eDiabetes Review
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   VOLUME 1 - ISSUE 2

INTENSIFYING THERAPY FOR GLYCEMIC CONTROL
Our guest author is Nestoras Mathioudakis, MD, Assistant Professor of Medicine, Division of Endocrinology, Diabetes, & Metabolism and Associate Director, Inpatient Diabetes Management at the Johns Hopkins University School of Medicine in Baltimore, Maryland.

After participating in this activity, the participant will demonstrate the ability to:
Describe the advantages and disadvantages of available glucose-lowering medications as add-on therapy to metformin.
Evaluate treatment options in patients with the suboptimal glycemic control already on three glucose-lowering medications.
Summarize the indications for insulin therapy and the principles involved in adjusting insulin dosing.

This discussion, offered as a downloadable audio file and companion transcript, covers the important topic of glycemic control and strategies to intensify therapy in the format of case-study scenarios for the clinical practice. This program is a follow up to the Volume 1, Issue 1 eDiabetes Review newsletter — Strategies for Intensifying Therapy for Glycemic Control.


Unlabeled/Unapproved Uses
Dr. Mathioudakis has indicated that his discussion will not refer to unlabeled or unapproved uses of drugs or products.
Nestoras Mathioudakis,MD Nestoras Mathioudakis, MD
Assistant Professor of Medicine
Division of Endocrinology, Diabetes, & Metabolism
Associate Director, Inpatient Diabetes Management
The Johns Hopkins University School of Medicine
Baltimore, Maryland

Faculty Disclosure
Dr. Mathioudakis has indicated that he does not have any relevant financial interests or relationships with any commercial entities.

Release Date
April 30, 2014
Expiration Date
April 29, 2016
Nestoras Mathioudakis, MD
Assistant Professor of Medicine Division of Endocrinology, Diabetes, & Metabolism Associate Director, Inpatient Diabetes Management The Johns Hopkins University School of Medicine Baltimore, Maryland
Om P. Ganda, MD
Associate Clinical Professor of Medicine
Harvard Medical School
Senior Physician and Director, Lipid Clinic
Chair, Clinical Oversight Committee Joslin Diabetes Center
Boston, Massachusetts
Susan Porter, MSN, CRNP, CDE
Clinical Nurse Practitioner and Certified Diabetes Educator
The Johns Hopkins University School of Medicine
Baltimore, Maryland
 Accreditation Statements
Physicians
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Johns Hopkins University School of Medicine and the Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Nurses
The Institute for Johns Hopkins Nursing and the American Nursing Credentialing Center do not endorse the use of any commercial products discussed or displayed in conjunction with this educational activity.

credit designations
Physicians
eNewsletter: The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Podcast:
The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
Newsletter: This 1 contact hour educational activity is provided by the Institute for Johns Hopkins Nursing. Each newsletter carries a maximum of 1 contact hour or a total of 6 contact hours for the six newsletters in this program.

Podcast: This 0.5 contact hour educational activity is provided by The Institute for Johns Hopkins Nursing. Each podcast carries a maximum of 0.5 contact hours or a total of 3 contact hours for the six podcasts in this program.

Successful Completion
To take the post-test for eViralHepatitis Review you will need to visit Johns Hopkins University School of Medicine's website or the Institute for Johns Hopkins Nursing's website If you have already registered for other Hopkins CE programs at these sites, simply enter the requested information when prompted. Otherwise, complete the registration form to begin the testing process. A passing grade of 70% or higher on the post-test/evaluation is required to receive CE credit.

There are no fees or prerequisites for this activity.

This activity is supported by educational grants from Eli Lilly and Company, Bristol-Myers Squibb, and Novo Nordisk, Inc.

Launch Date
April 30, 2014; activities expire 2 years from the date of publication.

Length of Activity: 30 minutes


Internet CME Policy
The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protecting the privacy of its members and customers. The Johns Hopkins University SOM CME maintains its Internet site as an information resource and service for physicians, other health professionals, and the public.

Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in an Internet-based CME program. Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine's CME program. CME collects only the information necessary to provide you with the services you request. .


Disclaimer Statement
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of The Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings, and adverse effects before administering pharmacologic therapy to patients.

Statement of Responsibility
The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.


Statement of Need
 
Clinicians do not appropriately intensify therapy as necessary to maintain glycemic control.
Conflicting data about the safety of incretin agents may unduly deprive patients of treatment benefits.
Clinicians are not aware of and/or are not implementing strategies to maximize the value of SMBG readings to improve patient outcomes.
Clinicians do not adequately understand or treat to control CVD risk factors in their patients with T2D.
Clinicians do not have a sufficiently current knowledge base to effectively consult patients about potential T2D therapeutic advances
Clinicians do not adequately counsel and treat their overweight/obese patients with T2D.


Intended Audience
The target audience for this initiative includes: endocrinologists, primary care clinicians, nurse practitioners, physician assistants, Certified Diabetes Educators, and other health care practitioners whose work/practice includes treating patients with T2D.

Planner disclosures
As a provider approved by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical Education (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control the content of a CME activity sponsored by OCME. Members of the Planning Committee are required to disclose all relationships regardless of their relevance to the content of the activity. Faculty are required to disclose only those relationships that are relevant to their specific presentation. The following relationship has been reported for this activity:

Om P. Ganda, MD, discloses that he has received grant/research funding from Amarin Pharma.

No other planners have indicated that they have any financial interest or relationships with a commercial entity.



POLICY ON FACULTY AND PROVIDER DISCLOSURE
It is the policy of the Johns Hopkins University School of Medicine that the faculty and provider disclose real or apparent conflicts of interest relating to the topics of this educational activity, and also disclose discussions of unlabeled/unapproved uses of drugs or devices during their presentation(s). Johns Hopkins University School of Medicine OCME has established policies in place that will identify and resolve all conflicts of interest prior to this educational activity. Detailed disclosure will be made in the newsletters/podcasts.

Guest Author Disclosures


Confidentiality Disclaimer for Conference Attendees

I certify that I am attending a Johns Hopkins University School of Medicine CME activity for accredited training and/or educational purposes.

I understand that while I am attending in this capacity, I may be exposed to "protected health information," as that term is defined and used in Hopkins policies and in the federal HIPAA privacy regulations (the Privacy Regulations). Protected health information is information about a person's health or treatment that identifies the person.

I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.

I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality. The contact information is Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.

"The Office of Continuing Medical Education at The Johns Hopkins University School of Medicine, as provider of this activity, has relayed information with the CME attendees/participants and certifies that the visitor is attending for training, education and/or observation purposes only."

For CME Questions, please contact the CME Office at (410) 955-2959 or e-mail cmenet@jhmi.edu.

For CME Certificates, please call (410) 502-9634.

Johns Hopkins University School of Medicine
Office of Continuing Medical Education
Turner 20/720 Rutland Avenue
Baltimore, Maryland 21205-2195

Reviewed and Approved by
General Counsel, Johns Hopkins Medicine (4/1/03)
Updated 4/09

hardware & software requirements
Pentium 800 processor or greater, Windows 98/NT/2000/XP/7 or Mac OS 9/X, Microsoft Internet Explorer 5.5 or later, 56K or better modem, Windows Media Player 9.0 or later, 128 MB of RAM, sound card and speakers, Adobe Acrobat Reader, storage, Internet connectivity, and minimum connection speed. Monitor settings: High color at 800 x 600 pixels.


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