Optimizing Insulin Therapy For Multiple Type 2 Diabetes Patients:
Who, When and How to Treat

Etie Moghissi, MD, FACP, FACE – Chairperson
Associate Clinical Professor
Department of Medicine
University Of California Los Angeles
Marina Del Ray, California
Javier Morales, MD
Advanced Internal Medicine Group
St. Francis Hospital
New Hyde Park, New York
Debbie Hinnen, ARNP, BC-ADM, CDE, FAAN
Education Coordinator
Mid-America Diabetes Institute
Wichita, Kansas
Activity Overview
Current evidence in the field of diabetes care has highlighted the importance of individualizing treatment approaches for glycemic control and the need to consider patient-centered outcomes in selecting a treatment regimen at all stages of the chronic disease. Emerging information regarding the use of insulin analogs demonstrates that they provide a means to individualize therapy and can have beneficial effects on patient-centered outcomes. This case studies series will focus on selecting the appropriate insulin regimen for several different types of patients and will review rationale for these choices. Different ethnic groups and age groups will be discussed, along with guidance for determining appropriate insulin delivery devices.
Intended Audience
This activity is intended for physicians, diabetes educators, nurses and other healthcare professionals who treat patients with diabetes.
Activity Format
This online activity consists of 5 interactive case studies.  After a brief review of each patient’s medical history and current laboratory data, the participant will be asked to select a treatment strategy. The benefits and limitations of each approach will be described in detail. Methods and delivery devices for initiating and intensifying glycemic control and with insulin therapy will also be discussed. Of note, patient concerns that may accompany insulin initiation or intensification will be addressed. Each question and its accompanying answer explanation must be reviewed before proceeding to the next case. Participants may pause between cases to make it easier to accommodate their busy schedules.
Learning Objectives
Upon completion of this activity, the participant should be able to:
CME/CE Accreditation Statements
For Physicians: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the Institute for Medical and Nursing Education, Inc. (IMNE) IMNE is accredited by the ACCME to provide continuing medical education for physicians.
IMNE designates this educational activity for a maximum of 2.5 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
For Nurses: IMNE is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC’s) Committee on Accreditation.
IMNE designates this educational activity for 2.5 contact hours (0.25 CEUs).
Accreditation by the ANCC’s Committee on Accreditation refers to recognition of educational activities and does not imply approval or endorsement of any product.
ANCC Accredited Providers have been approved by the National Certification Board for Diabetes Educators (NCBDE) as providers of continuing education (CE). Individuals seeking recertification from the NCBDE can use the CE contact hours received through participation in this activity.
In compliance with the ACCME and ANCC, it is the policy of IMNE to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All individuals involved in planning (eg, CME/CE provider staff, faculty, and planners) 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 products or investigational use of pharmaceutical agents and medical devices.
In accordance with ACCME and ANCC 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:
Etie Moghissi, MD, FACP, FACE
Advisory Board: Novo Nordisk Inc.; Eli Lilly and Company; Merck & Co, Inc.
Consultant: Novo Nordisk Inc.; Eli Lilly and Company
Speakers’ Bureau: Novo Nordisk Inc.; Bristol-Myers Squibb Company
Dr Moghissi discloses that she will not be discussing off-label or investigational uses of any products.
Javier Morales, MD
Advisory Board: Novo Nordisk Inc.
Consultant: Novo Nordisk Inc.
Speakers’ Bureau: Novo Nordisk Inc.
Dr Morales discloses that he will not be discussing off-label or investigational uses of any products.
Debbie Hinnen, ARNP, BC-ADM, CDE, FAAN
Speakers’ Bureau: Abbott; American Pharmacists Association; Eli Lilly and Company; PamLab, L.L.C.; Roche; sanofi-aventis
Consultant: Abbott; Eli Lilly and Company; PamLab, L.L.C.; Roche; sanofi-aventis
Ms Hinnen discloses that she will not be discussing off-label or investigational uses of any products.
CME Provider Staff
All staff of IMNE in a position to influence content have filed statements of disclosure with the CME provider. Any conflicts of interest were identified and resolved prior to their involvement in planning this activity. These disclosures are available for review by contacting Adelfo san Valentin at 1 404 443 1512 or by e-mail at adelfo.sanvalentin@imne.com.
Robin Devine, DO
Medical Writer
Dr Devine has nothing to disclose.
Angela McIntosh, PhD
Scientific Director
Dr McIntosh has nothing to disclose.
Amy Groves
Director of Program Development
Ms Groves has nothing to disclose.
Steve Weinman, RN
Executive Director
Mr Weinman has nothing to disclose.
Adelfo san Valentin, MBA
Associate Director CME
Mr san Valentin has nothing to disclose.
CME Reviewers
Robert Hash, MD
Texas A&M Health Science Center College of Medicine
College Station, Texas
Dr Hash has nothing to disclose.
Martin Quan, MD
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, California
Dr Quan has nothing to disclose.
Steve Weinman, RN
Institute for Medical and Nursing Education, Inc.
Raritan, New Jersey
Mr Weinman has nothing to disclose.
Editorial Acknowledgment
The faculty thanks the following individuals for their contributions to the content development of this educational activity: Robin Devine, DO and Angela McIntosh, PhD.
This activity is designed for HCPs for educational purposes. Information and opinions offered by the faculty 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.
Commercial Support Acknowledgment
This activity is supported by an educational grant from Eli Lilly and Company.