Managing Patients in Primary Care: Patient With Type 2 Diabetes Failing Metformin Therapy

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Program Overview:
Type 2 diabetes is a significant and growing concern for primary care clinicians, with significant associated complications, including CVD, peripheral neuropathy, nephropathy, and blindness. In patients with diabetes, appropriate treatment will slow progression, and therefore development of complications, making management with an appropriate regimen and lifestyle changes critical for long-term patient outcomes. This activity will combine a real-world example of diagnosis and disease progression with the latest data on treatment safety and efficacy to enable clinicians to develop the best protocol for each patient.

Learning Objectives:
After completing this activity, the participant will be able to

1. Identify treatment strategies for insulin use, based on patient outcomes and goal achievement
2. Identify the key mechanisms of incretin biology and incorporate appropriate treatment strategies to address glucose control

Accreditation/Designation Statement:
Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Primary Care Network designates this educational activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Target Audience:
This activity is targeted to all physicians and other healthcare professionals who treat patients with diabetes.

Release Date: September 30, 2009
Expiration Date: September 30, 2010

Medium: Podcast

Acknowledgment of Commercial Support:
This activity was developed from the live Best Practices in Primary Care™ program held in Las Vegas, Nevada, on April 25, 2009, which was funded by AstraZeneca/Bristol-Myers Squibb Alliance and The Amylin-Lilly Alliance.

Method of Participation:
To receive CME credit for this activity, you need to listen to the program. Upon finishing the podcast, complete the post-test and evaluation and fill out all required personal information. To receive your CME certificate you will need to pass the post-test with 70% accuracy or better.

Post-test and Evaluation: After completing this activity, click on the Post-test button at the end of the program. If you receive less than 70% on the post-test, you will be returned to the beginning of the activity to review the presentation again. Upon successful completion of the post-test, you will be asked to fill out a program evaluation form and prompted to print your CME certificate.

Statement of Disclosure and Independence:
It is the policy of Primary Care Network, Inc. to ensure all its sponsored educational activities are planned, developed, and conducted in accordance with the ACCME’s Essential Areas and Policies. In accordance with ACCME requirements, Primary Care Network has Conflict of Interest and Disclosure Policies that are designed to ensure that Primary Care Network sponsored educational activities are fair balanced, independent, evidence‐based and based on scientific rigor.

Primary Care Network’s Resolution of Personal Conflicts of Interest (COI) Policy aims to ensure that all conflicts are resolved prior to the activity, content is developed and presented free of commercial bias, and is in the interest of promoting improvements or quality in healthcare. All individuals who are in a position to influence and/or control content of a Primary Care Network sponsored activity are required to disclose to the participants any real or apparent conflict of interest related to the activity. The educational content is also reviewed for independence and content validation by an independent external clinical reviewer and internal clinical reviewer. Independence is also monitored through the activity and overall program evaluation process.

The opinions, ideas, recommendations, and perspectives expressed in the accompanying presentations at this Primary Care Education program are those of the program authors and presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations or perspectives of their affiliated institutions, Primary Care Network, Primary Care Education, Advisory Boards and Consultants, or the activity’s commercial supporters.

Faculty and Disclosure:
Lawrence Blonde, MD, FACP, FACE
Director, Ochsner Diabetes Clinical Research Unit
Ochsner Clinic Foundation
Department of Endocrinology, Diabetes, and Metabolic Diseases
New Orleans, LA

Dr. Blonde serves on the speaker’s bureau and is a consultant for Abbott Labs, Amylin Pharmaceuticals, AstraZeneca, Biodel, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, LifeScan, Merck, Novartis Corporation, Novo Nordisk, Pfizer, Roche, and sanofi-aventis. Dr. Blonde has received research grants from Amylin, Eli Lilly, MannKind Corporation, Merck, Novartis Corporation, Novo Nordisk, Pfizer, Roche, and sanofi-aventis. Dr. Blonde and his spouse are stock shareholders of Amylin and Pfizer.

Planning Committee and Disclosures:
Frank Lavernia, MD
Internal Medicine and Diabetes
Founder, North Broward Diabetes Center
Coconut Creek, FL

Dr. Lavernia serves on the speaker’s bureau for Abbott Labs. He is on an advisory board for AstraZeneca.

Jack Leahy, MD
Professor of Medicine
Chief, Division of Endocrinology, Diabetes, and Metabolism
University of Vermont Colchester Research Facility
Colchester, VT

Dr. Leahy serves on the speaker’s bureau for Merck & Co. He is on an advisory board for Bristol-Myers Squibb, Johnson & Johnson, Merck & Co., Novo Nordisk, and sanofi-aventis. Dr. Leahy is a consultant for sanofi-aventis and Daiichi Sankyo, and is a stock shareholder of Schering-Plough.

Bajet Nour, MD
Senior Medical Director
Vindico Medical Education
Thorofare, NJ

Dr. Nour has no relevant financial relationships to disclose.

Chris Rosenberg
Associate Medical Director
Vindico Medical Education
Thorofare, NJ

Mr. Rosenberg has no relevant financial relationships to disclose.

Megan Stewart
Activity Manager
Vindico Medical Education
Thorofare, NJ

Ms. Stewart has no relevant financial relationships to disclose.

Faith Bantivoglio
Compliance Manager
Vindico Medical Education
Thorofare, NJ

Ms. Bantivoglio has no relevant financial relationships to disclose.

Review Committee Disclosure
In accordance with PCN policy, all content is reviewed by external independent peer reviewers for balance, objectivity, and commercial bias.  The peer reviewers, staff, and other individuals who control content have no relevant financial relationships to disclose.

Unlabeled Use Declaration
During their presentation(s), faculty may discuss an unlabeled use or an investigational use not approved for a commercial product. Each faculty member is required to disclose this information to the audience when referring to an unlabeled or investigational use.

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