Case Challenges in the Use of Insulin in T2DM

Endocrinology
Curriculum:
Evolving Paradigms for Insulin Therapy of Type 2 Diabetes
Credits:
0.75 AMA PRA Category 1 Credit(s)™
Launch Date:
07-Dec-17
Expiration Date:
07-Dec-18

Primary Audience:

Endocrinologists, primary care physicians, and other members of the care team involved in the management of patients with T2DM, including endocrinology and primary care nurse practitioners (NPs), physician assistants (PAs), and nurses

Relevant Terms:

Type 2 diabetes; insulin therapy

Louis H. Philipson, MD, PhD

Louis H. Philipson MD, PhD
Professor of Medicine
Director, Kovler Diabetes Center
The University of Chicago Pritzker School of Medicine
Chicago, IL

Dr. Philipson is an endocrinologist and a leading world authority on diabetes mellitus. In 2011, he was named as one of America's Top Doctors by U.S. News & World Report magazine, and in 2016 Chicago Magazine named him a Top Doctor in Endocrinology, Diabetes and Metabolism. His research focuses on the biophysical, molecular and genetic aspects of insulin secretion, and the genetics of diabetes.

Dr. Philipson was a co-discoverer of insulin gene mutations causing neonatal diabetes, a novel class of mutations causing diabetes through beta-cell ER stress. These mutations are now known to be the second most common cause of permanent neonatal diabetes, as well as rare causes of later-onset diabetes. Dr. Philipson, together with his colleagues (Drs. Graeme Bell, Siri Atma Greeley and Rochelle Naylor) established the first United States registry for monogenic diabetes including neonatal diabetes and Mature Onset Diabetes of the Young (MODY).
 
Dr. Philipson is co-director of the Human Islet Transplantation project at the University of Chicago. He has served as principal investigator on numerous research projects and has been widely published in biomedical journals.
 
As president of the Chicago/Northern Illinois board of the American Diabetes Association and also a member of its national board, Dr. Philipson has been an invited speaker and presenter at scientific research conferences and symposia worldwide.

Neda Laiteerapong, MD, MS, FACP

Neda Laiteerapong, MD, MS, FACP
Assistant Professor, Section of General Internal Medicine
Associate Director, Center for Translational and Policy Research of Chronic Diseases
The University of Chicago Pritzker School of Medicine
Chicago, IL

Neda Laiteerapong, MD, MS is a practicing general internist and researcher in the Department of Medicine at the University of Chicago. Dr. Laiteerapong's work focuses on improving the understanding of how the quality of life in older adults with diabetes is affected by geriatric syndromes, hypoglycemia and macrovascular and microvascular complications of diabetes.  To examine this area, she uses data gathered from patient surveys and secondary data sources including pharmacy and health claims by Kaiser Permanente Northern California managed care.  She has also used diabetes microsimulation models to evaluate the effects of delays in achieving blood pressure control in adults with diabetes.  Currently she is studying how patients with diabetes incorporate the concept of time in their decisions to start intensive treatments now or later. Additionally, she has co-authored articles about the public health implications of bariatric surgery for diabetes treatment and the effects of health care reform on the delivery of chronic disease care. Dr. Laiteerapong completed medical school at the Boston University School of Medicine.
1. Describe the benefits and risks of currently approved insulin therapies for the management of T2DM.
2. Incorporate insulin into the management of patients with T2DM who do not achieve glycemic control.
3. Intensify insulin therapy for patients with T2DM who do not achieve glycemic goals with initial insulin therapy.
4. Summarize the current evidence-based practice guidelines for the management of T2DM.
5. Develop strategies to overcome patient-related adherence barriers to the use of insulin in patients with T2DM.

Disclosures
As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine, asks everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. This includes any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines "relevant financial relationships" as financial relationships in any amount occurring within the past 12 months including financial relationships of a spouse or life partner that could create a conflict of interest. Mechanisms are in place to identify and resolve any potential conflict of interest prior to the start of the activity. 

Dr. Philipson discloses that he has received grant/research support from Johnson & Johnson, Novo Nordisk, and Xoma. He has served as a consultant for Calico and Neurotronic, and has served on a speakers bureau for Merck.

Dr. Laiteerapong has no conflicts of interest to disclose.

Mahira Zec Bonomo, University of Chicago, Director for CME, has nothing to disclose. 
Joshua Kilbridge, medical writer, has nothing to disclose. 
Kathleen Hines, MCM Education VP, Editorial Services, has nothing to disclose. 
Terry Ann Glauser, MD, MPH, MCM Education VP, Medical Affairs, has nothing to disclose. 

Faculty members are required to inform the audience when they are discussing off-label or unapproved uses of devices or drugs. Devices or drugs that are still undergoing clinical trials are identified as such and should not be portrayed as standard, accepted therapy. Please consult full prescribing information before using any product mentioned in this activity. If using products in an investigational, off-label manner, it is the responsibility of the prescribing physician to monitor the medical literature to determine recommended dosages and uses of the drugs. Neither the publisher nor the providers promote the use of any agent outside of approved labeling.

Credit Statements
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 Chicago Pritzker School of Medicine and MCM Education in collaboration with RealCME. The University of Chicago Pritzker School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 

CREDIT DESIGNATION STATEMENT 
The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Nurses and other health care professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for educational activities certified for AMA PRA Category 1 CreditTM from organizations accredited by the ACCME, please consult your professional licensing board.

Commercial Support Statements
This activity is supported by independent educational grants from Novo Nordisk Inc. and Sanofi US, and Boehringer Ingelheim Pharmaceuticals, Inc. and Lilly USA, LLC.

Disclaimer
©2017 MCM Education. All rights reserved. None of the contents may be reproduced in any form without prior written permission from the publisher. The opinions expressed in this educational activity are those of the faculty and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, the University of Chicago Pritzker School of Medicine, Novo Nordisk Inc., Sanofi US, Boehringer Ingelheim Pharmaceuticals, Inc., or Lilly USA, LLC. Any medications, diagnostic procedures, or treatments discussed by the program presenters should not be used by clinicians or other health care professionals without first evaluating their patients' conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities. 

 
COURSE VIEWING REQUIREMENTS
Supported Browsers:
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Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above
 
Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.



 
 
COURSE VIEWING REQUIREMENTS
Supported Browsers:
Internet Explorer 8.0+ for Windows 2003, Vista, XP, Windows 7, Windows 8.1 and above
Google Chrome 28.0+ for Windows, Mac OS, or Linux
Mozilla Firefox 23.0+ for Windows, Mac OS, or Linux
Safari 6.0+ for Mac OSX 10.7 and above
 
Supported Phones & Tablets:
Android 4.0.3 and above
iPhone/iPad with iOS 6.1 or above.