Miriam E Tucker

May 16, 2016

For its silver anniversary meeting, the American Association of Clinical Endocrinologists (AACE) will pay homage to the past while simultaneously featuring present-day hot topics, including obesity management, transgender medicine, approaches to aging, diabetes drug trial outcomes, and new payment models that will change how endocrinologists are paid for what they do.

The AACE 2016 Annual Meeting will take place in Orlando, Florida, from May 25 to May 29. Preconference sessions are scheduled all day on Wednesday, and the main meeting runs Thursday through Sunday morning.

Several speakers from that first AACE meeting in 1991 will speak again, tying the information they gave then to the state of the art today and then the future as they see it. Topics to receive that back-to-the-future treatment include: lipid disorders; diabetes technology; molecular markers in thyroid-nodule management; and pheochromocytoma.

On Friday, a special tribute to Saul Hertz, MD, who discovered the use of radioactive iodine (RAI) for the treatment of thyroid disease 75 years ago, will also include talks on the latest approaches for RAI use.

"The focus will be to celebrate our accomplishments….We want the young people entering the field to appreciate where we came from, how fast it has changed, and to envision the future," AACE president George Grunberger, MD, told Medscape Medical News.

And AACE vice president and program chair Jonathan D Leffert, MD, added, "Twenty-five years is not too long, but it's certainly long enough for so many things to change in our field....That's a neat theme that I'm really excited about."

"Huge" New Obesity Guidelines

On Wednesday afternoon, new AACE obesity treatment guidelines will be presented in a 4-hour session "The Practice of Obesity Medicine in 2016."

This long-awaited document, to be published online and in AACE's journal Endocrine Practice, follows a series of actions by AACE including lobbying the American Medical Association to deem obesity a disease in 2013, a consensus conference in 2014, and an "advanced framework" white paper released during the AACE annual meeting that same year

The new evidence-based document will be quite comprehensive and long but will also include an executive summary and a colorful, easy-to-follow algorithm similar to the AACE's algorithm for diabetes management.

"It will be huge. Clearly we need to establish that obesity is a disease, and endocrinologists are the experts," Dr. Grunberger stressed.

Tackling Transgender Medicine

In an in-depth symposium on Friday entitled "Transgender Medicine: What an Endocrinologist Should Know," four speakers will address treatment of adolescents with transgender identity, standards of care in the diagnosis of gender dysphoria, guidelines for clinical care, and sex-reassignment surgery.

According to Dr Leffert, "Most endocrinologists don't [treat transgender patients]…on a usual basis or at all, but it is part of our field and something we should all know about….If we don't get involved, there will be other people who will and probably not as well and not with the basic training that we have. I think it's our responsibility to make sure our members are aware of the manifestations and be able to deal with them in the most appropriate way."

In addition, a special "Meet the Expert" session on Saturday will feature a case study of transgender teen activist and reality TV star Jazz Jennings and her family.

"This young woman is a very articulate spokesperson for the transgender community.…It will be unique for a medical society to do this kind of program where we involve a patient in this process, but she was very interested in being involved and she has a unique story to tell," Dr Leffert said.

Endocrinology and Aging

Also on Friday, a five-speaker in-depth symposium will take on a relatively new field — the medical approach to aging, including an exploration into whether growth hormone and/or testosterone might be used as antiaging medications.

Dr Grunberger noted, "Mother Nature didn't intend us to hang around this long.…Will people live longer and have better lives if we give them supplements to get back to the hormone levels of their youth? This is becoming a very interesting aspect of endocrinology."

The Future of Endocrinology Reimbursement

And another in-depth symposium sure to attract a good-sized audience on Friday will be "The Future of Endocrinology Reimbursement."

Speakers will address opting out of Medicare, the new merit-based payment system (MIPS) and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), participation in accountable-care organizations, and the path from meaningful use to precision medicine.

"Fee for service is going to be gone in a few years, and people are very concerned. How will we be paid for what we do? It's a very big challenge," Dr Grunberger noted.

Keeping Clinicians Up to Date

As always, there will be plenty of posters and a handful of oral abstract presentations of original research, including papers on diabetes management during air travel, radiofrequency ablation for treating adrenal neoplasms, and the relationship between vitamin D and diabetic retinopathy.

Yet Dr Grunberger pointed out that the AACE meeting differs from those of the large cardiology and diabetes research conferences, in which original research is a main feature, instead focusing more on translating research findings for clinical practice.

A major example of that is an in-depth Friday session entitled "Diabetes Update 2016" in which speakers will discuss the clinical implications of recent research on cardiovascular-outcomes trials including the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), as well as the role of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors in diabetes and the prevention of ketoacidosis in diabetes patients taking sodium–glucose cotransporter 2 (SGLT2) inhibitors.

"It may not be as glamorous as presenting [Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results—A Long Term Evaluation (LEADER)] or EMPA-REG] outcomes, but in the end physicians need to know how to translate results into managing people with diabetes. Everyone wants to know how to translate EMPA-REG," Dr Grunberger observed.

Dr Leffert told Medscape Medical News, "I think the program is fabulous.…As clinicians we're always trying to bridge the area between science and clinical medicine. In our talks we're always trying to make things relevant for our members who are going to go back to practicing medicine."

Dr Grunberger conducts research for Novo Nordisk, Eli Lilly, AstraZeneca, Sanofi, Lexicon, and Medtronic and is on the speaker's bureau for Novo, Lilly, Sanofi, and Janssen Pharmaceuticals. Dr Leffert has speaker, consultant, and/or research grant relationships with Novo Nordisk, Boehringer Ingelheim, Sanofi, AbbVie, Merck, Sharpe & Dohme, Mylan, AstraZeneca, Bristol-Myers Squibb, and Roche Diagnostics.

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