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National Association for Continuing Education
Course Reviewer
Mark Stolar, MD
Associate Professor of Clinical Medicine
Northwestern University Medical School
Chicago, IL

Medical Writer
Cedric Nazareth, MBBS

: Combination Basal Insulin and GLP-1 RA Therapy: A Physiologic Approach to Diabetes Care
Activity/Course #:
: NCME365
: Free
Release/Start Date:
: Oct 31 2018
Expiration Date:
: Oct 30 2019
: Diabetes
Target Audience:
: Primary Care Physicians, Nurse Practitioners, Physician Assistants
: Monograph
Estimated Time To Complete CME Activity:
: 1.0 Hour
: 1.0 AMA PRA Category I Credit(s)
1.0 AANP Contact hour(s) which includes 0.75 pharmacology hour(s)
Hardware/Software Requirements:
Diabetes affects 30.3 million people, i.e., 9.4% of the U.S population, with type 2 diabetes (T2DM) accounting for about 90-95% of diagnosed cases in adults. Diabetes is associated with an increased risk for microvascular and macrovascular complications, including heart disease, hypertension, stroke, retinopathy, kidney disease, nerve damage, amputation, periodontitis, and complications of pregnancy.

Key pathophysiological features of T2DM include insulin deficiency and insulin resistance, leading to hyperglycemia, which in turn contributes to β-cell failure and worsening insulin resistance. Due to the progressive nature of T2DM, most patients eventually need insulin therapy to reach/maintain glycemic targets. However, various clinician and patient barriers limit the use of insulin in practice, and glycemic control remains suboptimal. The GLP-1 RAs may help in overcoming some of the barriers to insulin use and may be an alternative to prandial insulin in certain patients.

This activity will review the benefits of pathophysiologic vs algorithmic approach to management of type 2 diabetes, strategies to overcome barriers of therapeutic intensification, and identify patients who are most likely to benefit from combined basal insulin GLP-1 RA therapy.

Learning Objective(s):

After completing this program participants should be able to:

  1. Discuss the benefits of a pathophysiologic vs algorithmic approach to type 2 diabetes mellitus (T2DM) management
  2. Utilize effective strategies to overcome barriers to therapeutic intensification and clinical inertia in T2DM management
  3. Realize the limits of basal insulin therapy in clinical practice and when there is a greater need to address post-prandial hyperglycemia
  4. Identify patients who are most likely to benefit from combined basal insulin-GLP-1RA therapy as an effective means of combining endogenous/exogenous insulin therapy

How to obtain the CME Certificate

  1. Register for the course at
  2. View the content.
  3. Complete and submit the post-test and evaluation.
  4. A minimum passing score of 70% must be earned on the post-test in order to complete the CME activity.
  5. Print your CME certificate.
Sponsored and Certified By
National Association for Continuing Education
Accreditation Designation Statement
The National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The National Association for Continuing Education designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

National Association for Continuing Education is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners. AANP Provider Number 121222. This program has been approved for 1 contact hours of continuing education which includes 0.75 pharmacology hours.
Faculty Disclosure Policy
Policy on Faculty and Provider Disclosure: It is the policy of the NACE to ensure fair balance, independence, objectivity and scientific rigor in all activities. All faculty participating in CME activities sponsored by the National Association for Continuing Education are required to present evidence-based data, identify and reference off-label product use and disclose all relevant financial relationships. Faculty disclosures are provided below.

Activity Planning Committee,
Mark Stolar, MD, serves as a speaker for AstraZeneca.

Gregg Sherman, MD, has no relationships to disclose.

Cedric Nazareth, MBBS, has no relationships to disclose.

Deborah Paschal, CRNP, has no relationships to disclose.

Harvey C. Parker, Ph.D., has no relationships to disclose.

Michelle Frisch, MPH, has no relationships to disclose.

Daniela Hiedra, BA, has no relationships to disclose.

Sandy Bihlmeyer, MEd, has no relationship to disclose.

Alan Goodstat, LCSW, has no relationships to disclose.
Commercial Support
This educational activity is supported by an educational grant from Sanofi US.