Joshua J. Neumiller, PharmD, CDE, CGP, FASCP Editor-in-Chief, Diabetes Spectrum Assistant Professor Department of Pharmacotherapy College of Pharmacy Washington State University Spokane, WA
Carol H. Wysham, MD Clinical Associate Professor of Medicine University of Washington School of Medicine Section Head, Endocrinology Rockwood Clinic Spokane, WA
1.0 Contact Hours of ACPE Credit
A CPE-certified online monograph with highlights from the American Society of Consultant Pharmacists workshop.
The prevalence of type 2 diabetes mellitus (T2DM) has reached epidemic levels and continues to rise. The American Diabetes Association (ADA) estimates that 25.8 million people, approximately 8.3% of the U.S. population, have diabetes. In the older adult population, the prevalence of diabetes is even higher with approximately 26.9% of all people over age 65 in the United States (10.9 million people). Changes associated with aging raise questions about appropriate treatment goals in these patients and the safety of intensifying therapy. The heterogeneity of this population and factors such as multiple comorbidities, shortened life expectancy, impaired cognition, polypharmacy, and functional disability further complicate the management of T2DM in older adults. Despite the availability of numerous treatment approaches and pharmacologic agents, the management of older adults with T2DM remains a major clinical challenge, and many patients may not receive optimal care based on their specific needs. Senior care and primary care clinicians on the multidisciplinary team, including pharmacists, have an opportunity to improve outcomes in older adults with T2DM by expanding and updating their skills and competency in the management of T2DM in older adults.
NOTE: This activity was presented on November 20, 2013, in conjunction with ASCP's Annual Meeting and Exhibition. Program Developer/Facilitator
. Target Audience
This activity is intended for consultant and senior care pharmacists as well as other pharmacists involved or interested in senior care pharmacy and the care of older patients with diabetes.
Upon completion of this educational activity, the participant should be able to:
List the geriatric syndromes that have been identified by guidelines as barriers to effective treatment of T2DM in older patients.
Prioritize factors that must be considered when setting glycemic goals for older patients with T2DM.
Discuss the mechanisms of action of all classes of glucose-lowering medications.
Identify which glucose-lowering medications would have an increased or decreased likelihood of causing hypoglycemia based on mechanism of action.
Recommend general treatment modifications for older adults with T2DM experiencing hypoglycemia.
It is the policy of the AAFP, ASCP, and NADONA to ensure balance, independence, objectivity and scientific rigor in all of its educational activities including those which are sponsored and cosponsored. All faculty are expected to disclose any significant financial interest or other relationship with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation. The intent of this disclosure is not to prevent a presenter with significant financial interest or other relationship from making the presentation, but rather to provide the audience with information with which they can make their own judgments. It remains for the audience to determine whether the speaker's interests or relationships may influence the presentation with regard to exposition or conclusion. Faculty are also expected to openly disclose any off-label, experimental, or investigational use of drugs or devices in their presentations.
Dr. Neumiller discloses the following:
Grant support: Merck, Novo Nordisk, Johnson & Johnson, AstraZeneca, Bristol-Myers Squibb
Consultant: Janssen Pharmaceuticals, Sanofi Aventis
Speakers Bureau: Janssen Pharmaceuticals
Dr. Wysham discloses the following:
Grant support: Novo Nordisk, Sanofi Aventis, Intarcia, Janssen, Bristol-Myers Squibb, Boehringer Ingleheim, Eli Lilly, and Merck
Consultant: Bristol-Myers Squibb, Boehringer Ingleheim, Eli Lilly, Sanofi Aventis, Janssen
Speakers Bureau: Bristol-Myers Squibb/AstraZeneca, Boehringer Ingleheim, Sanofi Aventis, Janssen, Novo Noridsk
Ms. Dechevalier has no relevant financial conflicts to disclose.
Dr. Gerber has no relevant financial conflicts to disclose.
Ms. Sharp has no relevant financial conflicts to disclose.
This educational activity may contain discussion of published and/or investigational uses of pharmaceutical agents. Some uses of these agents may not have been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
The American Society of Consultant Pharmacists (ASCP) is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This knowledge-based activity, ACPE Universal Activity #0203-9999-14-005-H01-P, has been assigned 1.0 Contact Hour (0.1 CEU).
Participants must view the activity in its entirety, successfully complete the post-test, and submit an evaluation to receive continuing pharmacy education credit.
Credit will be awarded for a score of 70% or better, and a statement may be printed immediately after passing the post-test.
This activity will take approximately 1 hour to complete. Commercial Support Statements
Supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc., which was made possible, in part, through collaboration with Eli Lilly and Company; and an educational grant from AstraZeneca LP.
There are no fees for participating in or receiving credit for this online educational activity.
This activity is designed to be completed within the time designated on this page; pharmacists should claim only those credits that reflect the time actually spent in the activity.
Review the intended audience, learning objectives, and author disclosures.
Study the educational content online. Be sure to review both written and audio/slide content.
Once completed, continue to post-test. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. In addition, you must also complete the Activity Evaluation.
Computer Requirements: Minimum System Requirements: • Pentium III, 600 MHz or Equivalent Processor • 512 MB of RAM • Windows XP, Vista, or 7 • Mac OS X • 800x600 Monitor Resolution • 16-bit Color • 16 bit Sound Card with Speakers
The opinions expressed in these educational activities are those of the faculty and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, American Society of Consultant Pharmacists, Boehringer Ingelheim, Inc., Eli Lilly, or AstraZeneca. Any medications, diagnostic procedures, or treatments discussed by the program presenters should not be used by clinicians or other health care professionals without first evaluating their patients’ conditions, considering possible contraindications or risks, reviewing any applicable manufacturer’s product information, and comparing any therapeutic approach with the recommendations of other authorities.