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 PresentationScientific Insights Into Incretin Signaling and Type 2 Diabetes
Eileen Egan, DNP, FNP-C, CDE
Relevant Resources
Mechanism-Based Strategies to Achieve Patient-Centered Care
Patient-Centered Management of Hyperglycemia in Primary Care
Integrating GLP-1 Receptor Agonists Into Multimodal Treatment Regimens
Translating Research Into Practice
Translating Reseach Into Practice
Overcoming Diagnostic Barriers and Optimizing Long-Term Patient Outcomes
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Evidence-Based Strategies for Improved Patient Outcomes
Discussions and Debates Around GLP-1 Receptor Agonists
Evolving Roles of GLP-1 Receptor Agonists
Proactive Diagnosis and Targeted Management
Differential Diagnosis and Comprehensive Management Strategies
Individualizing Evidence-Based Care
Optimizing Maintenance Therapy Across Healthcare Settings
Evolving Strategies for Diagnosis and Long-Term Management
Consensus and Controversies for Responsible Opioid Prescribing
Best Practices in Combination Therapy
Evolving Approaches to Insulin Based Therapy
Best Practices in Diagnosis and Management
Improving Outcomes for Patients with COPD
New Strategies for Insulin Replacement Therapy
Consensus and Controversies Around Intensifying Noninsulin Therapy
Clinical Updates in LDL-C Management
Identifying Patients and Tailoring Therapy
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A Focus on Patients With Opioid-Induced Constipation
Consensus and Controversies Across the Spectrum of Patient Presentations
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Evolving Best Practices to Optimize Outcomes
The PCP’s Role in Timely Recognition and Referral
An Evolving Role for Combinations of Injectable Antihyperglycemic Therapies
Integrating PCSK9 Inhibitors Into Hypercholesterolemia Management
Evolving Roles of GLP-1 Receptor Agonists
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
Key Issues Impacting OB/GYN Practice
Volume II: Expanding Evidence for the Role of Rapid ART Initiation in HIV Practice
Looking Beyond Hemoglobin A1c
Improving Patient Outcomes Through Shared Clinical Decision Making
What You Need to Know
Mechanistic Insights and Evolving Treatment Options
Clinical Resource Center
Implications for PCSK9 Inhibitors in Clinical Practice
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
The Clinical and Utilization Benefits of Exacerbation Prevention
A PrEP Primer
A Foundation for Managed Care
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Best Practices for Primary Care
New Paths to Chronic Pain Management
What the Pharmacist Needs to Know about PrEP
Unlocking Novel Paths to Patient Care
The Increasing Role of JAK Inhibitors
Preventing COPD Exacerbations to Improve Outcomes
A Whole Patient Case Series
Getting on the Fast Track to Identify AxSpA
Establishing Clinical Readiness Through Mentored Learning
Interdisciplinary Strategies for Adult and Pediatric Patients
Interdisciplinary Management of Eosinophilic Esophagitis and Hereditary Angioedema
Reducing LDL-C and a Lifetime of Cardiovascular Risk
Updates, Clinical Scenarios, and Future Directions
A Multidisciplinary Look at Early Diagnosis and Management
Best Practices for Diagnosis and Management
An Update on Best Practices
New Avenues to Pre-Exposure Prophylaxis
Are You Aware of New Blood-Based Multi-Cancer Screening Tools
A Look at the Changing HIV Playing Field
A “How To” Series Spanning Policy to Practice
Test Your Mastery!
Building Bridges to Reach People who Inject Drugs with the Goal of Employing PrEP for HIV Prevention
Strengthening Your Knowledge of Blood-Based Screening Tools
Bringing HIV Prevention to a New Level
Optimizing HIV Prevention in Primary Care
What You Need to Know About New Blood-Based Screening Tools
Monoclonal Antibodies for the Prevention and Treatment of COVID-19
Multidimensional Outcomes With SGLT2 Inhibitors
New Avenues to Improve Patient Outcomes
Exploring New Treatment Avenues in Nonadvanced Systemic Mastocytosis
Practical Updates on the 2023 GOLD Guidelines
A Phone-a-Friend CME Series – Volume 2
Best Practices for Screening, Diagnosis, and Management
Incorporating New Data and Updated Guidelines Into Daily Practice
Focus on Psoriasis
Capitalizing on BCMA-Directed Therapies
From the Airway Epithelium to Improved Patient Outcomes
Exercising Best Practices for Hospitalized Patients
Accelerating Diagnosis and Treatment
