ALL IN THE FAMILY 75 YEARS OF DIABETES TREATMENT OPTIONS FROM GLASS SYRINGES TO SGLT2 INHIBITORS PETER A. KRECKEL, R.PH.

Transcription

1 ALL IN THE FAMILY 75 YEARS OF DIABETES TREATMENT OPTIONS FROM GLASS SYRINGES TO SGLT2 INHIBITORS PETER A. KRECKEL, R.PH.

2 ALL IN THE FAMILY 75 YEARS OF DIABETES TREATMENT OPTIONS FROM GLASS SYRINGES TO SGLT2 INHIBITORS ACTIVITY DESCRIPTION Combining a touch of his family history along with the most current therapeutic recommendations, Professor Pete Kreckel takes you on a 75 year journey through diabetes. This 55 year old retail pharmacist is at the age that many patients are diagnosed with Type-2 diabetes, and see how his personal history might impact institution of insulin therapy. See what challenges his age bracket might have based on their family stories of this chronic disease. From his Grandmother who died of nephropathy in 1950, to his diabetic son, Professor Kreckel has indeed a unique presentation ranging from U-40 insulin and glass syringes to the newest Type-2 treatments, the SGLT2 inhibitors. TARGET AUDIENCE The target audience for this activity is pharmacists in hospital, community, and retail pharmacy settings. LEARNING OBJECTIVES After completing this activity, the pharmacist will be able to: Review the morbidity, mortality, and cost burdens that result from inadequate management of T2DM Describe the challenges of instituting insulin therapy based on a patient's perspective of insulin therapy List the key differences between oral medications available for treatment of Type- 2 diabetes including efficacy, safety, and tolerability profiles Discuss adherence counseling techniques to encourage people with Type-2 diabetes mellitus to be part of their healthcare team ACCREDITATION PHARMACY PharmCon, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. NURSING PharmCon, Inc. is approved by the California Board of Registered Nursing (Provider Number CEP 13649) and the Florida Board of Nursing (Provider Number ). Activities approved by the CA BRN and the FL BN are accepted by most State Boards of Nursing. CE hours provided by PharmCon, Inc. meet the ANCC criteria for formally approved continuing education hours. The ACPE is listed by the AANP as an acceptable, accredited continuing education organization for applicants seeking renewal through continuing education credit. For additional information, please visit Universal Activity No.: H01-P Credits: 1 contact hour (0.1 CEU) Release Date: May 19, 2014 Expiration Date: May 19, 2016 ACTIVITY TYPE Knowledge-Based, Home-Study Webcast FINANCIAL SUPPORT BY Pharmaceutical Education Consultants, Inc. 1

3 ABOUT THE AUTHOR: Professor Pete Kreckel is a practicing retail pharmacist who works in Altoona Pennsylvania. Both he and his wife, Denise are 1981 graduates of the University of Pittsburgh School of Pharmacy. He has worked independent retail pharmacy for over 30 years. He has been teaching Pharmacology in the Physician Assistant program at St. Francis University since He has been a regular PharmCon favorite since 2008 covering topics of primary interest to the retail pharmacist. He was inducted into Pi Alpha the Physician Assistant honorary fraternity, and was named as Preceptor of the Year by the Pennsylvania Pharmacists Association for his dedicated work to the education of pharmacy students from Duquesne University, and from his alma mater the University of Pittsburgh.. Peter Kreckel, R.Ph. Professor, St. Francis University FACULTY DISCLOSURE It is the policy of PharmCon, Inc. to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer of any commercial product(s) and/or service(s) discussed in an educational activity. Peter Kreckel reports no actual or potential conflict of interest in relation to this activity. Peer review of the material in this CE activity was conducted to assess and resolve potential conflict of interest. Reviewers unanimously found that the activity is fair balanced and lacks commercial bias. Please Note: PharmCon, Inc. does not view the existence of relationships as an implication of bias or that the value of the material is decreased. The content of the activity was planned to be balanced and objective. Occasionally, authors may express opinions that represent their own viewpoint. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient or pharmacy management. Conclusions drawn by participants should be derived from objective analysis of scientific data presented from this monograph and other unrelated sources. 2

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16 ACTIVITY TEST 1. During what year did NPH insulin become commercially available? A B C D According to the Use or Lose It study, by what percentage did two weeks of minimal activity reduce insulin sensitivity? A. 7% B. 11% C. 17% D. 23% 3. Assume a morbidly obese patient restricts their caloric intake by 1000 kcal per day. They also increase their physical activity and burn off 500 calories per day. How many pounds will they lose in 4 weeks? A. 8 pounds B. 12 pounds C. 16 pounds D. 18 pounds 4. At first diagnosis of Type-2 diabetes which drug should be prescribed? A. No drug therapy, diet and exercise only B. Glyburide (Micronase ) C. Metformin (Glucophage ) D. Sitagliptin (Januvia ) 5. Which of the following drugs is considered to be a secretagogue? A. Metformin (Glucophage ) B. Glimepiride (Amaryl ) C. Rosiglitizone (Avandia ) D. Acarbose (Precose ) 15

17 6. Which of the following oral drugs for treatment of diabetes was named by the Beers list 2012 to be avoided in the elderly? A. Glyburide (Micronase ) B. Glipizide (Glucotrol ) C. Metformin (Glucophage ) D. Canagliflozin (Invokana ) 7. Over a 5 year period, what percentage of beta cell failure would a Type-2 diabetic is expected to lose? A. 5% B. 12% C. 25% D. 40% 8. Which of the following drug s is most likely to cause GI upset and weight loss? A. Exantide (Bydureon ) B. Glyburide (Micronase ) C. Pioglitizone (Actos ) D. Insulin glargine (Lantus ) 9. Which of the following drugs blocks the breakdown of endogenous incretins? A. Exantide (Byetta ) B. Linagliptin (Tradjenta ) C. Acarbose (Precose ) D. Rosiglitizone (Avandia ) 10. Which of the following drugs works to lower blood sugar levels by facilitating excretion of glucose from the kidneys? A. Acarbose (Precose ) B. Pioglitizone (Actos ) C. Sitagliptin (Januvia ) D. Canagliflozin (Invokana ) Please submit your final responses on freece.com. Thank you. 16