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New Considerations in Diabetes Management

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Overview


This issue highlights the use of continuous glucose monitoring (CGM) systems, sodium glucose transport protein-2 (SGLT2) inhibitors, newer insulin formulations, and the expert guideline recommendations focused on individualization of therapy.

In 2017, the Centers for Disease Control reported that over 30 million people in the US (~10% of the population) have diabetes, including 7.2 million who are undiagnosed. The total estimated cost of diagnosed diabetes in the US was $327 billion in 2017.2 Individuals with diabetes incur average annual medical expenses of about $16,750 – more than twice the expense for people without diabetes.

Over the last decade, the options for managing diabetes have grown dramatically – including new medication classes (eg, glucagon- like peptide-1 agonists, sodium-glucose transport protein-2 inhibitors), new insulin analogs (eg, insulin degludec, biosimilar insulins), and new technologies to help patients monitor their diabetes (eg, continuous glucose monitoring).

Clinical practice guidelines have increased the emphasis on individualizing treatment options and goals to meet the needs of each patient. Patients have more say in the management of their diabetes and overall health. It is essential that healthcare providers help patients navigate the vast pool of information available at their fingertips. Diabetes patients can easily get confused by the often-conflicting information or misinformation available on television and the internet, and from friends and family members. Community providers need a good, working knowledge of patient-specific diabetes management, including current treatments and technologies...

Details

Publication Date: 09/21/2018
Expiration Date: 09/21/2021
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

Andrew Bzowyckyj, PharmD BCPS, CDE is an Associate Professor in the School of Pharmacy at Pacific University Oregon in Hillsboro, Oregon.

Amanda Stahnke, PharmD, BCACP is a Clinical Assistant Professor in the Department of Pharmacy Practice and Administration at the University of Missouri-Kansas City School of Pharmacy. She serves as a Patient-Aligned Care Team (PACT) Pharmacist at the Kansas City Veterans Affairs Medical Center.

Disclosure Statement

Dr. Bzowyckyj and Dr. Stahnke report no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Guest Editorial Advisor

Susan Cornell, PharmD, CDE, FAPhA, FAADE is an Associate Professor of Pharmacy Practice and Associate Director of Experiential Education at Chicago College of Pharmacy at Midwestern University in Downers Grove, IL. She is also a diabetes care provider at the Bolingbrook Christian Health Clinic and Will-Grundy Medical Clinic.

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 the current recommendations for continuous glucose monitoring (CGM) in patients with diabetes. Describe how personal CGM devices work and list the advantages and disadvantages of currently available products.
    2. Outline important considerations with the use of SGLT2 inhibitors, including cardiovascular benefits, use in patients with kidney dysfunction, and potentially serious side effects.
    3. Discuss new developments in insulin therapy, including ultra-rapid acting insulins and biosimilars (follow-on biologic insulins). Counsel a patient on converting from one insulin type to another.
    4. Discuss the proposed subcategories of T2DM. Be able to apply patient-centered treatment recommendations from the ADA and AACE/ACE.

Accreditation Statements

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

ACPE logo
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

California Board of Registered Nursing logo
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.

ACPE Universal Activity Number: 0428-0000-18-010-H01-P


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

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


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

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, 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

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

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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