Janine: Adjusting Insulin Therapy in the Primary Care Setting

1 AMA PRA Category 1 Credit(s)
Launch Date:
December 24, 2014
Expiration Date:
The accreditation for this activity has expired.

Primary Audience:

Primary Care Clinicians (e.g., MD, DO, NP, PA) who provide primary or front-line care for people with diabetes; including family practice physicians and internists; Specialists (e.g., cardiologists, nephrologists) who serve a significant role in the care of patients and who might have responsibility for insulin management; and office staff of any of these physician categories

Relevant Terms:

Type 2 diabetes; Insulin Therapy; Primary Care

Mark E. Molitch, MD

Mark E. Molitch, MD
Martha Leland Sherwin Professor of Endocrinology
Division of Endocrinology, Metabolism and Molecular Medicine
Northwestern University Feinberg School of Medicine
Chicago, IL

Mark E. Molitch, MD, earned an AB degree from Princeton University and an MD from the University of Pennsylvania. He did his house staff training at the Hospital of the University of Pennsylvania and an Endocrine Fellowship at the UCLA-Harbor General Hospital in Torrance, California. Prior to joining the faculty at Northwestern in 1984, Dr. Molitch was an Associate Professor at Tufts University School of Medicine in Boston, Massachusetts.

Dr. Molitch has participated in clinical research for many years, focusing on the pathogenesis of pituitary tumors and their treatment. He has participated in the development of most of the medical treatments for prolactinomas and acromegaly. He has also participated in international diabetes trials, including the Diabetes Control and Complications Trial, the Diabetes Prevention Program, and the Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial.

In addition to editing eight books and journal volumes, Dr. Molitch has authored or coauthored more than 350 original papers, review articles, book chapters, case reports and other publications.  Dr. Molitch has been an Associate Editor of the Year Book of Endocrinology and is currently an Editor of the journal, Pituitary.  In 1997, Dr. Molitch was named "Outstanding Physician Educator in the Field of Diabetes" by the American Diabetes Association and was elected to the Council of The Endocrine Society. Since 2009, Dr. Molitch has served as Chair for The Endocrine Society's Clinical Endocrinology Update.
1. Identify people for whom insulin therapy initiation or advancement is indicated as reflected by A1C and glycemic patterns
2. Design insulin treatment programs based on A1C, glycemic patterns, and an individualized assessment of underlying pathophysiology, comorbidities, self-care abilities, and patient perspectives
3. Describe what is needed, and self-assess one's own practice for current and potential care and support services, to optimize insulin initiation, titration, and patient support

Core Competencies:

X     Patient Care
X     Medical Knowledge
X     Practice-Based Learning and Improvement
        Interpersonal Skills and Communication
        Systems Based Practice
Course Director: Dr. Richard Beaser
Richard S. Beaser, MD
Associate Clinical Professor of Medicine
Harvard Medical School
Medical Executive Director, Professional Education
Joslin Diabetes Center
Boston, MA
Richard Beaser, MD, is the Medical Executive Director of Professional Education, Joslin Diabetes Center. He is a practicing physician in the Joslin Clinic and holds the position of Associate Clinical Professor of Medicine at Harvard Medical School. He has been on the staff of Joslin Diabetes Center since 1982. He has held numerous positions at Joslin, including Section Chief of the Adult Diabetology Practice, Medical Director of the Diabetes Treatment Unit, Coordinator of the Patient Education Section, and Medical Director of Joslin TrialNet, a clinical trials network. He has been a clinical research investigator, including the landmark Diabetes Control and Complications Trial. Dr. Beaser has written 4 books: Joslin Diabetes Manual, Outsmarting Diabetes, The Joslin Guide to Diabetes, and Joslin's Diabetes Deskbook: A Guide for Primary Care Providers. Dr. Beaser is a well-known national lecturer on clinical diabetes and its comorbidities. He is the author of numerous articles in peer-reviewed journals, review articles, and book chapters. In 1990, Dr. Beaser co-founded Joslin's Professional Education Department, which was incorporated into the Joslin Strategic Initiatives Division in 2000. As Medical Executive Director of this department, Dr. Beaser has overall responsibility for departmental activities. He specifically focuses on development or oversight of all the department's educational content for physicians, other medical professionals, and patients. He is responsible for the business and project development aspects of the department as well, working collaboratively to conceive, develop, and seek funding for all departmental projects and activities.
Mark E. Molitch, MD
Professor of Medicine
Division of Endocrinology, Metabolism and Molecular Medicine
Northwestern University Feinberg School of Medicine
Chicago, IL
Dr. Molitch graduated from the University of Pennsylvania School of Medicine in 1969. He did his house staff training at the Hospital of the University of Pennsylvania and his Endocrine Fellowship at UCLA–Harbor General Hospital in Los Angeles. His first faculty position was at Tufts University Medical School in Boston and he moved to Northwestern University in Chicago in 1984. At present, he is the Martha Leland Sherwin Professor of Medicine at Northwestern in the Division of Endocrinology, Metabolism and Molecular Medicine.
Dr. Molitch has been active in clinical research in diabetes and other areas of endocrinology and served as the Principal Investigator for the Northwestern center of the Diabetes Control and Complications Trial. In the DCCT, he was chair of the Complications Committee and was a member of the Planning Committee. At present, he remains Principal Investigator of the DCCT follow-up study called “Epidemiology of Diabetes and Its Complications” (EDIC), is Principal Investigator of the Northwestern Center of the ongoing Diabetes Prevention Program Observational Study (DPPOS), and was Co-Principal Investigator of the recently completed Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D)
Dr. Molitch has been active in the American Diabetes Association (ADA). He chaired the Professional Practice Committee that wrote the 2002 ADA “Standards of Medical Care for Patients with Diabetes Mellitus,” chaired the working group that wrote the ADA Position Statement “Diabetic Nephropathy,” and served as chair of the ADA’s Provider Recognition Program. He also chaired the Technical Expert Review Panel of the National Diabetes Quality Improvement Alliance. Dr. Molitch is on the working group that wrote the KDOQI Guideline for the treatment of diabetic kidney disease and its recent revision prepared by the National Kidney Foundation.
As part of its accreditation with the Accreditation Council for Continuing Medical Education, Joslin Diabetes Center must disclose to the audience of a Joslin continuing medical education activity the existence of any relevant financial relationships between Joslin and/or its planning and/or CME advisory committee members, speakers, and their spouses/partners and commercial entities. Joslin and its planning and CME advisory committee members and speakers must disclose any relationships they and their spouses/partners have or have had in the prior 12 months with proprietary entities producing healthcare goods or services, with the exception of nonprofit or government organizations and non–healthcare-related companies, which are exempt.
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fees, honoraria, ownership interests (e.g., stocks, stock options, or other ownership interest, excluding diversified mutual funds), or other financial benefit in any amount. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received or expected.
If a faculty or planning committee member has no information to disclose, this information will also be provided. If a faculty or planning committee member refuses to disclose, he/she will not be able to participate in the planning, management, presentation, or evaluation of any Joslin Diabetes Center CME activity. In addition, faculty have been asked to disclose when a product or device is not labeled for the use under discussion. The opinions and comments expressed in this program are those of the speakers and should not be considered the opinions or comments of Joslin Diabetes Center.
Faculty Disclosures
  • Dr. Richard S. Beaser,* Senior Staff Physician, Joslin Diabetes Center, is on the academic advisory panel for Boehringer Ingelheim Pharmaceuticals, Inc.
  • Dr. Lyle Mitzner has no relevant financial relationships.
  • Dr. Mark E. Molitch is a consultant for Lilly USA, LLC; Merck & Co., Inc.; Pfizer Inc.; and Janssen Pharmaceuticals, Inc.; and is a consultant and receives grant/research support from Novartis Pharmaceuticals Corporation and Novo Nordisk Inc.
  • Dr. Greeshma K. Shetty has no relevant financial relationships.
Copyright © 2014 by Joslin Diabetes Center, Inc. All rights reserved.
Joslin Diabetes Center designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™ per virtual clinic. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Joslin Diabetes Center is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
This CME activity was planned and produced in accordance with ACCME Essentials. Health professionals not eligible for continuing medical education credit will receive a certificate of participation that they may submit to their state licensing board for credit.
By reviewing the course content and successfully completing the post-test and evaluation, physicians are entitled to receive 1 AMA PRA category 1 credits™ per activity. Statement of credit will be available to print from your user history page.
  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Complete the post-test and activity evaluation.
  • Physicians who successfully complete the post-test and evaluation will receive CME credit. You must score with a 70% or higher on the post-test to receive credit for this activity.
  • All other participants who successfully complete the post-test and evaluation will receive a certificate of participation.
This activity is supported by educational grants from Lilly USA, LLC, and Novo Nordisk Inc..

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