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The American Journal Of Medicine

Building A Solid Foundation in Diabetes: The Nuts and Bolts of Insulin Therapy


Building A Solid Foundation in Diabetes: The Nuts and Bolts of Insulin Therapy

Program Chair
Alan J Garber, MD, PhD, FACE
Professor
Departments of Medicine, Biochemistry and Molecular Biology, Molecular and Cellular Biology
Baylor College of Medicine
Houston, Texas

Faculty
Rodolfo Alamia, MD, RPh, CDE
Sweet Vida Medical Center
Austin, Texas

Davida F Kruger, MSN, APN-BC, BC-ADM
Certified Nurse Practitioner
Henry Ford Health System
Division of Endocrinology, Diabetes,
Bone and Mineral Disease
Detroit, Michigan

Thomas Repas, DO, FACP, FACOI, FACE, CDE
Clinical Assistant Professor
Department of Internal Medicine
Sanford School of Medicine
University of South Dakota
Rapid City, South Dakota

Activity Overview:
All insulin-deficient individuals, including those with type 1 diabetes and many with long-standing type 2 diabetes (T2D), require exogenous insulin therapy for survival. Insulin is also used to improve glycemic control in some patients with T2D who are not profoundly insulin deficient. Insulin has several advantages (over other antidiabetic agents) that should be considered in patients with T2D. As such, family physicians need to acquire essential skills to be able to initiate and titrate common insulin regimens for their patients.

In this activity, you will be asked to consider a patient likely to be encountered in family practice. The case will begin at a basic level and become more complex throughout the activity, as new factors are added requiring additional consideration and treatment adjustments. This approach will permit piecewise acquisition of knowledge within the framework of a complete case using a jigsaw-puzzle format, engaging you in real-time learning with immediate clinical applicability. You will be able to submit and compare your responses to other participants.

Intended Audience:
This activity is intended for family physicians and related healthcare professionals (HCPs) involved in the management of patients with diabetes.

Learning Objectives:
At the conclusion of this activity, participants should be able to:

  • Compare and contrast the clinical relevance of differences in the time-action profiles of basal, prandial, and premixed/biphasic insulins
  • Implement a basal insulin regimen using appropriate dosage calculations
  • Calculate doses for titrating 2 common insulin regimens, using self-monitored blood glucose measurements as appropriate
  • Explain the benefits and limitations of current insulin therapy
  • Discuss new insulin formulations in development and the potential benefits of their integration into clinical practice

Program Agenda:
Constructing a Basal Insulin Regimen
Thomas Repas, DO, FACP, FACOI, FACE, CDE

Nailing Prandial Coverage: Two Techniques for Adding Prandial Coverage to a Basal Insulin Regimen
Rodolfo Alamia, MD, RPh, CDE

Taking Accurate Measurements: Using Self-Monitored Blood Glucose to Adjust Insulin Doses
Davida F Kruger, MSN, APN-BC, BC-ADM

New Tools: Emerging Developments in Insulin Therapy
Alan J Garber, MD, PhD, FACE-Program Chair

CME Accreditation and Designation Statements
This enduring material activity, Building a Solid Foundation in Diabetes: The Nuts and Bolts of Insulin Therapy, has been reviewed and is acceptable for up to 1.50 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins March 1, 2012. Term of approval is for 1 year from this date with the option of yearly renewal. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Institute for Medical and Nursing Education, Inc (IMNE) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

IMNE designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosures:
In compliance with the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of IMNE to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All individuals involved in planning (eg, faculty, continuing education provider staff, and educational partner staff) are expected to disclose any significant financial relationships with commercial interests over the past 12 months. IMNE also requires that faculty identify and reference off-label product or investigational uses of pharmaceutical agents and medical devices.

In accordance with the ACCME Standards for Commercial Support, parallel documents from other accrediting bodies, and IMNE policy, identification, and resolution of conflict of interest have been made in the form of external peer review of educational content.

The following disclosures have been made:

Faculty:
Rodolfo Alamia, MD, RPh, CDE

Speakers Bureau: Novartis

Dr Alamia has disclosed that he does not anticipate discussing off-label or investigational uses of any therapies, products, or devices.

Alan J Garber, MD, PhD, FACE
Advisory Board: Daiichi Sankyo Co, Ltd, GlaxoSmithKline, Merck & Co, Inc, Novo Nordisk Inc, and Roche Pharmaceuticals
Consultant: Daiichi Sankyo Co, Ltd, GlaxoSmithKline, Merck & Co, Inc, Novo Nordisk Inc, and Roche Pharmaceuticals
Speakers Bureau: Daiichi Sankyo Co, Ltd, GlaxoSmithKline, Merck & Co, Inc, and Novo Nordisk Inc.

Dr Garber has disclosed that he will be discussing investigational uses of therapies, products, or devices.

Davida F Kruger, MSN, APN-BC, BC-ADM
Advisory Board: Abbott Laboratories; Animas Corporation; Council for the Advancement of Diabetes Research and Education; Eli Lilly and Company; GlaxoSmithKline plc; Merck & Co, Inc; Patton Medical Devices, LP; Tethys Bioscience, Inc.
Honoraria: Abbott Laboratories; Amylin Pharmaceuticals, Inc; Animas Corporation; Calibra Medical, Inc; Eli Lilly and Company; Novo Nordisk Inc.
Grant/Research Support: Amylin Pharmaceuticals, Inc; Calibra Medical, Inc; Eli Lilly and Company; F. Hoffman-La Roche Ltd; Halozyme Therapeutics; National Institutes of Health
Speakers Bureau: Amylin Pharmaceuticals, Inc; Eli Lilly and Company; Novo Nordisk Inc.
Stockholder: Amylin Pharmaceuticals, Inc; Dexcom, Inc; Hygieia, Inc; Patton Medical Devices, LP

Ms Kruger has disclosed that she does not anticipate discussing off-label or investigational uses of any therapies, products, or devices.

Thomas Repas, DO, FACP, FACOI, FACE, CDE
Speakers Bureau: Abbott Laboratories; Eli Lilly and Company; GlaxoSmithKline plc; Novartis AG; Novo Nordisk Inc.; Pfizer Inc; Takeda Pharmaceuticals North America, Inc

Dr Repas has disclosed that he does not anticipate discussing off-label or investigational uses of any therapies, products, or devices.

IMNE Staff
Katie Fidanza
Senior Program Coordinator
IMNE
Ms Fidanza has nothing to disclose.

Amy Groves
Director, Program Development
IMNE
Mr Groves has nothing to disclose.

Angela C McIntosh, PhD
Scientific Director
IMNE
Dr McIntosh has nothing to disclose.

Marge Tamas
Editorial Manager
IMNE
Ms Tamas has nothing to disclose.

Steve Weinman, RN
Executive Director
IMNE
Mr Weinman has nothing to disclose.

Commercial Support Acknowledgment:
This activity is supported by an educational grant from Novo Nordisk Inc.

Method of Participation:
To obtain CME credit, each participant should:

  • View the content presented
  • Answer all questions posed throughout the activity
  • Complete and submit the CME demographic and evaluation form
  • Print the online CME certificate

This activity should take approximately 1.5 hours to complete. The expiration date for this activity is March 1, 2013. No credit will be granted after this date.

Minimum System Requirements:
The following system requirements are recommended for the best presentation viewing experience:

  • Microsoft Windows 2000, Windows XP, Windows 2003, Windows Vista, or Macintosh OS X
  • Display resolution of 800 x 600 pixels or greater
  • Windows-compatible sound card
  • Microsoft Internet Explorer 6.0 SP1.
  • Windows Media Player 9.0
  • Broadband Internet connection (256 Kbps & above)

For a complete list of system requirements needed to view the webcast please click here (this link opens a pdf document). If you have any questions about viewing the webcast please contact us.

Date of Original Release: Wednesday, September 14, 2011 (satellite symposium)
Release Date: March 1, 2012
Estimated Time to Complete this Activity: 1.5 hours

Disclaimer
This activity is designed for HCPs for educational purposes. Information and opinions offered by the faculty/presenters represent their own viewpoints. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information.

While IMNE makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

 I have read and understand the CME Information indexed above.

Webcast

CME/CE Posttest and Evaluation

    •  
    • CME/CE credit is offered upon successful completion of the posttest with a minimum passing score of 80%. The evaluation portion of this activity will be used to develop needs assessments for future educational programs on this topic. Thus, to the best of your ability, please respond with what you feel is the most accurate answer.
    •  
    • After completing the posttest and CME/CE evaluation, a continuing education certificate will automatically be generated and should be printed or saved to your computer for your records.
    •  
    • Contact IMNE for questions regarding CME Credits: steve.wienman@imne.com.
    •  
    • CME Evaluation - This portion of the activity allows us to evaluate the types of healthcare professionals who are participating in the activity. This information will also be used to develop needs assessments for future educational programs on this topic. Thus, to the best of your ability, please respond with what you feel is the most accurate answer.
    •  
    • CME Posttest - This should be completed after the demographic questionnaire.
    •  
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