Activity 5: Intensifying Insulin Therapy in Type 2 Diabetes: Strategies for Family Medicine

CME certification of this program has expired. The program is still available for viewing, but is no longer eligible for CME credit.

Program Overview

In patients with type 2 diabetes, normalization of blood glucose is the major therapeutic objective for prevention of end-organ damage and other complications. The majority of these patients ultimately require insulin therapy to achieve the recommended treatment target (A1C <7%) of the American Diabetes Association (ADA).1

Success in achieving and maintaining optimal blood glucose control is strongly influenced by physician-related factors. In Intensifying Insulin Therapy in Type 2 Diabetes: Strategies for Family Medicine, Dr. David Trachtenbarg, a family physician, talks with Dr. Amy Aronovitz, an endocrinologist, about the most challenging aspects of insulin regimens in primary care. These include transitioning patients from a basal insulin regimen to a basal/bolus insulin regimen, troubleshooting labile blood sugars, and evaluating and adjusting a basal/bolus insulin regimen. Knowledge and concepts reviewed in earlier activities in this series will be applied.

1. Executive Summary: Standards of Medical Care in Diabetes--2010. Diabetes Care 2010;33(Suppl 1):S4-10.

Intended Audience

This continuing medical education program is intended for family physicians and other healthcare professionals who manage type 2 diabetes.

Learning Objectives

After completing this activity, family physicians will be better able to:

  • Describe beta-cell function decline consistent with the natural history of type 2 diabetes
  • Describe the evidence-based rationale for prescribing insulin for patients who have type 2 diabetes
  • Intensify insulin therapy appropriately in patients with type 2 diabetes
  • Select appropriate insulin formulations and regimens based on pharmacodynamic properties and patient characteristics and lifestyle
  • Use practice tools to enhance the management of type 2 diabetes
  • Communicate effectively with patients regarding their need for insulin therapy, the appropriate administration of insulin and blood glucose self-monitoring techniques

Faculty

Amy Aronovitz, MD
Endocrinologist
Northshore University Health System
Chicago, IL

David Trachtenbarg, MD
Medical Director, Diabetes Care Center, Methodist Medical Center
Clinical Professor, University of Illinois College of Medicine at Peoria
Peoria, IL

Planning Committee

Neil Skolnik, MD
Professor of Family and Community Medicine
Temple University School of Medicine, Philadelphia, PA
Family Medicine Residency Program
Abington Memorial Hospital
Abington, PA

Serena Cardillo, MD
Assistant Professor of Medicine
Hospital of the University of Pennsylvania
Philadelphia, PA

Frances Love, MSN, RN, CDE, BC-ADM
Clinical Nurse Specialist/Diabetes Education Coordinator
PENN Rodebaugh Diabetes Center
University of Pennsylvania
Philadelphia, PA

John Russell, MD
Clinical Associate Professor of Family and Community Medicine
Temple University School of Medicine, Philadelphia, PA
Associate Director of Family Medicine Residency Program
Abington Memorial Hospital
Abington, PA

CME Accreditation

This enduring material activity, Intensifying Insulin Therapy in Type 2 Diabetes: Strategies for Family Medicine, has been reviewed and is acceptable for up to 1 Prescribed credit(s) by the American Academy of Family Physicians. This activity conforms to the AAFP criteria for evidence-based CME clinical content. AAFP accreditation begins March 1, 2011. Term of approval is for 2 year(s) from this date with the option of yearly renewal.

The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since some clinical research is ongoing, the American Academy of Family Physicians recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Academy of Family Physicians designates this enduring material for a maximum of 1 AMA PRA Category 1 credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Agenda

Introduction and Opening Remarks
Module 1: Case Study: Initiating Premeal Insulin
Module 2: Initiating Premeal Insulin: Video Vignette
Module 3: Troubleshooting Common Challenges with Basal/Bolus Regimens
Closing Remarks

Disclosures:

It is the policy of the AAFP that all CME planning committee/faculty/authors/editors/staff disclose relationships with commercial entities upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, they are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity.

The AAFP and MedEd Architects, LLC, staffs have indicated that they have no relationships to disclose relating to the subject matter of the activity. Drs. Trachtenbarg and Aronovitz returned disclosure forms indicating that they have no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material. Drs. Skolnik, Cardillo and Russell, and Ms. Love returned disclosure forms indicating that they have no financial interest in or affiliation with any commercial supporter or providers of any commercial services discussed in this educational material.

 

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