This activity will discuss how primary clinicians can address barriers to early initiation and appropriate intensification of insulin in patients with T2DM; recommend appropriate basal insulin regimens based on patients’ clinical needs, hypoglycemia risk, and drug clinical profile; and be aware of new and emerging basal insulins, which may have the potential of improving T2DM treatment and patient outcomes.
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.
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.
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.
There are multiple advantages to early, intensive treatment of type 2 diabetes with targeted levels of A1C in the range of James R. Gavin III, MD, PhD, clinical professor of medicine at Emory University School of Medicine in Atlanta, Georgia and Dr. Jessica Castle, Assistant Professor at Oregon Health & Science University, respond to questions regarding the risks of weight gain and hypoglycemia associated with more intensive antihyperglycemic therapy and comment on strategies to ensure durable, successful treatment of diabetes.