Many primary care providers caring for patients with diabetes on insulin are not appropriately intensifying therapy beyond basal insulin, increasing the risk of complications and premature mortality in this patient population. This session aims to close that gap by educating clinicians on when to initiate and how to advance mealtime insulin (MTI). You’ll explore the newer, faster-acting MTIs and compare the safety, efficacy, and dosing of the various formulations. But ultimately, managing the use of MTIs is complex, and this session encourages clinicians to take advantage of available diabetes technology and to lean on diabetes care teams to optimize their patients’ care. You’ll walk away from this session with the confidence and resources you need to appropriately prescribe MTIs to the patients who need it.

Learning Objectives

  • Determine when therapy intensification beyond basal insulin is beneficial and how to advance to mealtime insulin (MTI)
  • Demonstrate improved confidence in the ability to prescribe MTI
  • Compare and contrast available MTI formulations, including their efficacy, safety, and dosing
  • Examine how to best employ the diabetes healthcare team and diabetes technology to optimize care for people with diabetes (PWD) on insulin therapy


Amy Clouse, MD, FAAFP

Clinical Associate Professor of Family and Community Medicine, Sidney Kimmel Medical College at Thomas Jefferson University 
Associate Residency Director, Abington - Jefferson Health Family Medicine Residency Program

Patricia H. Montesinos, MSN, APRN, FNP-BC, BC-ADM, CDE

Medstar Diabetes Institute
Washington, DC


The following relevant financial relationships have been disclosed by faculty, and all have been mitigated by Pri-Med Institute.

Amy Clouse, MD, FAAFP: No relevant financial relationships disclosed

Patricia H Montesinos, MSN, APRN, FNP-BC, BC-ADM, CDCES:  No relevant financial relationships disclosed

Pamela Kushner, MD, FAAFP (Moderator): Advisor, Consultant and Speaker for AstraZeneca, Boehringer Ingelheim, Janssen Pharmaceuticals, Lilly  and Novo Nordisk. Advisor for Abbott, Intuity, Phathom, and Pfizer. Consultant for GlaxoSmithKline. Speaker for Bayer and GlaxoSmithKline. Stockholder with Abbott, AstraZeneca and Lilly. 

Paulina Duker, MPH, RN, CDCES: No relevant financial relationships disclosed 

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose.

CME/CE Information


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In support of improving patient care, this activity has been planned by Pri-Med Institute and the Association of Diabetes Care & Education Specialists. The Association of Diabetes Care & Education Specialists is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.


Accreditation Council for Pharmacy Education (ACPE)

The Universal Activity Number is JA4008258-9999-22-303-H01-P. This knowledge-based activity has been approved for 1.0 contact hour.

American Medical Association (AMA)

Association of Diabetes Care & Education Specialists designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Nurses Credentialing Center (ANCC)

Association of Diabetes Care & Education Specialists designates this activity for a maximum of 1.0 ANCC contact hour. This activity discusses 1.0 contact hours of pharmacotherapeutic content.


The Association of Diabetes Care & Education Specialists is approved by the California Board of Registered Nursing, Provider Number 10977, for 1.0 contact hour. 


Accreditation Statement

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners® (AANP) through the joint providership of Pri-Med Institute and Association of Diabetes Care & Education Specialists. Pri-Med Institute is accredited by the AANP as an approved provider of nurse practitioner continuing education. Provider Number 040308.  

Designation Statement

This activity is approved for 1.0 contact hour of continuing education, which includes 1.0 hours of pharmacology.



The Association of Diabetes Care & Education Specialists has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credit. PAs should only claim credit commensurate with the extent of their participation.

Commission on Dietetic Registration (CDR)

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CDR Credentialed Practitioners will receive 1.0 Continuing Professional Education units (CPEUs) for completion of this activity. Completion of this RD/DTR prefession-specific or IPCE activity awards CPEUs (One IPCE credit = One CPEU). If the activity is dietietics-related but not targeted to RDs or DTRs, CPEUs may be claimed which are commensurate with participation in contact hours (One 60 minute hour = 1 CPEU). RDs and DTRs are to select activity type 102 in their Activity Log. Spehere and Competency selection is at the learner’s discretion.

Certified Diabetes Care and Education Specialists: To satisfy the requirements for renewal of certification for the Certification Board for Diabetes Care and Education (CBDCE), continuing education activities must be diabetes related and approved by a provider on the CBDCE list of Approved Providers (www.ncbde.org). CBDCE does not approve continuing education. The Association of Diabetes Care & Education Specialists is on the CBDCE list of Approved Providers.

Other Health Professionals
It is the responsibility of each participant to determine if the program meets the criteria for re-licensure or recertification for their discipline.

Commercial Supporter

This activity is supported by an educational grant from Lilly

Education Partners

Pri-Med Institute

Association of Diabetes Care & Education Specialists

Fine Print

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The opinions, ideas, and recommendations expressed in this educational activity are those of the faculty only and are not necessarily endorsed by, nor do they necessarily reflect, those of their affiliated institutions, Pri-Med Institute, Pri-Med Institute Advisory Boards and Consultants, DBC Pri-Med, LLC.

Clinical judgment must guide each clinician in weighing the possible risks, benefits, or contraindications of any diagnostics, interventions or treatments discussed. Clinicians should review manufacturers’ product information and consider these with the recommendations of other authorities when applying the assessment and/or clinical management strategies discussed in this activity to the care of their patients. Data, indications, and guidelines presented in this activity are current as of the activity release date and they are subject to change as new information is published.

Pri-Med Institute educational activities are developed and conducted in accordance with the ACCME's Essential Areas and Policies. It is the mission of Pri-Med Institute to develop and present educational activities that are timely, fair-balanced, scientifically rigorous, and that serve to improve patient outcomes. To that end, we welcome your comments about how to better serve your needs.

Pri-Med Institute Accredited Provider
Pri-Med programs are owned and operated by DBC Pri-Med, LLC, a division of Diversified Communications, Inc. Pri-Med Institute, the accredited division of Pri-Med, is accredited with commendation by the ACCME and approved as a provider of continuing education by the AANP. Pri-Med Institute is the accredited provider for this activity.

Disclosures and Conflict of Interest
Pri-Med Institute requires all individuals in a position to influence educational content for Pri-Med Institute-certified CME/CE activities to disclose relevant personal financial relationships with commercial interests prior to contributing to its educational activities. Pri-Med Institute assesses disclosed relationships and follows a defined process to resolve real or implied conflicts to ensure, to the best of its ability, that all educational content is free of commercial bias. Financial disclosures are listed in the activity syllabus and will also be printed on the slides and announced at the start of each presentation.

Discussion of Off-Label Uses and Investigational Products
During the course of their presentations, the faculty may mention uses of products that have not been approved in the United States for the indication(s) being discussed. All presenters are instructed to notify participants when they are discussing unapproved uses or investigational agents. In addition, specific slides will include notation of the off-label use or investigational agent being discussed. Views presented related to unapproved uses of products are solely those of the presenter(s) and are not endorsed by Pri-Med Institute or DBC Pri-Med, LLC.

Questions? If you have questions about this activity, please email support@pri-med.com or call (877) 477-4633.