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Treating Diabetes with Insulin: Individualizing Therapy

Activity Description

CME Release Date: 09/30/11
CME Expiration Date: 07/31/2015

This Internet enduring material was developed as an original manuscript by the faculty.

This activity was reviewed and updated by the faculty on March 17, 2013

This activity is supported through an educational grant provided by Eli Lilly and Company, Novo Nordisk Inc., and sanofi-aventis U.S. LLC.

Statement of Need

Despite well-established treatment guidelines, many patients with diabetes are not managed with optimally effective insulin replacement programs and fail to achieve recommended levels of blood glucose control. While primary care physicians know that poor glycemic control puts their patients at increased risk for developing diabetes complications, many view the design and management of insulin replacement therapy as beyond their capabilities because of the complexity of these programs. This activity will expose you to the scope of knowledge and skills needed to design, initiate, and manage an insulin replacement program for people with type 1 or type 2 diabetes, and in doing so you can also self-identify your own personal and practice gaps in this regard. Included in this education will be demonstrations of how office systems and staff can help you manage insulin treatment for your patients without putting an excessive burden on your practice. You will also see how your patients can benefit from newer devices such as insulin pumps and pens, standard glucose monitors, and continuous glucose monitoring (CGM) devices, and how to interact with the consultative support of regional specialty centers, dietitians, diabetes educators, and other clinical services that can help improve your patients' blood glucose control and reduce their risks for therapeutic complications.

Target Audience

This certified CME Internet enduring material has been developed for primary care providers and their clinical and office staff and any clinicians who care for patients with diabetes and oversee insulin therapies. There is no fee to participate in this activity.

Learning Objectives

Participants will be provided with clinically relevant, evidence-based information.
Upon completion of this activity, participants should be able to:

  • Summarize patterns of insulin secretory defects seen in people with type 1 and type 2 diabetes
  • List common obstacles to insulin initiation, treatment, and adherence stemming from issues such as culture, self-care ability, office-based systems and capabilities, and regional healthcare delivery issues
  • Describe the process of designing, initiating, managing, and providing educational support for individualized insulin regimens to achieve targeted levels of glycemic control for people with type 1 and type 2 diabetes

Faculty and Disclosures

Richard S. Beaser, MD*
Associate Clinical Professor of Medicine
Harvard Medical School
Medical Executive Director, Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Richard S. Beaser is a consultant for CeQur Ltd.

*Also on the Planning Committee and the CME Advisory Committee

Acknowledgement

We would like to thank the following contributors for reviewing this enduring activity:

George Beauregard, DO
President/CMO
Southcoast Physicians Network
North Dartmouth, MA

Patricia Bonsignore, RN, CDE, MS
Manager, Clinical Education Programs
Health Care Services
Joslin Diabetes Center
Boston, MA

Planning Committee:

Julie A. Brown**
Director
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Julie A. Brown has no relevant financial relationships.

Karen J. Kuc**
Assistant Director, Grants and Projects
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Karen J. Kuc has no relevant financial relationships.

James E. Neighbours, MEd**
Associate Director, Education Design
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: James E. Neighbours has no relevant financial relationships.

Jonathan Scoble**
Grants Manager
Professional Education
Joslin Diabetes Center
Boston, MA

Disclosure: Jonathan Scoble has no relevant financial relationships.

Kenneth J. Snow, MD, MBA**
Assistant Professor of Clinical Medicine
Harvard Medical School
Director, Medical Programs, Strategic Initiatives
Senior Physician, Adult Diabetes Section
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Kenneth J. Snow has no relevant financial relationships.

**Also on the CME Advisory Committee


CME Advisory Committee

Enrique Caballero, MD
Director, Medical Affairs
Professional Education
Director, Latino Diabetes Initiative
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Enrique Caballero is a consultant and on the speakers bureau and scientific advisory board for Amylin Pharmaceuticals, Inc., AstraZeneca Pharmaceuticals LP, Bristol-Myers Squibb Company, Daiichi Sankyo, Inc., and Eli Lilly and Company.

Jerry Cavallerano, OD, PhD
Optometrist
Beetham Eye Institute
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Jerry Cavallerano has no relevant financial relationships.

A. Patrick Egan, MD
Family Practice
Internal Medicine Specialist
Dorchester House Multi-Service Center
Boston, MA

Disclosure: Dr. A. Patrick Egan has no relevant financial relationships.

Ann E. Goebel-Fabbri, PhD
Instructor in Psychiatry
Harvard Medical School
Psychologist
Behavioral and Mental Health Unit
Joslin Diabetes Center
Boston, MA

Disclosure: Anne E. Goebel-Fabbri has no relevant financial relationships.

Osama Hamdy, MD, PhD, FACE
Assistant Professor of Medicine
Harvard Medical School
Medical Director, Obesity Clinical Program
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Osama Hamdy is on the speakers bureau for Amylin Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Merck & Co., Inc., Novo Nordisk Inc., and Takeda Pharmaceuticals North America, Inc.

Robert C. Stanton, MD
Associate Professor of Medicine
Harvard Medical School
Chief of Nephrology
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Robert C. Stanton has no relevant financial relationships.

Howard A. Wolpert, MD
Assistant Professor of Medicine
Harvard Medical School
Director, Insulin Pump Program
Senior Physician
Joslin Diabetes Center
Boston, MA

Disclosure: Dr. Howard A. Wolpert is a consultant for Abbott Diabetes Care; Becton, Dickinson and Company; Insulet Corporation; and Novo Nordisk, Inc.

Accreditation and Designation of Credit

Joslin Diabetes Center, Boston, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Joslin Diabetes Center designates this educational activity for a maximum of 1.50 AMA PRA Category 1 Credits.TM Physicians should only claim credit commensurate with the extent of their participation in the activity.

This CME activity was planned and produced in accordance with ACCME Essentials.

Participants not eligible for continuing medical education credit will receive a certificate of participation.

Computer Requirements

To participate in this activity, your computer will need the following hardware and software:

Credit Instructions

  1. Read the learning objectives, accreditation information, and faculty disclosures at the beginning of the activity.
  2. Read the text and view the slides.
  3. Complete the posttest and evaluation.
  4. Physicians who receive a grade of 70% or better on the posttest and who complete the evaluation will receive immediate CME credit.
  5. All other participants who receive a grade of 70% or better on the posttest and who complete the evaluation will receive a certificate of participation.

Questions About This Activity

For questions regarding the content of this activity, contact the accredited provider for this CME activity: cme@joslin.harvard.edu

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Page last updated: October 31, 2014