Complementary Insulin Combinations to Optimize Glycemic Control in T2D

Optimizing the Safety-Efficacy Equation for Comprehensive Glycemic Regulation in Complex Patients with T2D—The Physiologic Rationale for Complementary Pharmacologic Approaches Based on Insulin plus Incretin System-Targeting Agents

Vivian A. Fonseca, MD, FRCP

Video

The Critical Role of Postprandial Hyperglycemia (PPG) in Difficult-to-Manage Diabetic Patients: Strategies for Measuring PPG and Assessing the Contribution of PPG to Overall Glycemic Dysregulation in the Challenging Diabetic Patient

Vanita Aroda, MD

Video

ARS-Based, Interactive Session Focused on Patient with T2D Who is On an Oral Agent Plus Basal Insulin and Has Suboptimal Control of Total HA1c Level and Who Has Evidence of PPG

Vanita Aroda, MD

Video

The Physiologic and Mechanistic Basis for Long-Acting Basal Insulin in T2D: The Evidence for Basal Insulin as Initial Foundational Therapy for Challenging Patients Requiring Comprehensive (FPG and PPG) Glycemic Control?

Lawrence Blonde, MD, FACP, MACE, PA-C

Video

The Practical and Mechanistic Role of Short-Acting GLP-1 Receptor Agonists for Managing PPG in Complex Patients Already on Basal Insulin: How Do Short-Acting GLP-1 RAs Optimize the Safety-Benefit Equation in Patients Requiring Pan-Glycemic Control?

Focus on Mitigating Hypoglycemia and Weight Gain

Vivian Fonseca, FRCP, MD

Video

ARS-Based, Interactive Session Focused on a Complex Patient with T2D Who Has a High Risk for Hypoglycemia, is Overweight, and Despite Basal Insulin Therapy, Has Significantly Elevated Post-Prandial Glucose Levels

Vivian Fonseca, FRCP, MD

Video

New Insulin Combinations: For Whom? Why? When? The Rationale, Effectiveness and Safety of Fixed Ratio, Single Injection Regimens Combining a Short-Acting GLP-1 RA and Basal Insulin:

Focus on FPG and PPG Control, Titration Strategies Reducing Risk of Hypoglycemia & Weight Gain Mitigation in Challenging Patients with T2D

Juan P. Frias, MD, FACE

Video

An ARS-Based, Interactive Session Focused on the Patient with T2D Who Requires Pan-Glycemic (FPG and PPG) Control, is Averse to Multiple Daily Injections, and Needs to Lose Weight and Improve Overall HA1c Levels

Juan P. Frias, MD, FACE

Video

Q&A Session and Special “Hot Topics” Session

Vivian Fonseca, FRCP, MD

Vanita Aroda, MD

Lawrence Blonde, MD, FACP, MACE, PA-C

Juan P. Frias, MD, FACE

Program Medium

Internet-based program

Estimated Time to Complete Educational Activity

2.5 hours

Course Overview

In this web-based program, physicians and optometrists will learn how recent developments have helped to advance the management of Type 2 diabetes.

Release Date: July 14, 2017

Expiration Date: July 14, 2019

Method of Physician Participation Utilized in Learning Process

There are no fees for participating and receiving CME credit for this activity. During the period January 6, 2017 through January 6, 2019 participants must:
1) read the learning objectives and faculty disclosures;
2) study the educational activity, and are expected to view all 9 segments totaling 1.5 hours to successfully complete the activity and earn CME credit;
3) register and complete the evaluation form and post-test;
4) score 100% on the post-test; and
5) print out your CME certificate.

Registration

Participation in this WebCAST is complimentary, and clinicians are invited to view this CME-certified program and/or share this invitation with other colleagues, departmental staff members, and healthcare professionals.

Grantor Support

Supported by an educational grant from Sanofi Diabetes.

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Massachusetts Medical School and CMEducation Resources, LLC. ‘The University of Massachusetts Medical School is accredited by the ACCME to provide continuing medical education for physician.

Credit Designation Statement

Postgraduate Institute for Medicine designates this enduring activity for a maximum of 2.5 AMA PRA Category 1 Credits™.Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Policy on Faculty & Provider Disclosure

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. The existence or absence of COI for everyone in a position to control content will be disclosed to participants prior to the start of each activity.

Other Credits

American Nurses Credentialing Center (ANCC) accepts AMA PRA Category 1 Credits™ from organizations accredited by the ACCME.
American Academy of Nurse Practitioners (AANP) accepts AMA PRA Category 1 Credits™ from organizations accredited by the ACCME.
American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credits™ from organizations accredited by the ACCM.

Program Faculty and Disclosure

VIVIAN A. FONSECA, MD, FRCP
Program Chair
Professor of Medicine and Pharmacology
Tulis Tulane Alumni Chair in Diabetes
Chief, Section of Endocrinology
Tulane University Health Sciences Center
New Orleans, LA

Research Support (To Tulane): Grants from Asahi, Bayer
Consulting and Speaking: Takeda, Novo Nordisk, Sanofi-aventis, Eli Lilly, Astra-Zeneca, Janssen

JUAN P. FRIAS, MD, FACE
Clinical Assistant Professor of Medicine
University of California
President
National Research Institute
Los, Angeles, California

Consulting: Astra Zeneca, BMS, Johnson and Johnson, Novo Nordisk, Sanofi
Speaker’s Bureau: Sanofi, Eli Lilly, Novo Nordisk, Astra Zeneca
Contracted Research: AbbVie, AstraZeneca, Boehringer Ingelheim, BMS, Elcelyx, Eli Lilly, IONIS, Janssen, Johnson and Johnson, Ligand, Merck, Mylan, Novartis, Novo Nordisk, Pfizer, Sanofi, Theracos, vTv

LAWRENCE BLONDE, MD, FACP, MACE
Director, Ochsner Diabetes Clinical Research Unit,
Frank Riddick Diabetes Institute,
Department of Endocrinology,
Ochsner Medical Center
New Orleans, LA

Grant/Research Support: AstraZeneca, Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co.
Speaker Honoraria: Novo Nordisk, Sanofi, AstraZeneca, Janssen Pharmaceuticals, Inc.,
Consultant: Merck & Co., Novo Nordisk, Sanofi, AstraZeneca, GlaxoSmithKline, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, Sanofi

VANITA R. ARODA, MD
Associate Professor of Medicine
Georgetown University School of Medicine
Physician Investigator, Scientific Director
MedStar Health Research Institute
Hyattsville, MD

Consultant and Grant/Research Support: Novo Nordisk, Sanofi

Educational Objectives

Upon completion of this activity, participants will be able to:

Identify patients who, because of postprandial hyperglycemia, are not optimizing overall HA1c target goal attainment; and who, therefore, may be appropriate candidates for therapy with specific agents, including GLP-1 agonists, in combination with basal insulin, to optimize their glycemic management
Apply titration strategies for the dose(s) of both basal insulin and a GLP-1 agonist, when used in combination formulations, to achieve optimal HA1c control, weight loss, reduction in risk of hypoglycemia, and postprandial glucose control
Describe the mechanisms, metabolic issues, and physiological rationale for combining anti-hyperglycemic agents—such as basal insulin, that preferentially targets fasting hyperglycemia, in conjunction with agents such as GLP-1 agonists that preferentially target postprandial hyperglycemia—in order to optimize glycemic management and HA1c targets in patients with T2D
Identify T2D patients in whom the possible advantages of incretin system-targeted therapy with GLP-1 agonists—including better PPG control, weight loss, and HA1c reductions— may make them guideline-appropriate candidates for combination regimens
Individualize multimodal, pharmacologic management in patients with T2D, and improve patient outcomes by deploying combination regimens that act through multiple, complementary mechanisms—including new basal insulin and incretin system-targeted combination-based interventions—to achieve ADA/EASD target goals

Hardware and Software Requirements:

To participate in this program, viewers must have a PC or Macintosh computer that has active, ongoing internet access for the duration of the program, as well as a compatible Flash-viewer. An email address is required for registration, and a printer is required to print out the CME certificate.

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