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2018 Case Simulation: New Developments in Type 2 Diabetes Treatment to Decrease the Risk of Hypoglycemia

2018 Case Simulation: New Developments in Type 2 Diabetes Treatment to Decrease the Risk of Hypoglycemia


Case-Based Decision Tree

Time to Complete

30 minutes


December 24, 2018


December 24, 2019
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Maximum Credits

0.50 / AMA PRA Category 1 CreditsTM
0.50 / CNE Contact Hours
0.50 / CE for Pharmacists (0.05 CEUs)
0.50 / CPEU for Registered Dietitians

Accredited Provider

This activity is jointly provided by The University of Cincinnati and Tarsus Cardio Inc. dba Cardiometabolic Health Congress for ACCME credit. This activity is jointly provided by Global Education Group and Tarsus Cardio Inc. dba Cardiometabolic Health Congress for ANCC, CDR and ACPE credit.

Commercial Supporter

This activity is supported by an educational grant from Sanofi US.

Program Description

Due to the progressive nature of type 2 diabetes mellitus (T2DM), insulin is typically initiated when patients are unable to achieve and maintain glycated hemoglobin (HbA1c) target levels with lifestyle changes and addition of one or more antidiabetic drugs to the treatment regimen. However, the initiation and intensification of diabetes treatment with insulin is often delayed in many patients due to clinical inertia and fears of hypoglycemia. This educational activity will address the barriers to intensifying T2DM treatment with insulin, including clinical inertia and the risk of hypoglycemia, current treatment recommendations for glycemic control in T2DM, and efficacy and safety data for fixed-ratio insulin/GLP-1 RA combinations to achieve glycemic control and reduce hypoglycemic risk

This case-based, patient simulation technology will be utilized to provide learners with the opportunity to explore different decision paths and then immediately observe the consequences of their decisions—without risk. Learners will receive the benefit of engaging in deliberate practice in an environment that is safe, consistent, convenient and individualized to improve their management of patients with T2DM and risk of hypoglycemia.

Intended Audience

US-based healthcare professionals, including primary care clinicians (PCPs), nurse practitioners (NPs), physician assistants (PAs), endocrinologists, diabetologists, pharmacists, cardiologists, lipidologists, and other allied health professionals.

Educational Objectives

Upon completion of this activity, participants should be able to:

  • Discuss strategies to overcome barriers to insulin intensification in T2DM, including clinical inertia and the risk of hypoglycemia
  • Develop individualized T2DM therapy based on a clinical understanding of the features of oral and injectable antidiabetic medications and patient-specific needs and preferences
  • Outline the safety, efficacy, and pharmacological data on new insulin therapies and fixed-ratio GLP-1RA/basal insulin combinations
  • Implement patient education and patient-prescriber communication strategies to aid patients in overcoming concerns about insulin intensification and fear of injections, thus increasing patient adherence to therapy and improving clinical outcomes

Conflict Of Interest Disclosure Policy

The University of Cincinnati requires instructors, planners, managers and other individuals and their spouse/life partner who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by the University of Cincinnati for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.


Robert E. Ratner, MD (Chair)
Professor of Medicine
Georgetown University School of Medicine
Washington, DC

Dr. Ratner discloses the following:
Consultant/Independent Contractor: Novo Nordisk, Verta, Merck, Intarcia
Stock Shareholder: J&J, Abbott

Robert H. Eckel, MD
Professor of Medicine
Division of Endocrinology, Metabolism and Diabetes
Division of Cardiology
Professor of Physiology and Biophysics
Charles A. Boettcher II Chair in Atherosclerosis
Director, T32 in Obesity and Cardiovascular Disease
University of Colorado Anschutz Medical Campus
Director, Lipid Clinic, University Hospital
Aurora, CO

Dr. Eckel discloses the following:
Consultant/Independent Contractor: Sanofi/Regeneron, Novo Nordisk

Davida F. Kruger, MSN, APNBC, BCADM
Certified Nurse Practitioner
Henry Ford Health System
Division of Endocrinology, Diabetes, Bone and Mineral Disease
Detroit, MI

Ms. Kruger discloses the following:
Advisory Boards: Novo Nordisk, Abbott, Eli Lilly and Company, Sanofi Aventis, Janssen, Dexcom, Intarcia
Speakers Bureau: Janssen, Valeritas, AstraZeneca, BI/Lilly, Novo Nordisk, Dexcom, Lilly, Abbott, Insulet
Grants/Research Support to Henry Ford Health System: AstraZeneca, Eli Lilly, Novo Nordisk, Hemsley Foundation, Dexcom, Lexicon
Stock: Dexcom

Deborah J. Wexler, MD, MSc
Associate Professor of Medicine, Harvard Medical School
Associate Clinical Chief, MGH Diabetes Center
Massachusetts General Hospital
Boston, MA

Dr. Wexler discloses the following:
Stock Shareholder: Apolo 1 Bio

Accredited Provider Disclosure

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Ashley Marostica, RN, MSN, has nothing to disclose.
Lindsay Borvansky has nothing to disclose.
Andrea Funk has nothing to disclose.
Amanda Turner has nothing to disclose.
Erin Franceschini, MS, has nothing to disclose.
Karin McAdams has nothing to disclose.
Bruce Gebhardt, MD has nothing to disclose.
Susan P. Tyler, M.Ed., CMP, CHCP, FACEHP has nothing to disclose.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the University of Cincinnati and CMHC.

The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

Designation Statement

The University of Cincinnati designates this online activity for a maximum of 0.50 AMA PRA Category 1 CreditTM  .  Physicians should claim only the credits commensurate with the extent of their participation in the activity.




CNE Contact Hour(s)

Accreditation Statement

Global Education Group is accredited with distinction as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Designation Statement

This educational activity for 0.50 contact hours is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.




CE for Pharmacists

Accreditation Statement

Global Education Group is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Designation Statement

Global Education Group designates this continuing education activity for 0.50 contact hour(s) (0.05 CEUs) of the Accreditation Council for Pharmacy Education. Universal Activity Number (UAN): 0530-9999-18-432-H01-P




CPEU Credit

Accreditation Statement

Global Education Group is a Continuing Professional Education (CPE) Accredited Provider with the Commission on Dietetic Registration (CDR).

Designation Statement

CDR Credentialed Practitioners will receive 0.50 Continuing Professional Education units (CPEUs) for completion of this activities / materials. CPE Provider #GE012

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The University of Cincinnati and CMHC do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.


To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed all 4 modules, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

If you have any other questions relating to your certificate or other issues with the activity, please contact

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