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Tuesday, May 21, 2013
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6:33 PM Eastern 5:33 PM Central
4:33 PM Mountain 3:33 PM Pacific

Origination date: 5-21-13
Termination date: 5-23-20


Georgia has the second highest rate of childhood obesity in the U.S. Physicians are treating more and more children with diseases once seen only in adults such as hypertension and type 2 diabetes.

The Strong4Life Provider Program is presenting an enduring webcast on evaluating and managing pediatric insulin resistance and related conditions. This in-depth discussion will cover a range of topics from diagnosis to treatment.


Stephanie Walsh, MD

Nina Young-Jee Ham, MD


In order to meet STARK regulatory requirements that allow Children's to provide a limited amount of non-monetary compensation to physicians, we must note your participation in this online CME at a value of $10 per credit. This amount will be applied to your non-monetary compensation allowance. No action is required on your part. Thank you for your interest in the CME opportunities.


This educational activity does not necessarily reflect the views, opinions, policies or procedures of Children’s Healthcare of Atlanta, its staff or representatives. Children’s cannot and does not assume any responsibility for the use, misuse or misapplication of any information provided.


Children's Healthcare of Atlanta is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

Children's designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


This activity is designed to be completed within the time designated below; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted below. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 80% on the post-test.


At the end of the event, registered participants will be able to take the post-event evaluation and test in order to receive a certificate. The certificate will be sent via email.


The following speakers, planners and anyone who has control of the content have disclosed that they have no financial relationships: Stephanie Walsh, MD, Nina Young-Jee Ham, MD, Cheryl Williams, Wendy Palmer, Cagney Stigger

The following planners who have control of the content have disclosed an affiliation or financial interest: Julius Sherwinter, M.D. - Sponsored Research for Alexion Pharmaceuticals, Inc. - receives honorarium


  1. Identify insulin resistance in overweight and obese children
  2. Screen for related conditions of insulin resistance, such as pre-diabetes, polycystic ovarian syndrome, dyslipidemia
  3. Implement management strategies to reduce the endocrine complications of insulin resistance


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Children's Healthcare of Atlanta CME program will perform periodic basic demographics analysis, such as website user surveys, to determine the greatest needs and interest for future CME activities and events.

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All attendees must register to earn credit. If you do not register you will not have access to the evaluation and post test which are required in order to earn credit. If you plan to watch the content with a group, make sure to register in advance. After the webcast you will receive an email with the link to the evaluation and post test.

If you are interested in participating in this CME activity, please complete the pre-survey and registration form below. You are required to take the pre-survey. You will not be graded on the pre-survey. The pre-survey is a baseline assessment of the knowledge of our learners. Your pre-survey will not be tracked on an individual basis.

If you are unable to register online or do not receive your confirmation email after registering (don't forget to check your Junk email folder), please contact our Registration Desk at 866-872-5840 (international callers please dial 617-502-2061). You can also contact us by email Send Email

Pre-Activity Survey

1. What are the appropriate steps in identification of insulin resistance in a pediatric population?

A) Assess Body Mass Index (BMI) percentile
B) Complete a physical examination
C) Order labs

2. In your office you see a pediatric patient that has a physical exam positive for a BMI greater than the 95th percentile and acanthosis nigricans. You are concerned about insulin resistance.

a) What labs should be ordered to further diagnose this patient?

A) Fasting Insulin
B) Fasting Glucose
C) Oral Glucose Tolerance Test

b) What treatment protocol should be followed upon identification of insulin resistance?

A) Provide lifestyle modification counseling focused on weight reduction, regular physical activity, and dietary modifications
B) Begin metformin therapy regiment
C) Refer pediatric patient to the care of a specialist

3. In your office you see the following three:

Patient #1: 14 year old male patient with a fasting glucose of 95; HbA1c of 6.0
Patient #2: 11 year old male patient with a fasting glucose of 130; HbA1c of 6.0
Patient #3: 17 year old male patient with a fasting glucose of 110; HbA1c of 6.0

Which of the following patients would you refer to the care of a specialist?

4. In your office you see a 15-year-old female patient that has a BMI above the 90th percentile, positive for acanthosis nigricans, has an irregular menstrual cycle, signs of hirsutism, and acne. What treatment protocol should be followed upon identification of insulin resistance?

A) Provide lifestyle modification counseling focused on weight reduction, regular physical activity, and dietary modifications
B) Consider oral contraceptive pills
C) Refer pediatric patient to the care of a specialist

5. I am confident in my ability to identify insulin resistance among pediatric patients.
6. I am confident in my ability to provide evidence-based management to pediatric patients that have been identified with insulin resistance.
7. In my practice I will identify and treat pediatric patients with insulin resistance, rather than refer.
8. Have you participated in a Strong4Life Provider Training in Motivational Interviewing?
9. Have you participated in any other Strong4Life Webcast?
10. Sex: (optional)
11. Do you consider yourself to be Hispanic, Latino, or of Spanish origin?
(If YES, skip to 13) (optional)
12. Would you describe yourself as... (optional)
13. Years since medical school completed: (optional)
14. How did you hear about the webcast?

First Name* Address*
Last Name* City*
Job/Role Title* State/Province*
Email* County*
Secondary Email Zip*
Phone* Country*
CHOA Employee?* Years In Practice*
Credentials* Specialty*
Practice Name or Hospital Affiliation*
If private practice, how many physicians in group?
*Required field

Estimated time to complete activity: 45 minutes


Insulin resistance in children: consensus, perspective and future directions. J Clin Endocrinol Metab. 2010 Dec;95(12):5189-98 Obesity and insulin resistance in children. J Pediatr Gastroenterol Nutr. 2010 Dec;51 Suppl 3:S149-50

Treatment of clinical insulin resistance in children: a systematic review. Quinn SM et al. Obes Rev. 2010 Oct;11(10):720-30.

The cardio-metabolic risk of moderate and severe obesity in children and adolescents. Rank M et al. J Pediatr. 2013 Feb 20.

Insulin resistance and metabolic syndrome in the pediatric population.Metab Syndr Relat Disord. 2010 Feb;8(1):1-14.

Screening of metabolic syndrome in obese children: a primary care concern. J Pediatr Gastroenterol Nutr. 2009 Sep;49(3):329-34.

Management of type 2 diabetes mellitus in children and adolescents. Springer SC et al. Pediatrics. 2013 Feb;131(2):e648-64.

Management of newly diagnosed type 2 diabetes mellitus (t2dm) in children and adolescents. Copeland KC et al. Pediatrics. 2013 Feb;131(2):364-82.


Children's owns the copyright for, or has received permissions for use of, materials within this CME activity.

For questions related to this activity please email