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Diabetes Update 2010

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Overview

As we learn more about the pathophysiology of type 2 diabetes mellitus (T2DM), the level of therapeutic complexity continues to grow. Whether this involves the approval of new medications, new insights into potential drug side effects, or changes in treatment goals, it is in the community provider’s best interest to stay abreast of the latest developments in the management of T2DM.

This article updates the participant on 7 key developments in the treatment of T2DM: 1) saxagliptin (OnglyzaTM), the new dipeptidyl-peptidase-4 (DPP-4) inhibitor, 2) research evaluating “tight” glucose control in patients with T2DM, 3) cardiovascular risk with rosiglitazone (Avandia®) and pioglitazone (Actos®), 4) safety warnings for insulin secretagogues (i.e., sulfonylureas, meglitinides), 5) the potential link between insulin glargine (Lantus®) and cancer, 6) promising new insulin formulations through the inhaled and buccal routes of administration, and 7) liraglutide, a once-daily glucagon-like peptide-1 (GLP-1) analog similar to exenatide (Byetta®). Accompanying each review is a synopsis of pertinent patient counseling information.

Publication Date: Jan-1-10
Expiration Date: Jan-1-13
CE Credit: 1.5 (0.15 CEU)
Type of activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP, Assistant Professor, Department of Pharmacotherapy, Washington State University, and Matthew Rhea, MBA, PharmD Candidate (2010), Washington State University, Spokane, WA.

Disclosure Statement

Dr. Neumiller receives grant support from Novartis, Merck, and GlaxoSmithKline. Mr. Rhea has nothing to disclose. Professor Campbell (guest editor) is on the Speaker’s Bureaus for Daiichi-Sankyo and Eli Lilly and Co.

Guest Editorial Advisor

R. Keith Campbell, RPh, MBA, CDE, FASHP

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Discuss recent developments surrounding the development and clinical use of medications for the treatment of T2DM.
    2. Outline important considerations and counseling points for patients currently on, or previously taking, medications such as saxagliptin (Onglyza), thiazolidinediones, insulin secretagogues, and insulin glargine (Lantus®).
    3. Discuss how insulin products and incretin mimetics in the developmental pipeline have the potential to improve patient care, adherence, and treatment acceptance.
    4. Provide practical guidance and counseling regarding cardiovascular risk for patients taking a thiazolidinedione or receiving intensive glucose management.

Exam & Credit Statement procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Lecturer
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
And
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD


Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

CE for this article is no longer valid.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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CE for this article is no longer valid.