Webinar 3: Hypoglycemia in Special Populations Across the Life Span: Young Children, Pregnant Women, and Older Adults

Tuesday, January 27, 2015

Method of Participation/How to Obtain CME/CE Credit


Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have the potential to provide multiple therapeutic benefits for patients with type 2 diabetes mellitus (T2DM), and their use is strongly advocated in evidence-based recommendations. New and emerging GLP-1 RAs provide additional options to facilitate use of this beneficial class of agents in individualized regimens for the treatment of T2DM. However, clinicians need to be aware of several clinically relevant differences among the agents within the GLP-1 RA medication class—including efficacy, weight effects, injection frequency, and adverse event profiles—when making patient-centered treatment decisions. This activity will help a multidisciplinary clinical audience recognize the unique characteristics of GLP-1 RAs, including those of new and emerging agents.

The content of this webinar will be delivered in a 1-hour live broadcast and will include a real-time question-and-answer session with expert faculty via an online web portal or by telephone. The webinar will provide a critical review of recent efficacy and safety data for new and emerging GLP-1 RAs, including the potential to reduce cardiovascular risks and weight in patients with T2DM, and offer expert perspectives regarding the agents' anticipated roles and significance in clinical practice.



Vivian A Fonseca, MD, FRCP
Program Chair

Tullis-Tulane Alumni Chair in Diabetes Professor of Medicine
Chief, Section of Endocrinology
Tulane University School of Medicine
New Orleans, Louisiana

Robert R Henry, MD
Professor of Medicine
University of California, San Diego Chief, Section of Endocrinology, Metabolism & Diabetes
Veterans Affairs Healthcare System
San Diego, California

For your convenience, this webinar has been scheduled to occur at 4 different times throughout each day. To complete your registration, please select the date and time you wish to participate below.

This activity is designed for diabetes-treating clinicians, including endocrinologists, diabetologists, primary care physicians, physician assistants, nurse practitioners, nurses, certified diabetes educators, and other healthcare providers who are involved in the management of patients with T2DM.

At the conclusion of this activity, participants should be able to:
• Review the rationale for developing additional agents in the GLP-1 RA class
• Compare the study design, endpoints, and patient baseline characteristics of randomized clinical trials of emerging GLP-1 RAs
• Summarize primary and secondary cardiovascular and safety outcomes with emerging GLP-1 RAs, as available

This activity is supported by an educational grant from Novo Nordisk Inc.


The Institute for Medical and Nursing Education, Inc. (IMNE), is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

IMNE designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

IMNE is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's (ANCC's) Commission on Accreditation.

IMNE designates this educational activity for 1.0 contact hours. Accreditation by the ANCC's Commission on Accreditation refers to recognition of educational activities and does not imply approval or endorsement of any product

Diabetes Educators
ANCC-accredited providers have been approved by the National Certification Board for Diabetes Educators (NCBDE) as providers of continuing education (CE). Individuals seeking recertification from the NCBDE can use the CE

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Webinar Registration

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1. How confident do you feel in your ability to select appropriate glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for individual patients based on administration and dosing characteristics?

2. Mavis is a 74-year-old woman who has had type 2 diabetes mellitus (T2DM) for 8 years. She is overweight (body mass index [BMI] = 28 kg/m2), and her dexterity is limited by arthritis in her hands. Her glycated hemoglobin (A1C) is 8.2%, indicating a need for additional antihyperglycemic therapy to reach her individualized A1C goal of 7%. She is otherwise healthy and active. She lives alone, but a home healthcare aide comes every Wednesday to help with health-related needs. Mavis' current blood glucose control regimen includes metformin 1500 mg/day and glimepiride 8 mg/day. She is worried about needing to use "big needles" with injectable therapy. Considering this information, which of the following is the best statement regarding choice of a GLP-1 RA for Mavis?

3. How confident do you feel in your ability to select glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for an individual patient according to the agent's therapeutic effects (ie, glycemic control efficacy, weight change)?

4. Renata is a 40-year-old woman who has obesity (body mass index [BMI] = 33 kg/m2) and was diagnosed with type 2 diabetes mellitus (T2DM) 6 months ago. She was prescribed lifestyle management, with a goal of 5% weight loss, and started on metformin 2000 mg/day. Her current glycated hemoglobin (A1C) is 8.1%, and she has lost 1% of her starting weight. She is discouraged that her blood glucose level and weight have not improved more. She is willing to take an injection but no more than 1 per day. Considering this information, which of the following is likely to offer the greatest benefits in helping Renata achieve her A1C and weight goals?

5. How confident do you feel in your ability to select glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for individual patients who may be at increased risk of hypoglycemia or who may have comorbidities (eg, renal impairment, cardiovascular disease)?

6. Zeke is a 73-year-old man who was diagnosed with type 2 diabetes mellitus (T2DM) 12 years ago. He has obesity (body mass index [BMI] = 33 kg/m2) and moderate renal insufficiency (estimated glomerular filtration rate [eGFR] = 48 mL/min/1.73 m2) but no history of pancreatitis or thyroid tumors. His glycated hemoglobin (A1C) is 8.2% with metformin 2000 mg/day, sitagliptin 100 mg/day, and glimepiride 4 mg/day. His prescription refill records indicate that he is highly adherent to treatment. He reports that he has experienced hypoglycemia twice in the last year, and both times, he was able to treat it himself by eating several handfuls of jelly beans.

Which of the following is true regarding use of a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in Zeke's glucose control regimen?

7. How confident do you feel in your ability to select glucagon-like peptide-1 receptor agonists (GLP-1 RAs) to reduce cardiovascular risk in patients with established cardiovascular disease?

8. John is a 58-year-old man who was diagnosed with type 2 diabetes mellitus (T2DM) 1 year ago, when he was hospitalized for a myocardial infarction. His glycated hemoglobin (A1C) is 8.1%, and he is on lifestyle management and metformin 2000 mg/day for glycemic control. According to current American Diabetes Association treatment guidelines, which of the following carries the strongest recommendation for intensifying John's glycemic control regimen and reducing cardiovascular risk?

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