A PATIENT-TAILORED APPROACH TO T2DM: A Case-Based Look at Individualizing Therapies

Program Overview

According to the American Association of Clinical Endocrinologists (AACE), more than 60% of diabetes mellitus (DM) patients do not reach HbA1c target goals. Advances in the understanding of glucose homeostasis have helped identify new therapeutic targets, such as incretin hormones, which may address some of the unmet needs of conventional type 2 diabetes medications. These agents are associated with a low risk of unwanted adverse events and offer physicians additional options to deliver individualized care.

DM management recommendations are being updated regularly, and guidelines are a helpful starting point for physicians, providing them with evidence-based treatment options. However, treatments should be individualized to each patient, and DOs need all the latest information and up-to-date data in order to deliver such individualized care. This CME-certified online monograph is designed to bridge the gap between physicians’ current understanding of the role of treatment guidelines and incretin therapies in type 2 diabetes management, and the confident application of that knowledge in clinical practice.

Faculty

	NATASHA N. BRAY, DO (Chair) Assistant Professor of Internal Medicine Nova Southeastern University College of Osteopathic Medicine Director of Graduate Medical Education/Internal Medicine Program Director Broward General Medical Center/Broward Health Ft. Lauderdale, FL Read Biography Natasha N. Bray, DO is an Assistant Professor in the Department of Internal Medicine at Nova Southeastern University College of Osteopathic Medicine. She also serves as Director of Graduate Medical Education and Program Director of the Internal Medicine Residency Program at Broward General Medical Center in Fort Lauderdale, FL. Dr. Bray completed her internal medicine residency and fellowship training at Cambridge Health Alliance and Harvard Medical School Affiliated Program in Cambridge, MA, and concluded her health policy fellowship training through the American Osteopathic Association in 2009. In addition to her extensive teaching responsibilities, Dr. Bray is active in the university’s academic medical practice.
	ELLEN MILLER, MD Associate Professor of Medicine Hofstra North Shore-LIJ School of Medicine Uniondale, NY Clinical Associate Professor of Medicine Albert Einstein College of Medicine Bronx, NY Read Biography Ellen Hirschman Miller, MD is a Clinical Associate Professor of Medicine at the Albert Einstein College of Medicine and an Associate Professor of Medicine at the Hofstra North Shore-LIJ School of Medicine. In addition, she is the Vice President of Academic Affairs and Assistant Medical Director of the Southside Hospital in Bay Shore, NY. She also has a private practice in internal medicine, endocrinology, and reproductive endocrinology in Hewlett, NY. Dr. Miller received her medical degree from New Jersey Medical School in 1980 and completed her post-graduate work at Beth Israel Medical Center and Columbia University. She is on the editorial boards of Postgraduate Medicine, Physician and Sports Medicine, and Hospital Practice and is a Fellow of the American Association of Clinical Endocrinologists. Dr. Miller has conducted extensive research in the areas of endocrinology and women’s health, and has authored articles that have been published in numerous medical journals.
	KELLY ANNE SPRATT, DO Clinical Associate Professor of Medicine University of Pennsylvania School of Medicine Philadelphia, PA Read Biography Kelly Anne Spratt, DO is a Clinical Associate Professor of Medicine at the University of Pennsylvania and an integral part of the preventive cardiology Cardiovascular Risk Intervention Program, a program designed to include outstanding primary and seconday prevention strategies. Her practice includes noninvasive cardiology, with a strong emphasis on preventive aspects of cardiovascular disease, as well as heart disease in women. Dr. Spratt has authored journal articles and chapters in cardiology textbooks and lectures regionally and nationally. She is involved in teaching of medical students and house staff and is also actively involved in patient education in several media, including radio, television, and the Internet. She had previously served as a consultant for “Ask the Doctor” for the Better Homes and Gardens health website, a resource for patients with a variety of health concerns. She has spoken to a variety of audiences on various cardiology topics. She has received several awards for service and leadership from the American Heart Association, where she has served on the local Board of Directors and has been member of the Executive Leadership Team for the past few years. Dr. Spratt received her medical degree at the Philadelphia College of Osteopathic Medicine, and completed her residency in internal medicine, as well as a fellowship in cardiology, at Hahnemann University Hospital in Philadelphia. She is board-certified in both internal medicine and cardiovascular disease.

Target Audience

Educational Objectives

This program is designed to address the following IOM competencies: provide patient centered care and employ evidence-based practice.

At the conclusion of this activity, participants should be able to demonstrate improved ability to:

• Diagnose a patient with DM based on the new ADA diagnostic criteria
• Make patient-oriented therapeutic decisions based on the safety and efficacy of the treatment regimen, as well as a patient’s presentation, preference, and risks for hypoglycemia and cardiovascular events
• Explain the MOA of incretin therapies and discuss how each agent fits into the present armamentarium for T2DM
• Explain how future formulations might help address the remaining clinical gaps in T2DM management

Accreditation

The AOA’s continuing medical education program (CME) strives for growth of knowledge, refinement of skills, and the deepening of understanding for the osteopathic profession. The AOA Board of Trustees establishes accreditation policy for osteopathic CME sponsors. The Council on Continuing Medical Education (CCME) has been delegated authority by the AOA Board of Trustees to monitor osteopathic CME and to grant or deny Category 1 accreditation status to osteopathic CME sponsors.

Designation Statement

The American Osteopathic Association’s Council on Continuing Medical Education approved the activity for 1.0 hour of Category 1-B AOA credit.

Disclosure Information

The American Osteopathic Association and Rockpointe Corporation adhere to the policies and guidelines, including the Standards for Commercial Support, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of a continuing medical education program are required to disclose any relevant financial relationships with any commercial interest to AOA or Rockpointe, as well as to learners. All conflicts are identified and resolved by AOA and Rockpointe in accordance with the Standards for Commercial Support in advance of delivery of the activity to learners. The content of this activity was vetted by an external medical reviewer to assure objectivity and that the activity is free of commercial bias.

The faculty reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Natasha N. Bray, DO: Nothing to Disclose

Ellen Miller, MD: Speaker: Boehringer Ingelheim, Lilly, Merck, Amgen

Kelly Anne Spratt, DO: Advisory Board: Digitas Health (Medical Information Company)

Non-faculty content contributors and/or reviewers reported the following relevant financial relationships that they or their spouse/partner have with commercial interests:

Carole Drexel, PhD; Bradley Pine; Blair St. Amand; Jay Katz; Gregg Lapin: Nothing to Disclose

FDA Disclosure

The contents of some CME activities may contain discussions of non-approved or off-label uses of some agents mentioned. Please consult the prescribing information for full disclosure of approved uses.

System Requirements

In order to view this monograph, your computer must have Adobe Reader to view PDF files.

Adobe Reader can be downloaded for free here.

Instructions for Participants and Obtaining CME Credit

There is no fee for this activity. To receive credit, participants must take the pre-test, view this CME activity in its entirety, and then complete the post-test and evaluation. To complete the evaluation online, choose the best answer to each question. The estimated time for completion of this activity is 1.0 hour. To receive their certificates, participants must demonstrate mastery of the presented material via the post-test.

Jointly Sponsored By

This activity is jointly sponsored by:

Supported By

This program is supported through an educational grant from Amylin Pharmaceuticals, Inc. and Lilly USA, LLC.