Early Intervention In The Continuum Of Hyperglycemia - The Role of Initial Combination Therapy

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Ralph A. DeFronzo, MD

Professor of Medicine
Chief, Diabetes Division
University of Texas Health Science
Center Deputy Director,
Texas Diabetes Institute
San Antonio, Texas

Zachary T. Bloomgarden, MD / Chair

Clinical Professor of Medicine
Mount Sinai School of Medicine
Assistant Attending in Medicine
Mount Sinai Hospital
Consultant in Endocrinology
Lawrence Hospital
New York, New York

Samuel Dagogo- Jack, MD

A.C. Mullins Chair in Translational Research
Professor of Medicine & Director,
Division of Endocrinology, Diabetes & Metabolism
President, Medicine & Science,
American Medical Association
Director, Clinical Research Center
University of Tennessee Health Science Center
Memphis, Tennessee

Yehuda Handelsman MD, FACP, FACE, FNLA / Chair

Chair & Program Director
World Congress Insulin Resistance,
Medical Director & Principal Investigator
Metabolic Institute of America
Tarzana, California

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Program Description

In the past, a major challenge in safely treating type 2 diabetes was in controlling glucose without inducing hypoglycemia and weight gain. Additionally many patients were largely unmonitored due to the antiquated approach of introducing new therapies only after failure. In recent years new agents were developed. The incretin based therapy, namely GLP1-RA and DPP4i, help improve insulin secretion and reduce endogenous glucose production; and SGLT2 inhibitors, which reduce glucose re-absorption, have been approved for the management of type 2 diabetes. The development of appropriate and safe therapeutic pathways led to new approaches in reaching and maintaining glycemic control. Early intervention in the continuum of hyperglycemia, often in combination, has the potential to slow the progression of diabetes and allows reaching desired goals safely. This program will address the change in paradigm in managing diabetes and lead the clinician in developing treatment modalities which do not cause failure but rather reach success by implementing early intervention in combination achieving goals safely, while also impacting CV risk factors like blood pressure, weight and reduced complications.

Learning Objectives

1) Describe diabetes as a continuum of hyperglycemia with its progressive and accumulated complications.

2) Explain how early and intensive intervention may halt, if not reverse, progression to complications.

3) Discuss the contemporary approach to managing diabetes addressing all risk factors.

4) Analyze early intervention strategies with combination medications to achieve fast control to reduce complications.

5) Describe the benefit of novel therapy specifically incretins and SLGT2 inhibitor and the potential effect beyond glycemia on weight, blood pressure, and the kidney.


CME information

This activity has been planned and implemented  in accordance  with the Essenntial Areas and policies of the Accreditation Council for Continuing Medical Eduation through the joint sponsorship of PESI, Inc and Metabolic Endocrine Education Fundation (MEEF). PESI, Inc is accredited by the ACCME to provide continuing medical education for physicians. The PESI, Inc designated this enduring educational activity maximum of 2.0 ama pra Category 1 Credits(s). Physicians should only claim credit commensurate With the extent of their participation in the activity.

Activity information

  • Duration: Duration 2.00 hours you will earn FREE AMA PRA Category 1 Credit(s)™

  • Based on live Satellite Symposium of 13th WCIRCD.

  • Date of release:  December 31st, 2015

  • Date of expiration: December 31st, 2016

Target Audience

This educational initiative is designed for Endocrinologists, cardiologists, family physicians, internists, diabetologists, nurse practitioners, and other health care professionals interested in diabetes and obesity.

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Program Provided By

PESI, Inc..
Metabolic Endocrine Education Foundation (MEEF)

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Acknowledgement of Support

This is a CME Program Supported by an Educational Grant from Astrazeneca

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CME information

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To Receive a Certificate for This CME Activity

View the presentations in this CME activity and Complete the evaluation. Your certificate will be mailed to you upon satisfactory completion of these documents.

Faculty Disclosures and Conflicts of Interest

It is the policy of PESI, Inc., Aspen CME Services and the Metabolic Endocrine Education Foundation, accreditors of this live educational activity that anyone that can affect the content of an educational activity must provide disclosure of financial relationships that they or their partner may have with commercial supporters.  Speakers are also required to disclose if their presentation will contain information on off-labeled, investigational, or unapproved use of a product.

Aspen CME Services is approved by the California Board of Registered Nursing, provider number CEP14739, has designated this activity for 2.00 contact hours.  For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 Credit TM issued by organizations accredited by the ACCME.  State pharmacy boards accept AMA PRA Category 1 Credit TM issued by organizations accredited by the ACCME.

The planning faculty,  speakers, and moderators for this activity have provided the following information:

First Name Last Name Relationship
Ralph DeFronzo Novo Nordisk & AstraZeneca=Speaker's Bureau;  AstraZeneca, Novo Nordisk, Janssen, Lexicon & BI=Advisory Board;  Janssen, BI, Takeda & AstraZeneca=Research Grant                   Attestation
Zachary  Bloomgarden AstraZeneca, Janssen, Novo Nordisk & Merck=Speaker; AstraZeneca, Janssen, NovoNordisk, Merck, Amgen & Novartis=Consultant;  Baxter Int'l, CVS Carmark, Roche Holdings, St Jude Medical & Novartis=Stockholder 
Yehuda  Handelsman Amgen, BI, Gilead, Intarcia, GSK, Lexicon, Merck, Novo Nordisk, Sanofi & Takeda=Research Grant;  Amarin, Amgen, (Amlylin) BMS, BI, diaDeux, DSI, Eisai, Gilead, GSK, Halozyme, Hanssen, LipoScience, Merck, Novo Nordisk, Sanofi, Santarus & Vivus=Consultant; Amarin, AstraZeneca-BMS(Amylin), BI-Lilly, DSI, GSK, Hanssen, Novo Nordisk, Santarus & Vivus=Speaker's Bureau
Samuel  Dagogo-Jack AstraZeneca, Novo Nordisk & BI=Investigator on Clinical trials; Merck, Novo Nordisk & Janssen=Consultant

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 providership of PESI, Inc, and the Metabolic Endocrine Education Foundation (MEEF). PESI, Inc is accredited by the ACCME to provide continuing medication education for physicians.

AMA PRA Designation Statement
PESI, Inc designates this enduring activity for a maximum of 2.00 AMA PRA Category 1 credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.

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For questions regarding this CME activity, please contact us

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