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Postgraduate Institute for Medicine and CMEducation Resources, LLC
This activity is supported by an independent educational grant from Sanofi Diabetes

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Postgraduate Institute for Medicine and CMEducation Resources, LLC. This activity is supported by an independent educational grant from Sanofi Diabetes

Diabetes Disease Burden and Clinical Challenges. The number of people worldwide with diabetes is projected to rise from 296 million in 2013 to 439 million in 2030, significantly increasing the burden of diabetes care for internal medicine and primary care specialists. This increasing burden on physicians is worsened by the number of existing patients with diabetes whose disease is inadequately controlled, and who require progressive titration and intensification of therapy to optimize glycemic regulation.
   
An estimated 57% of adult patients with diabetes mellitus still have HA1c levels above ADA recommended goals, suggesting the need for intensifying therapy using a strategy that combines oral agents with insulin, earlier rather than later in the disease course. Because poor control places patients with diabetes at increased risk for serious complications, including cardiovascular disease, the leading cause of diabetes-​related death, the need to achieve guideline-​directed targets is a pivotal mandate of internal medicine-​based care for the patient with diabetes.
     
Data also suggest that early, intensive glycemic control can have a long-​term influence on clinical outcomes and diabetes-​related complications; and too often, intensification with insulin-​based therapy, even when appropriate and guideline-​consistent, is delayed in the internal medicine setting, a finding that one study indicates sets back the quality of care for a broad patient base with T2D. Using national authorities on diabetes management as faculty, this CME activity will focus on the on the role, indications, guidelines, and evidence supporting optimal approaches to early use and guideline-​directed use of basal insulin therapy for diabetes-​and subsequently, its use in new combinations with GLP-​1 receptor agonists to optimize pan-​glycemic (FPG and PPG) control to achieve desired ADA HA1c target goals.
   
Moreover, this scientifically rigorous, expert-​generated CME program of national scope will help primary care, internal medicine, nurse practitioner (NP), diabetes nurse practitioners (DNP), physician assistants (PA), CNE specialists, and other clinicians focused on diabetes management, apply an individualized and patient-​specific, "evidence-​based roadmap" for using new fixed-​ratio combination insulin regimens to provide control across the continuum of glycemic dysregulation in diabetes; and to do so in a manner this is consistent with the evidence, principles, and treatment recommendations outlined in ADA/EASD and AACE Position Statements on T2D.
 
In addition, the program will focus on the current state of the science and medicine related to the ongoing development, recent introduction, and/or ongoing clinical investigation of insulin and its role as a foundational agent in combination with agents targeting the incretin system; and, how the efficacy, safety, pharmacokinetic profiles, administration, titration strategies, and side effect profiles (especially the risk of hypoglycemia and weight gain) of these combination strategies-​alone or with other therapies-​compare with alternative treatments. The unique applicability of combination approaches in challenging, high-​risk patients with FPG and PPG dysregulation that are typically managed in the primary care and internal medicine specialty care setting will be discussed as well.