Moving Beyond “Treat-to-Failure” Strategies in T2DM: Evidence Along the Risk/Reward Path of Treatment Intensification
Approximately ___ of the 21 million patients with type 2 diabetes mellitus (T2DM) in the United States are meeting guideline-recommended hemoglobin A1C (HbA1C) targets.
C. 50%. Approximately 50% of the 21 million patients with type 2 diabetes mellitus (T2DM) in the United States are meeting guideline-recommended hemoglobin A1C (HbA1C) targets. (Carls G, Huynh J, Tuttle E, et al. Diabetes Ther. 2017;8:863-73.)
Anne Peters, MD
Director, USC Clinical Diabetes Program
Professor of Clinical Medicine, Keck School of Medicine of USC
University of Southern California
Los Angeles, CA
Timothy S. Reid, MD
Mercy Diabetes Center
Amy Burdette, PhD
Manager, Educational Strategy & Content
Kathryn Schaefer, MSN, RN
Lead Nurse Planner
East Lansing, MI
Upon completion, participants should be able to:
- Describe the benefits of earlier treatment intensification with injectable combination therapies versus the traditional stepwise approach to T2DM management
This activity is intended for primary care physicians and endocrinologists.
Statement of Need
Currently, only 50% of the roughly 21 million patients with type 2 diabetes mellitus (T2DM) in the United States meet guideline-recommended hemoglobin A1C (HbA1C) targets. Unfortunately, numerous studies have shown that delays in treatment intensification for patients with T2DM occur frequently. Although the factors that contribute to delayed intensification of therapy are complex and multifactorial, one important issue is likely the reliance on a traditional stepwise progression through diabetes management. Another contributing factor is the discordance between clinicians and their patients with uncontrolled diabetes in their perceptions of diabetes control, with physicians reluctant to intensify therapy when there is a lack of patient agreement. The earlier use of injectable combination therapy, such as glucagon-like peptide-1 receptor agonists and insulin therapy, affords clinicians the ability to address multiple pathophysiologic defects associated with T2DM simultaneously and potentially delay or slow disease progression. The major barriers to the earlier use of combination therapy are related to concerns about patient adherence, cost, side effects, and patient disease acceptance.
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To receive credit, read the introductory CME material, listen to the audiocast, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.
Initial Release Date: December 19, 2018
Expiration Date: December 18, 2019
Estimated Time to Complete This Activity: 15 minutes
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Anne Peters, MD
Consulting fees/advisory boards: Abbott Laboratories, Becton, Dickinson and Company, Boehringer-Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Lexicon Pharmaceuticals, Inc., Livongo Health, Merck & Co., Inc., Novo Nordisk, Optum, Inc., Sanofi-aventis U.S., Inc.
Fees received for promotional/non-CME activities (Speakers bureau): Novo Nordisk, Sanofi-aventis U.S., Inc.
Contracted research: AstraZeneca, Dexcom, Inc., MannKind Corporation
Ownership interest (stocks/stock options – excluding mutual funds): Mellitus Health, Inc., Omada Health, Inc., Stability Healthcare
Timothy S. Reid, MD
Consulting fees/advisory boards: AstraZeneca, Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk, Sanofi-aventis U.S., Inc.
Fees received for promotional/non-CME activities: Janssen Pharmaceuticals, Inc., Novo Nordisk, Sanofi-aventis U.S., Inc.
The peer reviewers and activity planners have no financial relationships to disclose.
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This activity is supported by an educational grant from Sanofi US.
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