Two years after being diagnosed with type 2 diabetes mellitus (T2DM), Roxanne presents for a routine follow-up. She began with metformin at diagnosis and was titrated to her maximum tolerated dose, with sitagliptin added 1 year ago and canagliflozin 8 months ago, but she has never attained her individualized glycated hemoglobin (A1C) target. What is the next step? In this case-based activity for nurse practitioners (NPs) and physician assistants (PAs), a diabetes expert provides current guidelines and best practices for the timely introduction of injectable medications for glycemic control: glucagon-like peptide-1 receptor agonists (GLP-1 RAs), ultra–long-acting basal insulins, and insulin/GLP-1 RA coformulations.
Home study chapter in printable format
After completing this activity, participants should be better able to:
- Review and assess current guidelines for individualizing therapy in T2DM with basal insulin and/or GLP-1 RAs
- Compare the benefits and limitations of using basal insulin, a GLP-1 RA, or an insulin/GLP-1 RA combination for the treatment of T2DM
- Initiate and adjust treatment regimens to include basal insulin, GLP-1 RAs, or fixed-ratio combinations of these agents, as appropriate
NPs and PAs
There are no prerequisites to participate in this activity.
Continuing Nursing Education Provider Unit, Boston University School of Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This educational activity has been provided by Continuing Nursing Education Provider Unit, Boston University School of Medicine and jointly provided by Practicing Clinicians Exchange.
Contact hours: 1.0, which are eligible for 1.0 pharmacology credits.
Course director: Jason Worcester, MD, Boston University School of Medicine
CNE course advisor: Claire Murphy, MSN, NP-C, Boston University School of Medicine
This program has been reviewed and is approved for a maximum of 1.0 AAPA Category 1 CME credits by the AAPA Review Panel. Approval is valid for one year from the issue date of October 31, 2017. Participants may submit the post-test at any time during that period.
This program was planned in accordance with AAPA's CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs.
This program was cosupported by educational grants from AbbVie Inc., Bristol-Myers Squibb Company, Daiichi Sankyo, Inc., GlaxoSmithKline, Novartis Pharmaceuticals Corporation, Sanofi Genzyme and Regeneron Pharmaceuticals, and Sanofi US.
This activity is supported by an educational grant from Sanofi US.
Practicing Clinicians Exchange gratefully acknowledges Institute for Medical and Nursing Education for their contribution as educational partner for this program.
The opinions or views expressed in this continuing education activity are those of the faculty and do not necessarily reflect the opinions or recommendations of the American Academy of Physician Assistants, Boston University School of Medicine, Continuing Education Alliance, Practicing Clinicians Exchange, or any educational supporter.
THIS CONTINUING MEDICAL EDUCATION PROGRAM IS INTENDED SOLELY FOR EDUCATIONAL PURPOSES FOR QUALIFIED HEALTH CARE PROFESSIONALS. IN NO EVENT SHALL BOSTON UNIVERSITY BE LIABLE FOR ANY DECISION MADE OR ACTION TAKEN IN RELIANCE ON THE INFORMATION CONTAINED IN THE PROGRAM. IN NO EVENT SHOULD THE INFORMATION CONTAINED IN THE PROGRAM BE USED AS A SUBSTITUTE FOR PROFESSIONAL CARE. NO PHYSICIAN-PATIENT RELATIONSHIP IS BEING ESTABLISHED.
Boston University School of Medicine asks all individuals involved in the development and presentation of Continuing Medical Education (CME) activities to disclose all relevant relationships with commercial interests. This information is disclosed to CME activity participants. Boston University School of Medicine has procedures to resolve any apparent conflicts of interest. In addition, faculty members are asked to disclose when any discussion of unapproved use of pharmaceuticals and devices is being discussed.
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration.
Ms Hinnen: consultant/speaker: Janssen, Lilly, Novo Nordisk, Sanofi.
The Planning Committee for this activity included Patti-Ann Collins, DNP, MSN, MBA, RN (Lead Nurse Planner), of Healthcare Advocacy Services; Mark Christiansen, PhD, PA-C, of the University of the Pacific; Claire Murphy, MSN, NP-C, Jason Worcester, MD, Jody Walker, MS, Julie L. White, MS, of Boston University School of Medicine; Amy Carbonara of Institute for Medical and Nursing Education; and Ruth Cohen and Warren Beckman of Practicing Clinicians Exchange. None of the aforementioned members of the Planning Committee have any relevant relationships to disclose.
Participants wishing to earn CE/CME credit must:
- Read the content
- Relate the content material to the learning objectives
- Complete the post-test and evaluation form online
Successful completion of the post-test is required to earn CE/CME credit. Successful completion is defined as a cumulative score of at least 70%.
The estimated time to complete this activity is 1.00 hours.
Release date: October 31, 2017
Expiration date: October 30, 2018
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