Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been embraced by management guidelines from the American Diabetes Association and the American Academy of Clinical Endocrinologists as an important treatment option for type 2 diabetes mellitus (T2DM). GLP-1 RAs improve both postprandial and fasting glucose levels without elevating hypoglycemia risk and can be used as monotherapy or as second-line treatment after metformin or other oral antidiabetes medications. GLP-1 RAs can achieve particular therapeutic synergies when used in combination with basal insulin, even countering the weight gain associated with insulin use. To that end, fixed-dose GLP-1 RA/basal insulin combinations are available, simplifying administration with a single daily injection. Yet many clinicians have been slow to use these medications in clinical practice for reasons that include clinical inertia, reluctance to initiate needle-delivered medications, and lack of familiarity with the class and the multiple individual agents within it.
To address these knowledge and practice gaps, this myCME TOWN WALLTM activity convenes diabetes experts to discuss evidence-based perspectives on GPL-1 RAs in T2DM: the pathophysiologic rationale; the underappreciation of the incidence and impact of hypoglycemia in T2DM; and characteristics of the various short- and long-acting GLP-1 RAs. The faculty will also provide their clinical perspectives how best to use GLP-1 RAs in practice—including patient-selection criteria, managing adverse effects of treatment, and coaching patients through initiation of injection therapy.
Endocrinologists/diabetologists, family physicians, internal medicine physicians, nurse practitioners, and physician assistants.
After completing the activity, the participant should be better able to:
Evaluate the pharmacologic properties and safety profiles of the spectrum of short-acting and long-acting GLP-1 RAs
Analyze the limitations and benefits of individual GLP-1 RAs, including delivery technologies, that may advance glycemic control for patients with T2DM
Initiate dual GLP-1 RA/basal insulin therapy when appropriate in patients with T2DM
Implement strategies to address the lack of medication adherence and persistence among patients receiving GLP-1 RAs
Conflict Of Interest Disclosure Policies
In accordance with the ACCME Standards for Commercial Support, HME requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. HME resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational activities.
Peter Salgo, MD, Moderator Professor of Medicine and Anesthesiology Columbia University College of Physicians and Surgeons Associate Director, Surgical Intensive Care Columbia University Medical Center New York, NY
Dr. Salgo has no relevant financial relationships to disclose.
Daniel Einhorn, MD, FACP, FACE Medical Director Scripps Whittier Diabetes Institute Clinical Professor of Medicine University of California, San Diego President, Diabetes and Endocrine Associates La Jolla, CA
Dr. Einhorn receives consulting fees from AstraZeneca and Janssen Pharmaceuticals and is on the speakers’ bureaus for Janssen and Sanofi. Dr. Einhorn receives research funds from AstraZeneca, Janssen Pharmaceuticals, Lilly, MannKind Corporation, Novo Nordisk, and Sanofi. He has ownership interest in Epitracker, GlySens Incorporated, and Halozyme, Inc.
Javier Morales, MD, FACP, FACE Clinical Associate Professor of Medicine David and Barbara Zucker School of Medicine at Hofstra/Northwell at Hofstra University Hempstead, NY Vice President Advanced Internal Medicine Group, P.C. East Hills, NY
Dr. Morales receives consulting fees from and is on the speakers’ bureaus for Eli Lilly and Company, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, and Novo Nordisk.
Joel Zonszein, MD, CDE, FACP, FACE Professor of Medicine Albert Einstein College of Medicine Department of Medicine Division of Endocrinology and Metabolism Montefiore Medical Center The University Hospital for Albert Einstein College of Medicine Bronx, NY
Dr. Zonszein is a consultant for Boehringer Ingelheim, Merck/Schering-Plough Pharmaceuticals, and Novo Nordisk. He is on the speakers’ bureaus for Boehringer Ingelheim and Novo Nordisk.
CONTRIBUTING FACULTY Helena Duffy, ANP-BC, CDE Montefiore Clinical Diabetes Center Bronx, NY
Ms. Duffy has no relevant financial relationships to disclose.
Edwin Torres MS, RN, CHNP, FNP-C Montefiore Clinical Diabetes Center Bronx, NY
Mr. Torres has no relevant financial relationships to disclose.
Silvie Georgens, PA-C, RD, CDE Diabetes and Endocrine Associates La Jolla, CA
Dr. Georgens receives fees for promotional talks for Health-Scripts and Janssen Pharmaceuticals.
Andrea Stallings, PA-C Diabetes and Endocrine Associates La Jolla, CA
Dr. Stallings has no relevant financial relationships to disclose.
Accredited Provider Disclosure
Haymarket Medical Education staff involved in the planning and content review of this activity have no relevant financial relationships to disclose.
AMA PRA Category 1 Credit(s)TM
Haymarket Medical Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Haymarket Medical Education designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Additional Credit Information
Physician Assistant Continuing Education AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM from organizations accredited by ACCME or a recognized state medical society. PAs may receive a maximum of 1.00 Category 1 Credit for completing this activity.
Nurse Practitioner Continuing Education The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts certificates of participation for educational activities certified for AMA PRA Category 1 CreditTM from organizations accredited by ACCME. Individuals are responsible for checking with the AANPCP for further guidelines.
Disclosure of Unlabeled Use
This CME activity may or may not discuss investigational, unapproved, or off-label use of drugs. Participants are advised to consult prescribing information for any products discussed. The information provided in this CME activity is for continuing medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options for a specific patient's medical condition.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Sanofi US. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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 this program, 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.