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Interactive Exchange

Incretin-Based Therapies For Type 2 Diabetes

Improving Comprehensive Patient Care

Meeting Slides

Guidelines

Standards of medical care in diabetes—2016.

The ADA’s Standards of Care provide clinicians, patients, researchers, payers, and other interested individuals with the components of good diabetes management, general treatment goals, and tools to evaluate the quality of care. Importantly, these recommendations should be adjusted based on individual preferences, comorbidities, and other patient-related factors.

American Diabetes Association. Diabetes Care. 2016;39(suppl 1):S1-S112.

AACE/ACE Comprehensive Diabetes Management Algorithm 2016. 

The AACE/ACE algorithm provides recommendations on evaluating the whole patient, outlines potential risks and complications, and highlights evidence-based treatment approaches for diabetes. The document contains sections on lifestyle changes, considerations for obese individuals, prediabetes, glycemic goals, antihyperglycemic therapies, treatment algorithms, modifications for atherosclerotic cardiovascular disease risk factors, and overall principles of diabetes management. 

Garber AJ, et al. Endocr Pract. 2016;22(1):84-113.

American Association of Clinical Endocrinologists and American College of Endocrinology—Clinical Practice Guidelines for Developing a Diabetes Mellitus Comprehensive Care Plan—2015. 

These clinical practice guidelines provide practical recommendations for comprehensive care, integrate microvascular and macrovascular risk, and emphasize individualized targets for weight loss, glucose control, lipid levels, and blood pressure. There is also information on hypertension management, nephropathy management, hypoglycemia, and antihyperglycemic therapies.

Handelsman Y, et al. Endocr Pract. 2015;21(suppl 1):1-87.

Patient and Caregiver Resources

Diabetes HealthSense

Created as part of the National Diabetes Education Program, Diabetes HealthSense includes easily accessible resources that can help patients live well and meet their goals—whether they have diabetes or are at risk for the disease. 

Decision Aids for T2DM

To facilitate shared decision making, these examples of medication choice decision aids from the Mayo Clinic are organized into 7 issues that may be of interest to patients with T2DM. A video demonstrating the use of these cards can be found at: www.youtube.com/watch?v=SYTPqceFgSw.

Suggested Readings

Is insulin the most effective injectable antihyperglycaemic therapy?

Buse JB, et al. Diabetes Obes Metab. 2015;17(2):145-151.

Pharmacology, physiology, and mechanisms of incretin hormone action.

Campbell JE, Drucker DJ. Cell Metab. 2013;17:819-837.

From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus.

Defronzo RA. Diabetes. 2009;58(4):773-795.

Minimizing hypoglycemia in diabetes.

International Hypoglycemia Study Group. Diabetes Care. 2015;38(8):1583-1591. 

Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes.

Inzucchi SE, et al. Diabetes Care. 2015;38(1):140-149.

Loss of incretin effect is a specific, important, and early characteristic of type 2 diabetes.

Holst JJ, et al. Diabetes Care. 2011;34 (suppl 2):S251-S257.

Liraglutide and cardiovascular outcomes in Type 2 diabetes.

Marso SP, et al. N Engl J Med. 2016 June 13 [Epub ahead of print].

Benefits of combination of insulin degludec and liraglutide are independent of baseline glycated haemoglobin level and duration of type 2 diabetes.

Rodbard HW, et al. Diabetes Obes Metab. 2016;18(1):40-48.

GLP-1 receptor agonists: a review of head-to-head clinical studies.

Trujillo JM, et al. Ther Adv Endocrinol Metab. 2015;6(1):19-28.

Type 2 diabetes patients reach target glycemic control faster using IDegLira than either insulin degludec or liraglutide given alone.

Vilsbøll T, et al. Clin Drug Investig. 2016;36(4):293-303.

Blood pressure-lowering effects of GLP-1 receptor agonists exenatide and liraglutide: a meta-analysis of clinical trials.

Wang B, et al. Diabetes Obes Metab. 2013;15(8):737-749.

Comparison of GLP-1 analogues versus sitagliptin in the management of type 2 diabetes: systematic review and meta-analysis of head-to-head studies.

Wang T, et al. PLoS One. 2014;9(8):e103798.

Interactive Presentation

Scientific Insights Into Incretin Signaling and Type 2 Diabetes

Eileen Egan, DNP, FNP-C, CDE


Relevant Resources

Incretin-Based Therapies for Type 2 Diabetes

Mechanism-Based Strategies to Achieve Patient-Centered Care

Insulin Replacement Therapy for Type 2 Diabetes

Patient-Centered Management of Hyperglycemia in Primary Care

Improving Outcomes in Type 2 Diabetes

Integrating GLP-1 Receptor Agonists Into Multimodal Treatment Regimens

A Focus on Bipolar Depression

Overcoming Diagnostic Barriers and Optimizing Long-Term Patient Outcomes

Acute Management of Migraine Attacks

Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes

Clinical Updates on the Management of Gout

Evidence-Based Strategies for Improved Patient Outcomes

Clinical Issues in Type 2 Diabetes

Discussions and Debates Around GLP-1 Receptor Agonists

Clinical Issues in Type 2 Diabetes

Evolving Roles of GLP-1 Receptor Agonists

Opioid-Induced Constipation

Proactive Diagnosis and Targeted Management

Chronic Obstructive Pulmonary Disease, Asthma, or Both

Differential Diagnosis and Comprehensive Management Strategies

Improving Outcomes for Women with Type 2 Diabetes

Individualizing Evidence-Based Care

Improving Outcomes in Chronic Obstructive Pulmonary Disease

Optimizing Maintenance Therapy Across Healthcare Settings

Managing Gout in Primary Care

Evolving Strategies for Diagnosis and Long-Term Management

Clinical Issues in Chronic Pain

Consensus and Controversies for Responsible Opioid Prescribing

Noninsulin Approaches to Managing Type 2 Diabetes

Best Practices in Combination Therapy

Hitting the Target in Type 2 Diabetes

Evolving Approaches to Insulin Based Therapy

Improving Outcomes in Congenital and Acquired Lipodystrophy

Best Practices in Diagnosis and Management

Clearing the Air

Improving Outcomes for Patients with COPD

Clinical Updates in Type 2 Diabetes

New Strategies for Insulin Replacement Therapy

Clinical Issues in Type 2 Diabetes

Consensus and Controversies Around Intensifying Noninsulin Therapy

How Low Do You Go?

Clinical Updates in LDL-C Management

Improving Outcomes in Non–24-Hour Sleep-Wake Disorder

Identifying Patients and Tailoring Therapy

Comprehensive Management of Chronic Obstructive Pulmonary Disease

Collaborative Approaches to Guideline-Concordant Patient Care

Clinical Updates in the Management of Severe Asthma

New Strategies for Individualizing Long-term Care

Comprehensive Chronic Pain Management

A Focus on Patients With Opioid-Induced Constipation

Clinical Issues in Bipolar Depression

Consensus and Controversies Across the Spectrum of Patient Presentations

Clinical Updates in Rheumatoid Arthritis

Evolving Treatment Algorithms and Expert Perspectives on Biosimilars

Caring for Patients with Severe Asthma

Evolving Best Practices to Optimize Outcomes

Can You Spot Axial Spondyloarthritis?

The PCP’s Role in Timely Recognition and Referral

Clinical Updates in Type 2 Diabetes

An Evolving Role for Combinations of Injectable Antihyperglycemic Therapies

Raising the Bar by Lowering the Target

Integrating PCSK9 Inhibitors Into Hypercholesterolemia Management

Injecting New Ideas into Managing Type 2 Diabetes

Evolving Roles of GLP-1 Receptor Agonists

Advancing the Care of Severe Asthma

Differential Diagnosis, Multidisciplinary Management, and Patient Engagement

Updates in HCV Screening and Treatment

Key Issues Impacting OB/GYN Practice