCOPE Points by completing SCOPE e-learning modules and attending SCOPE courses. You also need to provide evidence of your practical experience of working with obese patients. Attending this SCOPE School will earn you four SCOPE Points.The SCOPE e-learning facility is a valuable resource featuring bite-sized modules developed by leading obesity experts, key articles and forums in which to network and share best practices. With SCOPE, you can create a customised learning programme to address your knowledge gaps and areas of interest. We hope that you enjoy the programme and the opportunity to network with your colleagues and the faculty.

3 CONFERENCE SCHEDULE 2016 School CONTENTS SCOPE School 2016: London Conference Schedule 5 Speaker Abstracts 7 Speaker Biographies 10 Tuesday 14th June AM Start Time Registration 08:45 Welcome 09:15 Are we treating a patient with obesity complicated by diabetes or a patient with diabetes complicated by obesity? 09:30 How to approach management of the patient with obesity and prediabetes? 10:15 Refreshment Break 11:00 Managing the dysregulation of the metabolic milieu in patients with obesity with or without diabetes. What are risk benefit ratio of treatments? How do we adapt diet approaches for patients with obesity with or without diabetes? 11:30 12:15 PM Lunch 13:00 Using non-commercial meal replacement strategies for the treatment of obesity and how to adapt them for patients with obesity and diabetes Using commercially available meal replacement strategies to optimise wellness and how to adjust them for patients with diabetes 14:00 14:45 Refreshment Break 15:30 Useful Information Wifi Details The purpose, challenges, environment and processes required to have a positive impact with exercise in both the obese and type 2 diabetic populations How can primary care contribute? Integrating care and developing patient pathways 16:00 16:45 Network: CDH Password: time2work Networking Reception 17:30 Professional Development Attendance provides 4 SCOPE points and 16 CPD points. 4 SCOPE School 2016

4 Wednesday 15th June AM Start Time Registration 08:30 What have we learnt from clinical trials of patients with diabetes where the intervention aimed to achieve weight loss. What have we learnt from clinical trials of patients with obesity where the intervention aimed to improve their glycaemic control. Understanding the clinical trials of drugs aimed at patients with diabetes and obesity. 09:00 09:45 10:30 Refreshment Break 11:15 What are the differences between bariatric surgery and diabetes surgery? 1145 PM Lunch 12:30 Case study presentation by participants and discussion of cases 13:30 Multiple choice exam and feedback 14:30 Feedback on exam and summary of what we learnt during the course 14:45 Finish 15:30 ABSTRACTS Are we treating a patient with obesity complicated by diabetes or a patient with diabetes complicated by obesity? Abd Tahrani, University of Birmingham, UK Type 2 diabetes is a heterogeneous disorder with varying degrees of insulin resistance and beta cell failure resulting in chronic hyprglycaemia and the development of vascular disease. Although insulin resistance plays an important role in the development of Type 2 diabetes and vascular disease; hyperglycaemia occurs only when the beta cells fail to secrete enough insulin to overcome the insulin resistance. Obesity is a major risk factor for the development of Type 2 diabetes and contribute to the development of insulin resistance and beta cell failure by multiple mechanisms such as increased inflammation, oxidative stress, protein kinase C activation and endoplasmic reticulum stress. However, fat distribution plays an important role in the metabolic consequences of obesity, which are mainly related to visceral adiposity rather than subcutaneous or thighs fat. Furthermore, the obesity in patients with Type 2 diabetes can be exacerbated by some of the glucose lowering agents which are used to intensify glycaemic control and prevent the long term diabetes-related complications. Hence, a treatment approach that focusses on improving glycaemic control while at the same time addressing obesity is preferable. In this presentation we will discuss the pathogenesis of type 2 diabetes; the role of fat distribution in the pathogenesis of Type 2 Diabetes; the impact of Type 2 diabetes treatments on weight and the benefits of using a treatment approach that focusses on treating the obesity and not only the hyperglycaemia in patients with Type 2 Diabetes. How to approach management of the patient with obesity and prediabetes? Nick Finer, UCL, UK The close links between type 2 diabetes and obesity are well established. However, the prolonged, often by many years, metabolic abnormalities that precede a formal diagnosis of diabetes have been termed pre-diabetes. The American Diabetes Association has defined criteria for diagnosing prediabetes based upon either fasting plasma glucose, 2-hour glucose after a glucose load (impaired glucose tolerance), or elevated A1c. The risk and rate of progression from pre-diabetes to diabetes varies by these different criteria. Three clinical approaches could be considered for those with prediabetes: waiting until they cross the threshold for a diagnosis of type 2 diabetes, early institution of hypoglycaemic drugs (e.g. metformin), or management of the presumed underlying cause i.e. overweight and obesity. There is now much evidence that diet and lifestyle interventions are highly effective at preventing or delaying the progression of pre-diabetes to diabetes, and that even if weight loss is poorly maintained there may be long-term (10-20 year) benefits. However, there is also now evidence that the use of weight loss drugs (that may also have hypoglycaemic effects) such as orlistat and liraglutide can both lead to weight loss and delay diabetes development. The choice of which clinical option to recommend to an individual will depend on a personalised approach to their clinical risks, needs as well as the availability and cost of the intervention. Managing the dysregulation of the metabolic milieu in patients with obesity with or without diabetes. What are risk benefit ratio of treatments? Francis Finucane, National University of Ireland, Ireland Why is it that obesity is associated with disorders such as diabetes and liver steatosis? Through a better understanding of the metabolic dysregulation that occurs in patients with obesity, we can devise more effective treatment strategies. Also, by examining the metabolic effects of therapeutic interventions, we can better understand the mechanistic basis for obesity related disorders. 6 SCOPE School 2016

5 ABSTRACTS How do we adapt diet approaches for patients with obesity with or without diabetes? Therese Coleman, BSc. MSc PG Dip Human Nutrition and Dietetics, MINDI Options to manage weight loss in the treatment of obesity are limited. Dietary restrictions and increased physical activity form the basis of all conventional therapeutic approaches to achieve a sustained energy deficit to promote weight loss. Maintaining 5-10% weight loss has clinically significant benefits including improvements in blood glucose control and quality of life. Diet plans with nutrient-dense and calorie-controlled meal replacements have been repeatedly shown to be safe and effective as a weight-management strategy in both obese and diabetic subjects by increasing compliance with dietary regimens I with the addition of anti-obesity medication further weight loss and maintenance can be achieved. II, III This presentation will provide an overview of the development of a diet and lifestyle approach to help patients to lose and sustain weight loss using evidence from two large randomised controlled trials IV, V I Flechtner-Mors et al (2010) Enhanced weight loss with protein-enriched meal replacements in subjects with the metabolic syndrome. Diabetes Metab Res Rev Jul 26(5) II Richelsen et al (2007) Effect of Orlistat on Weight Regain and Cardiovascular Risk Factors Following a Very Low Energy Diet in Abdominally Obese Patients. Diabetes Care, 30(1) III Wadden et al (2013) Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: The SCALE Maintenance randomized study. IV International Journal of Obesity (2013) 37, IV The Look AHEAD Research Group (2006) Look AHEAD Study: A Description of the Lifestyle Intervention and the Evidence Supporting it. Obesity May 14(5): V Larsen et al (2010) Diets with High or Low Protein Content and Glycemic Index for Weight-Loss Maintenance. N Engl J Med 2010;363: Using non-commercial meal replacement strategies for the treatment of obesity and how to adapt them for patients with obesity and diabetes. Nick Finer & Therese Coleman There is a long history of the development and use of meal replacement diets, which are most usually also low or very low in energy. Such diets can also vary as to whether the meal replacements are liquid or in the form of nutrition bars or specially formulated meals. Much of the early development of this approach was driven by attempts to commercialise formula products provided as drinks or sachets delivered in conjunction with support or more formal cognitive behavioural programmes from counsellors. Garrow adopted an approach using milk as the basic source of nutrition, and this approach has been widely used in the context of national health- based obesity systems. Audit data from implementation of this approach will be presented, and pragmatic algorithms for adjusting concomitant therapies for diabetes, hypertension etc. discussed. The key issue for this approach is how to improve the prospects for long-term weight loss maintenance. Using commercially available meal replacement strategies to optimise wellness and how to adjust them for patients with diabetes. Abstract not submitted The purpose, challenges, environment and processes required to have a positive impact with exercise in both the obese and type 2 diabetic populations. Mr John C. Murphy B Physio (NUI) MSc, GDBS, Clinical Director Medfit Proactive Healthcare Exercise interventions improve function if successfully implemented. The outcomes include positive improvements in confidence, self-esteem, cardio respiratory, pain reduction levels and in muscular skeletal systems. The exercise intervention can be simply designed but needs t o be safe. Successful implementation requires leadership, and an integrated professional approach, with priority on understanding the psychological component of exercise behavioural changes. The environment chosen has to be flexible to meet various needs and personalities. The focus of attention should be on changing activity aspiration levels, which is linked to socio economic factors. A successfully outcome would involve changing a % of those who are classified as inactive to a low/medium activity level. Earlier community based but medically led interventions are advised. Exercise interventions, integrated among other services, and tasked to improve activity levels are cost effective in reducing future health costs. Resourced services designed to improve activity should play a significant role in type 2 diabetes and obesity management strategies. How can primary care contribute? Integrating care and developing patient pathways. What have we learnt from clinical trials of patients with diabetes where the intervention aimed to achieve weight loss. Nick Finer, UCL, UK Abstract not submitted What have we learnt from clinical trials of patients with obesity where the intervention aimed to improve their glycaemic control. Alex Miras, Imperial College London, UK I will be discussing the most recent randomised controlled clinical trials in the field of obesity and type 2 diabetes mellitus and how these have changed the landscape of the treatment for both conditions. Particular importance will be placed on cardiometabolic risk and event reduction. Understanding the clinical trials of drugs aimed at patients with diabetes and obesity. Francis Finucane, National University of Ireland, Ireland This talk will focus on trials using different drugs in obese diabetic patients. It will examine the implications of these trials for bariatric clinical practice. It will discuss the strengths and limitations of these studies and compare them to other bariatric interventions such as lifestyle modification and surgery. Carly Hughes, NHS North Norfolk, UK This session will look at the role of primary care practitioners in raising the topic of obesity, behavioural advice and referral. The Norfolk obesity network will be used illustrate to an inexpensive way of integrating care between public health, primary care, and secondary care providers. The session is designed to be informal and interactive, with case examples which should be applicable to international attenders, and differing healthcare systems. What are the differences between bariatric surgery and diabetes surgery? Carel le Roux, University College Dublin, Ireland Abstract not submitted 8 SCOPE School 2016

6 SPEAKER BIOGRAPHIES Nick Finer Professor Finer is a Senior Principal Clinical Scientist with Novo Nordisk, and honorary Consultant Endocrinologist at University College Hospital, London, and Honorary Professor in the Institute of Cardiovascular Science, University College London. Finer chaired World Obesity - Clinical Care (formerly IASO EMTF) until January 2016, and is past-chair of the UK Association for the Study of Obesity. He was awarded the Bisset Hawkins Medal for work in advancing sanitary science or in promoting public health by the Royal College of Physicians. Finer co-authored the recent Royal College of Physicians report Action on obesity: comprehensive care for all, and has been a member of the UK Government Advisory Group on Obesity, the NHS England Clinical Reference Group on commissioning of specialist obesity services, and the NICE Public Health Advisory Group. Prof Finer is editor-in-chief of Clinical Obesity. Finer s research focuses on clinical aspects of obesity and associated endocrine disease with over 170 peer-reviewed scientific papers, 3 books and 21 book chapters. Abd Tahrani Francis Finucane Francis Finucane is a consultant endocrinologist at Galway University Hospitals and an honorary senior lecturer in medicine at NUI Galway. He completed an MRC-funded post-doctoral career development fellowship at the Institute of Metabolic Science in Cambridge, UK, where he led an aetiological randomised controlled trial of a lifestyle intervention to reduce metabolic risk in older people. Since returning to Ireland, Dr. Finucane has established a regional bariatric service for patients with severe and complicated obesity. His clinical research focuses on the relationship between adiposity and insulin resistance. Therese Coleman John C Murphy John is a Specialist Member of the Irish Society of Chartered Physiotherapists. He is co-founder of Medfit Proactive Healthcare, and is a practicing consultant physiotherapist in Carysfort Clinic, Blackrock, County Dublin since His clinical focus is on optimising recovery, reducing recurrence rates and maintaining function in both chronic and acute conditions. Academically John graduated from UCD in He subsequently completed a research MSc in Physiotherapy in UCD, and a Graduate Diploma in Business Studies. He is a published lead author in both the American and British Journals of Sports Medicine. He is the current Director of the GAA Injury Prevention Program, with the objective of successfully implementing a community-led evidence based approach to limiting future sporting injuries. His current and active research areas outside of sport relate to improving joint, muscle and cardiac function in the over 60 age group. He is specifically interested in reducing the recurrence rates of injury, and optimising rehabilitation service delivery, thereby achieving targeted outcomes. His team use this integrated approach to deliver secondary baseline changes and to target metabolic syndrome. Carly Hughes Dr Carly Hughes trained at Cambridge University, and the Royal London Hospital Whitechapel. Whilst an undergraduate she studied at the Dunn nutrition unit. She was a GP partner for 22 years, and during that time changes are bariatric physician using the SCOPE programme. She now runs a multidisciplinary weight management service in Norfolk. She was on the NICE CG 189 group, and is currently on the NICE quality standards group for obesity. She is a world obesity SCOPE National fellow, was awarded the association for the study of obesity best practice award 2015, and was made of fellow of the Royal College of general practitioners in 2015 in recognition of her work in the obesity field. She is an honorary lecturer at the University of East Anglia, and research interests include obesity management, weight maintenance and increasing physical activity. Abd Tahrani is a NIHR Clinician Scientist at the University of Birmingham (UOB), Honorary Consultant and lead for weight management research at Birmingham Heartlands Hospital. He obtained his PhD in 2012 and became a SCOPE National fellow in His research interests include the metabolic consequences of sleep disorders, the pathogenesis of diabetes-related microvascular complications, and obesity management including bariatric surgery. Dr. Tahrani has published over 80 articles and book chapters and more than 100 abstracts. He was invited to speak in several conferences in the US, Europe and Asia. He has won several awards from the American Academy of Sleep Medicine, NIHR and Diabetes UK amongst others. Dr. Tahrani is the diabetes section editor for BMC Endocrine disorders and an editorial advisor to BMC Obesity. He was an editorial consultant for the American College of Physicians. He is a grant reviewer for the NIHR and other international funding bodies and a regular peer reviewer for the leading journals in the field. Dt. Tahrani also serves as an expert advisor to NICE Therese Coleman is a dietitian and nutritionist. She graduated in 1999 with a BSc. (Hons) Nutritional Science from University College Cork, (UCC), and an MSc. in Food Business and Development (2001). Therese completed the postgraduate diploma in Human Nutrition and Dietetics at London Metropolitan University in Therese worked at University College London Hospital in the specialist bariatric services MDT. She also worked within the Trust at the National Hospital for Neurology and Neurosurgery Prior to this Therese worked for Nestle Cereals as Health & Nutrition Brand Manager and at the Home Grown Cereals Authority (HGCA) as Nutrition Manager and as a Nutrition Consultant in the UK food industry. She currently works as a clinical dietitian in the National Rehabilitation Hospital and also at Medfit Proactive Healthcare in Dublin. Alex Miras Dr Alexander Miras graduated from medical school at Imperial College London, UK, and trained as a junior doctor and Specialist Registrar in Diabetes and Endocrinology in the London deanery rotations between In 2010, he was awarded with a Medical Research Council (MRC) Clinical Research Training PhD fellowship, which enabled him to investigate the effects of bariatric surgery on food reward using functional neuroimaging and behavioural methodologies both in humans and rodents. He is currently a NIHR Clinical Lecturer in Endocrinology at Imperial College London and interested in the mechanisms through which bariatric surgery and medical devices improve weight, metabolic control and diabetes-related microvascular complications. Carel le Roux Professor Carel le Roux graduated from medical school in Pretoria, South Africa and completed his PhD at Imperial College, London. He was appointed Head of Pathology at University College Dublin in He has focussed on translational research and the understanding of the physiological role and pathological changes in appetite control using the model of bariatric surgery. 10 SCOPE School 2016

7 For further information about World Obesity activities please contact: World Obesity Federation Charles Darwin 2, 107 Gray s Inn Road, London, WC1X 8TZ, UK Tel +44 (0) enquiries@worldobesity.org Registered Charity No /