Estimated time to complete the program: 1 hour
5 min Welcome and Overview
15 min Case Presentation – Understanding T2DM Pathophysiology in the Aging: Duration of Disease
15 min Case Presentation – Choosing Appropriate Therapy for Managing A1C in Aging Patients: Efficacy, Adverse Events, and Convenience
15 min Case Presentation – Cardiovascular Risks in Aging Patients with Diabetes: Optimal Strategies to Minimize Risk
10 min Question and Answer Session
Type 2 diabetes mellitus (T2DM) is an epidemic in the US and around the world. The 2011 Centers for Disease Control (CDC) report shows that 26.9% of individuals 65 years of age or older have diabetes. Additionally, 50% of adults 65 years of age or older were reported to have prediabetes, and in 2010, 390,000 new cases of diabetes were reported in this age group. Recent data show that the risk of coronary death and death from vascular causes in patients with diabetes was 2.31- and 2.32-fold higher than those without diabetes. Diabetes has been shown to decrease life expectancy by 6 years in individuals who are 50 years of age. Despite the availability of a wide variety of pharmaceuticals, T2DM in the aging remains a difficult condition to treat. A recent CDC analysis showed that between 2003 and 2006, ~32% of patients who were ≥65 years of age had an A1C level ≥7.0; ~11% had an A1C level ≥8%; and 4.1% had an A1C >9%. The complex nature of T2DM pathology and rapid emergence of new data, especially with respect to incretin-based therapies, makes it difficult for clinicians to stay abreast of the latest developments. Clearly, continuing education activities are needed to highlight the novel strategies that allow clinicians to not just control their aging patients' glycemic profiles but also help minimize cardiovascular risks. Therefore, this activity will begin with an overview of the prevalence and morbidity associated with T2DM in aging patients and barriers such as fear of weight gain, fear of hypoglycemia, and ease and convenience of use of therapies that frequently hinder optimal management. Next, using the case of an aging patient, the faculty will review the current understanding of the pathophysiology of T2DM and highlight the mechanism of action of incretin-based therapies in this context. They will then highlight the role of a multifaceted approach for better glycemic control and for minimized cardiovascular risks consistent with guideline recommendations. Furthermore, they will discuss recent clinical trial data demonstrating the ease and convenience of use, safety and efficacy profiles of short- and long-acting incretin-based therapies in managing T2DM in aging patients. Finally, the expert faculty will drive home the key clinical takeaways and guideline recommendations that physicians can implement immediately into their clinical practices in order to improve care for their patients with T2DM.
This activity has been designed to meet the educational needs of primary care clinicians, registered nurses, pharmacists, and other healthcare professionals involved in the care of patients with type 2 diabetes mellitus.
Physician Continuing Medical Education
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Postgraduate Institute for Medicine and ACCELMED. The Postgraduate Institute for Medicine is accredited by the ACCME to provide continuing medical education for physicians.
The Postgraduate Institute for Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Pharmacist Continuing Education
Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Postgraduate Institute for Medicine designates this continuing education activity for 1.0 contact hour(s) (0.1 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number – 0809-9999-13-283-L01-P)
Type of Activity
Hardware / Software Requirements
To view this educational activity you will need a personal computer or smartphone with internet access and one of the following web browsers:
Flash Player 8.0 or later (http://www.adobe.com/go/getflash) (Flash Player 10 or later recommended), and one of the following browsers:
Windows: Firefox 1.1+, Internet Explorer 7.0+, Safari 1.0+, Google Chrome, or Opera
Macintosh: Firefox 1.1+, Safari 1.0+, Google Chrome, or Opera
Linux: Firefox 1.1+
Broadband connection with 500+ Kbps
Policy on Privacy and Confidentiality
Please see final activity for the policy on privacy and confidentiality that relates to this internet activity.
Upon receipt of the completed activity evaluation form, transcript information will be available at www.mycpemonitor.net within 4 weeks.
Nursing Continuing Education
Postgraduate Institute for Medicine is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This educational activity for 1.0 contact hours is provided by Postgraduate Institute for Medicine.
California Board of Registered Nursing
Provider approved by the California Board of Registered Nursing, Provider Number 13485, for 1.0 contact hours.
There is no fee for this educational activity.
A statement of credit will be issued only upon receipt of a completed activity evaluation form and will be emailed to you upon completion of the program.
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.
The faculty reported the following financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity:
Louis Kuritzky, MD
Consultant Fees: Boehringer-Ingelheim GmbH; Daiichi Sankyo, CO., LTD.; Janssen Global Services, LLC; Johnson & Johnson; Lilly USA, LLC; Novartis International AG; Novo Nordisk A/S; Ortho-McNeil; sanofi-aventis; Takeda Pharmaceuticals Company Limited
Grant Reviewer: Pfizer Inc.
Frank Lavernia, MD
Speakers' Bureaus: Janssen Global Services, LLC; Novo Nordisk A/S
Anne Peters, MD, FACP, CDE
Consultant Fees: Abbott Diabetes Care; Amylin Pharmaceuticals, Inc./Lilly USA, LLC; Becton, Dickinson and Company; F. Hoffman-La Roche Ltd.; Janssen Pharmaceuticals, Inc.; Medtronic, Inc.; Takeda Pharmaceutical Company Limited; sanofi-aventis, U.S. LLC
Speakers' Bureaus: Amylin Pharmaceuticals, Inc./Lilly USA, LLC; Novo Nordisk A/S
Helena W. Rodbard, MD, FACP, MACE
Consultant Fees: Amylin Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Lilly USA, LLC; Novo Nordisk A/S
Consultant Fees Spouse: Amylin Pharmaceuticals, Inc.; Halozyme Therapeutics; Merck & Co., Inc.
Speakers' Bureaus: Amylin Pharmaceuticals, Inc.; Boehringer Ingelheim GmbH; Lilly USA, LLC; Merck & Co., Inc.; Novo Nordisk A/S
Contracted Research: Amylin Pharmaceuticals, Inc.; Biodel Inc.; Merck & Co., Inc.; Novo Nordisk A/S; sanofi-aventis, U.S. LLC
The planners and managers reported the following financial relationships or relationships they or their spouse/life partner have with commercial interests related to the content of this continuing education activity:
The following PIM planners and managers, Laura Excell, ND, NP, MS, MA, LPC, NCC, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CCMEP, Jan Schultz, RN, MSN, CCMEP, and Patricia Staples, MSN, NP-C, CCRN, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.
The following ACCELMED planner and manager, Jason LeDune, MS, hereby states that he or his spouse/life partner has no relationships with commercial interests.
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 planners of this activity 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 the planners. 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 or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.
This activity is supported by an independent medical education grant from the Bristol-Myers Squibb and AstraZeneca Pharmaceuticals LP, Alliance Partners.