Working Toward the Same Goals: Strategies to Optimize Patient and Provider Use of Fixed-Ratio Combinations of GLP-1 Receptor Agonists and Insulin

Working Toward the Same Goals: Strategies to Optimize Patient and Provider Use of Fixed-Ratio Combinations of GLP-1 Receptor Agonists and Insulin

Med-IQ Select
Online Course | Specialties: Family Medicine, Internal Medicine, Primary Care
Released: 5/26/2021
Expires: 5/25/2022
Max Credits: 1.25
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Elizabeth A. Beverly, PhD
Associate Professor
Department of Primary Care
Ohio University Heritage College of Osteopathic Medicine
Athens, OH

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

Katherine Yu, DO, MPH
Internal Medicine Resident Physician
Alameda Health System, Highland Hospital
Oakland, CA

Activity Planners
Iwona Misiuta, PhD, MHA
Clinical Content Manager
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Kathryn Schaefer, MSN, RN, CPHRM, CHCP
Associate Director, Education Quality and Compliance
East Lansing, MI

Learning Objectives
Upon completion, participants should be able to:

  • Use person-first, strengths-based, nonjudgmental language when communicating with patients with T2D about their glycemic goals and treatment intensification
  • Identify patients with T2DM who may benefit from earlier treatment intensification with injectable, fixed-ratio combination therapies and address their expectations regarding treatment initiation, efficacy, adverse effects, and titration
  • Individualize diabetes treatment intensification decisions based on patients’ needs, goals, and preferences and consider how these factors might change decisions during the COVID-19 pandemic

Target Audience
This activity is intended for primary care clinicians (physicians, nurse practitioners, and physician assistants) and nurses who care for patients with T2DM.

Statement of Need
According to the most recent statistic in the United States (US), more than 34 million adults 18 years or older have type 2 diabetes mellitus (T2DM)—a number that accounts for 13% of the US population. It is critically important that patients with T2DM initiate and—when needed—intensify treatment to reach glycemic goals early to prevent diabetes-related organ damage. Factors that contribute to delayed intensive treatment are complex and multifactorial; however, one important issue is the traditional reliance on a stepwise progression through diabetes management. In addition, other barriers include adherence, cost, side effects, and suboptimal disease knowledge. Newer injectable, fixed-ratio combination therapies have been shown to be effective in helping patients reach glycemic targets more quickly and with favorable side effect profiles that include weight loss and decreased risks of cardiovascular issues. Clinicians should be well versed in the clinical evidence on injectable, fixed-ratio combinations, including benefits, limitations, and strategies to overcome barriers to treatment intensification.

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 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Med-IQ is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

This nursing activity has been approved for up to 1.25 contact hours.

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 1.25-credit CME activity. To receive credit, read the introductory CME 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: May 26, 2021
Expiration Date: May 25, 2022
Estimated Time to Complete This Activity: 1 hour and 15 minutes

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 24 months that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

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.

Elizabeth A. Beverly, PhD, has indicated no real or apparent conflicts.

Jay H. Shubrook, DO, FACOFP, FAAFP
Consulting fees/advisory boards: Bayer HealthCare, Eli Lily & Co., Novo Nordisk, Sanofi-aventis U.S. Inc.

Katherine Yu, DO, MPH, has indicated no real or apparent conflicts.

The 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, it is the policy of Med-IQ 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.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.

Contact Information
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email

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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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This activity is available free of charge to participants.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Sanofi US.



Welcome to this Med-IQ Select on appropriate language to use when discussing glycemic goals and treatment intensification with fixed-ratio combination GLP-1 RA/insulin injectable therapies in a nonjudgmental and destigmatizing with patients with T2DM. Med-IQ Select is a unique online educational offering that allows you to pick and choose the content you would like to view—in any order and at your convenience. Key clinical takeaways from this activity include:

  • Strategies for explaining diabetes progression and the importance of intensifying treatment
  • Methods to dispel fears about injectable medication
  • Tips for showing patients how to use fixed-ratio combination GLP-1 RA/insulin injectables
  • Best practices for building a diabetes management team

View reference list.

Click "Continue" to proceed through this activity and/or receive credit. To receive credit and a certificate, you must complete all of the modules in this activity.

Unless otherwise indicated, photographed subjects who appear within the content of this activity or on artwork associated with this activity are models; they are not actual patients or doctors.

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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