Integrating GLP-1 RAs Into T2D Treatment Plans: What Your Patients Need to Know

Integrating GLP-1 RAs Into T2D Treatment Plans: What Your Patients Need to Know

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Released: 11/17/2021
Expires: 11/16/2022
Max Credits: 1.0
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Jay H. Shubrook, DO, FACOFP, FAAFP
Professor, Primary Care Department
Director of Clinical Research and Diabetes Services
College of Osteopathic Medicine
Touro University California
Vallejo, CA

Activity Planners
Susan Kuhn, MHSc
Manager, Educational Strategy and Content
Baltimore, MD

Laura Rafferty, ELS
Senior Editorial Manager
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Katherine Kahn
Holyoke, MA

Learning Objectives
Upon completion, participants should be able to:

  • Identify patients with T2D who may benefit from earlier initiation of GLP-1 RA treatment
  • Address patient expectations and concerns regarding GLP-1 RA treatment, including glycemic and extra-glycemic effects and adverse effects

Target Audience
This activity is intended for primary care providers, including physicians, nurse practitioners, and physician assistants, who treat patients with or at risk of developing type 2 diabetes.

Statement of Need
Treatment plans for type 2 diabetes (T2D) should be individualized for each patient based on treatment goals, comorbidities, and preferences. This personalization is possible due to the availability of multiple glucagon-like peptide-1 receptor agonists (GLP-1 RAs), which are recommended as second-line treatment after metformin for T2D patients across the treatment continuum. These agents have been shown to be effective in reducing HbA1C levels and body weight and confer a minimal risk of hypoglycemia; moreover, 3 GLP-1 RAs have been shown to lower the risk of major adverse cardiovascular events. Despite these benefits, this drug class is underused. Busy primary care clinicians may have limited time to familiarize themselves with the different GLP-1 RA formulations and dosing regimens. Because adherence and persistence rates to GLP-1 RAs are suboptimal, clinicians should educate their patients on correct usage and be able to identify specific GLP-1 RA attributes that may improve patient adherence. Clinicians also need to ensure that their patients have realistic expectations regarding GLP-1 RAs and address any bothersome adverse effects or other challenges that may contribute to low adherence or treatment discontinuation.

Providership Statement
Provided by Med-IQ.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Med-IQ designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

Medium/Method of Participation
This is a 1.0-credit CE activity. To receive credit, read the introductory CE material, complete all of the modules, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: November 17, 2021
Expiration Date: November 16, 2022
Estimated Time to Complete This Activity: 1 hour

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Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity.

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Jay H. Shubrook, DO, FACOFP, FAAFP
Consulting fees/advisory boards: Bayer Healthcare Pharmaceuticals, MannKind, Novo Nordisk

The writer, peer reviewers, and activity planners have no financial relationships to disclose.

Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

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Contact Information
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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Complimentary CE
This activity is available free of charge to participants.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Novo Nordisk.


The following material has been developed to accompany this activity:

Patient Video: Understanding the Role of GLP-1 Medicines in Managing Type 2 Diabetes

Note: This material is not accredited for CME and, therefore, does not offer any CME/CE credit.


Welcome to this Med-IQ activity on integrating GLP-1 RAs into T2D treatment plans. Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • GLP-1 RAs play a central role in T2D management; the American Diabetes Association guidelines now recommend GLP-1 RAs as second-line T2D treatment, especially in people who have compelling comorbid conditions (eg, ASCVD, heart failure, chronic kidney disease)
  • Like native GLP-1, GLP-1 RAs act in the gut, liver, and pancreas, activating GLP-1 receptors when blood glucose levels increase after food is ingested
  • All GLP-1 RAs have been shown to be effective in reducing HbA1C levels; however, clinically significant differences exist among individual GLP-1 RAs in duration of action, magnitude of HbA1C reduction, extra-glycemic effects (eg, weight loss, satiety, CV risk reduction), and frequency and severity of adverse effects
  • The short-acting injectable GLP-1 RAs lixisenatide and exenatide IR are administered once and twice daily, respectively; they primarily affect postprandial glucose and have a smaller effect on fasting glucose
  • Long-acting injectable GLP-1 RAs (liraglutide, exenatide ER, dulaglutide, semaglutide) allow for once-daily and once-weekly dosing; these agents exert greater effects on overnight and fasting glucose and HbA1C
  • The recent FDA approval of once-daily oral semaglutide, whose unique formulation protects it from degradation and facilitates absorption through the gastric mucosa, provides an additional option when considering patient preferences
  • Helping patients with T2D choose appropriate treatment regimens, counseling patients on adverse effects, and setting treatment expectations are important in T2D management

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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