In this Expert Perspective, Dr. Guillermo E. Umpierrez provides his clinical insights into A1C targets, the importance of controlling both fasting and postprandial glucose in patients with type 2 diabetes, and the use of GLP-1 receptor agonists in combination with basal insulin for optimal glycemic control in patients who require intensification of therapy.
In this case presentation, Kathleen Wyne, MD, PhD, Associate Professor of Clinical Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism at The Ohio State University College of Medicine shares strategies for intensification of diabetes management that incorporate real life patient challenges with evidence based medicine to develop a regimen that is likely to attain the patient’s A1C target. These strategies include working with what the patient is actually willing to do while trying to attain A1C target, with consideration to importance of controlling both fasting and postprandial glucose in patients with type 2 diabetes, and the use of GLP-1 receptor agonists in combination with basal insulin for optimal glycemic control in patients who require intensification of therapy.
Diabetes continues to have a significant impact on morbidity and mortality in the United States, and is an ongoing treatment challenge for primary care providers who lack confidence with treatment intensification including newer agents and combination therapies resulting in clinical inertia. Further, approaches to improved adherence and lifestyle modification through shared-decision making continue to evolve with the goal of improving quality of care.
The expanded number of therapies with varying mechanisms of action for type 2 diabetes has resulted in novel combination regimens for patients not achieving goals despite therapy with metformin. Dr. Serge Jabbour will review novel combinations and approaches to intensifying therapy in this interactive case study.
In this interactive case study, Dr. Richard Pratley, Medical Director of the Florida Diabetes Institute, walks through the clinical decision-making process for a 60-year-old African American woman with type 2 diabetes whose diabetes is progressing despite metformin therapy. Dr. Pratley examines factors likely contributing to this patient's poor glycemic control, as well as steps for intensification of therapy beyond metformin and considerations for treatment selection, such as risk for hypoglycemia and cardiovascular issues.
This program is designed to increase the knowledge and confidence of primary care healthcare professionals (HCPs) with the goal of individualizing therapy with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for the treatment of adult patients with type 2 diabetes mellitus (T2DM). In this interactive case study of a simulated patient, participants will be able to identify and address individual challenges that they may normally encounter in their clinical practices.
With an ever-increasing array of oral and injectable treatment options available for management of patients with type 2 diabetes mellitus (T2DM) at all stages of the disease, it is more challenging than ever for clinicians to appropriately select and titrate antihyperglycemic agents. In this case compendium, Vivian Fonseca, MD, Professor of Medicine and Pharmacology and Chief, Section of Endocrinology at Tulane University Health Sciences Center, New Orleans, presents three patient cases at different stages of T2DM in order to illustrate how clinicians can set treatment goals, select therapies, monitor response, and intensify therapy in both the newly diagnosed patient and one with long-standing disease and multiple comorbidities.
This educational initiative was developed to educate primary care providers on the benefits of early insulin therapy, when to initiate insulin therapy in patients with type 2 diabetes, the advantages and disadvantages of various insulin regimens, and the current data for new and emerging basal insulin formulations.
This program will review the importance of timing and the benefit and barriers of initiating insulin in patients with type 2 diabetes. Various types of insulin will also be discussed including how to incorporate into clinical practice and how to use different types of insulin to optimize administration.
This Expert Perspective highlights the salient points of the joint Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), published in 2012, on the management of hyperglycemia in type 2 diabetes.