What s New in Diabetes Medications. Jena Torpin, PharmD

Size: px
Start display at page:

Download "What s New in Diabetes Medications. Jena Torpin, PharmD"

Transcription

1 What s New in Diabetes Medications Jena Torpin, PharmD 1

2 Objectives Discuss new medications in the management of diabetes Understand the mechanism of the medications discussed Understand the side effects of the medications discussed 2 Acknowledgement: Some slides adapted/used with permission from Dr. Heather Blue s Presentation, Diabetes Medication Update, 3/5/2015

3 Review of Diabetes Types of Diabetes o o Type 1: complete insulin deficiency Type 2: decreased insulin secretion & insulin resistance Hepatic Glucose Production Blood Glucose Pancreatic Insulin secretion Peripheral Glucose Uptake 3 Cefalu, Diabetes Care, 2016; Khardori R,

4 Review of Diabetes- Diagnosis Test Fasting Plasma Glucose (FPG) Dx Criteria 126 mg/dl 2 Hour Plasma Glucose 200 mg/dl A1C 6.5% Random Glucose 200 mg/dl + symptoms of hyperglycemia/crisis 4 Cefalu, Diabetes Care, 2016; Khardori R,

5 Review of Diabetes-Goals Patient population A1C Goal (%) Most adults (non-pregnant) 7 Select patients (low risk for hypoglycemic events) 6.5 Select patients (high risk for hypoglycemic events, advanced age, vascular complications) 8 5 Cefalu, Diabetes Care, 2016

6 Review of Diabetes- Treatment of Type 2 Diabetes 1 st Line 2 nd Line Metformin Oral Agent GLP-1 Analog Insulin Sulfonylurea Thiazolidinedione DPP-4 Inhibitor SGLT2 Inhibitor 6 Cefalu, Diabetes Care, 2016

7 Previous Toolbox Metformin Sulfonylureas Thiazolidinediones Insulin Meglitinides Alpha-glucosidase inhibitors 7

8 Previous Toolbox- Biguanide (Metformin) Mechanism: Hepatic Glucose Production Insulin Sensitivity Effectiveness: Decreases A1C by 1-1.5% Dosing: titrate to goal 1000mg BID or 2000mg qday if ER Adverse Drug Events: GI Side (need to titrate/take with food), Vitamin B12 deficiency, lactic acidosis (rare) Cost: $4 list 8 Cefalu, Diabetes Care, 2016; UpToDate; Bahal O Mara, Pharmacist s Letter, 2015

9 Previous Toolbox- Sulfonylureas (Glyburide, Glipizide, Glimepiride) Mechanism of Action: pancreatic release of insulin Effectiveness: Decreases A1C by 1-1.5% Dosing: Start low and go slow in elderly patients and those with hepatic or renal disease Adverse Drug Events: hypoglycemia Cost: $4 list 9 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015

10 Previous Toolbox- Thiazolidinediones (TZDS- Pioglitazone, Rosiglitazone) Mechanism of Action: Increased insulin sensitivity Effectiveness: Decreases A1C by 1-1.5% Dosing: titrate cautiously- monitor for signs of heart failure Adverse Drug Events: Edema, heart failure, fractures, increased LDL (rosiglitazone) Cost: Low 10 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; UpToDate

11 Previous Toolbox-Insulin 11 Micromedex, Lexicomp, UpToDate

12 Previous Toolbox-Insulin Profiles 12 Micromedex, Lexicomp, UpToDate

13 Previous Toolbox Efficacy/A1C reduction Hypoglycemia Risk Metformin Sulfonylurea TZD Insulin High: 1-1.5% High: 1-1.5% High: 1-1.5% Highest: % Low Moderate Low High Weight Neutral Gain Gain Gain Side Effects GI, lactic acidosis (rare) Hypoglycemia Edema, Heart failure, fractures Hypoglycemia Costs Low- $4 list Low- $4 list Low Variable 13 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015

14 New Diabetes Medications Sodium-glucose cotransporter 2 (SGLT2) Inhibitors Dipeptidyl pepidase-4 (DPP-4) Inhibitors (gliptins) Injectable glucagon-like peptide 1 (GLP-1) receptor agonists New insulin formulations -Inhaled insulin -New concentrations 14

15 Sodium Glucose Co-Transporter 2 Inhibitors 15

16 Sodium-glucose transporter 2 inhibitors Drugs: o canagliflozin (Invokana ) o dapagliflozin (Farxiga ) o empagliflozin (Jardiance ) Mechanism: Prevents glucose from being reabsorbed by kidneys, resulting in glucose loss into urine 16 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; UpToDate

17 Effectiveness of SGLT2 Inhibitors Reduced A1c by 0.5-1% points Weight loss seen in trials (up to 4.5 kg) Reduction of blood pressure (up to 7 mmhg) No hypoglycemia Decreased CVD events/mortality in pt s with CVD 17 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; Nauck, Drug Des Devel Ther, 2014

18 Dosing of SGLT2 Inhibitors canagliflozin dapagliflozin empagliflozin Usual adult dose GFR >60 ml/min/1.73 m(2) 100mg 300mg daily 5mg 10mg daily 10mg 25mg daily GFR ml/min/1.73 m(2) Limit dose at 100mg daily Do not use 10mg 25mg daily GFR <45 ml/min/1.73 m(2) Do not use Do not use Do not use 18 Micromedex

19 Adverse Effects of SGLT2 Inhibitors Urinary tract infections (~5%) Genital infections (up to ~11%) Renal impairment Polyuria (~5%) Hypovolemia Increased LDL Bladder cancer? 19 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; Micromedex, UpToDate

20 Dipeptidyl Peptidase-4 Inhibitors 20

21 Dipeptidyl Peptidase-4 Inhibitors Drugs: o sitagliptin (Januvia ) o saxagliptin (Onglyza ) o linagliptin (Tradjenta ) o alogliptan (Nesina ) Mechanism: Inhibit dipeptidyl peptidase-4 which is an enzyme which breaks down endogenous incretins o e.g. glucagon like peptide 1 (GLP-1) 21 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015

22 Endogenous Incretin Mechanism of Action Insulin Secretion/Synthesis Glucagon secretion 22 Henry RR,

23 23 Image: Adapted from Henry RR,

24 Effectiveness of DPP-4 Inhibitors Reduced A1C by 0.5-1%; some believe to more around 0.7% No hypoglycemia (monotherapy) Weight neutral 24 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015

25 Dosing of DPP-4 Inhibitors sitagliptin saxagliptin linagliptin alogliptin Usual dose 100 mg daily mg daily 5 mg daily 25 mg daily Renal CrCl mg daily CrCl <30 25 mg daily CrCl <50ml/min 2.5 mg daily No adjustments needed mg daily < mg daily 25 UpToDate

26 Adverse Effects of DPP4-Inhbitors Potential for pancreatitis May increase risk of hospitalizations due to heart failure Immune mediated dermatological/angioedema side effects 26 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015

27 Glucagon-Like Peptide-1 (GLP-1) Agonist 27

28 Glucagon-like peptide 1 receptor agonists Short Acting o Exenatide (Byetta )-- twice daily o Liraglutide (Victoza ) -- once daily Long Acting Weekly dosing o Albiglutide (Tanzeum ) o Exenatide extended release (Bydureon ) o Dulaglutide (Trulicity ) Mechanism: bind to GLP-1 receptors 28 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; UpToDate

29 29 Image: Adapted from Henry RR,

30 Effectiveness Reduced A1C by 1-1.5% Few/no hypoglycemic events (monotherapy) Weight loss (~1-2.7kg) Some CV risk reduction 30 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; Micromedex

31 Dosing Exenatide Liraglutide Usual dose 5 mcg 10 mcg SubQ BID 0.6 mg mg SubQ qday Renal CrCl ml/min: use caution CrCl <30 ml/min: not recommended No adjustment needed Exenatide (extended release) Albiglutide Dulaglutide Usual dose 2mg SubQ qweek 30 mg 50 mg SubQ qweek 0.75mg 1.5mg SubQ qweek Renal CrCl ml/min: use caution CrCl <30 ml/min: not recommended No adjustments needed No adjustment needed (use with caution) 31 UpToDate,

32 Adverse effects of Glucagon-like peptide 1 receptor agonists Boxed warning: thyroid C-cell tumors GI Side Effects: Nausea/vomiting/diarrhea: 10-50% Potential for pancreatitis Renal dysfunction Injection site reactions 32 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015; Micromedex

33 New Diabetes Medications Efficacy/A1C reduction Hypoglycemia Risk DPP-4 Inhibitor SGLT2 Inhibitor GLP-1 Receptor Agonist Intermediate: 0.5-1% Intermediate: 0.5-1% Low Low Low Weight Neutral Loss Loss Side Effects Rare Genitourinary, dehydration Costs High High High High: 1-1.5% GI 33 Cefalu, Diabetes Care, 2016; Bahal O Mara, Pharmacist s Letter, 2015

34 34 Insulin

35 Inhaled Insulin Inhaled insulin Afrezza regular insulin 4 unit, 8 unit, and 12 unit cartridges Dosing: Injected Prandial Insulin Up to 4 units Afrezza Dose 4 units 5-8 units 8 units 9-12 units 12 units units 16 units units 20 units units 24 units Side Effects: hypoglycemia, cough, throat pain 35 Afrezza, Prescribing Information, 2014

36 Other/New Insulin Formulations Lispro (Humalog KwikPen): 200 units/ml Glargine (Toujeo SoloStar): 300 units/ml Degludec (Tresiba FlexTouch): 100 units/ml & 200 units/ml Degludec/aspart 70/30 (Ryzodeg 70/30): 100 units/ml 36 UpToDate

37 Take Away Points Many new medications with novel mechanisms Mainstay of therapy while patients are in the hospital still remains insulin therapy 37

38 thank you!

Type 2 Diabetes: Where Do We Start with Treatment? DIABETES EDUCATION. Diabetes Mellitus: Complications and Co-Morbid Conditions

Type 2 Diabetes: Where Do We Start with Treatment? DIABETES EDUCATION. Diabetes Mellitus: Complications and Co-Morbid Conditions Diabetes Mellitus: Complications and Co-Morbid Conditions ADA Guidelines for Glycemic Control: 2016 Retinopathy Between 2005-2008, 28.5% of patients with diabetes 40 years and older diagnosed with diabetic

More information

Update on Therapies for Type 2 Diabetes: Angela D. Mazza, DO July 31, 2015

Update on Therapies for Type 2 Diabetes: Angela D. Mazza, DO July 31, 2015 Update on Therapies for Type 2 Diabetes: 2015 Angela D. Mazza, DO July 31, 2015 Objectives To present the newer available therapies for the management of T2D To discuss the advantages and disadvantages

More information

Objectives. How Medicine Works to Control Blood Sugar Levels. What Happens When We Eat? What is diabetes? High Blood Glucose (Hyperglycemia)

Objectives. How Medicine Works to Control Blood Sugar Levels. What Happens When We Eat? What is diabetes? High Blood Glucose (Hyperglycemia) How Medicine Works to Control Blood Sugar Levels Stacie Petersen, RN, CDE Objectives Define Diabetes List how medications work (ominous octet) Identify side effects of medications for diabetes What is

More information

The Death of Sulfonylureas? A Review of New Diabetes Medications

The Death of Sulfonylureas? A Review of New Diabetes Medications The Death of Sulfonylureas? A Review of New Diabetes Medications Kelly Hoenig, Pharm.D., BCPS Cedar Rapids Family Medicine Residency 2/4/17 Objectives Review GLP-1 Agonists, DPP-IV Inhibitors and SGLT-2

More information

RPCC Pharmacy Forum. The Type 2 Diabetes Issue. Type 2 Diabetes: The Basics

RPCC Pharmacy Forum. The Type 2 Diabetes Issue. Type 2 Diabetes: The Basics Nov/Dec 2015 Issue 11 RPCC Pharmacy Forum Special Interest Articles: Diabetes Medication Chart Insulin Chart Afreeza Did you know? Exanatide, marketed as Byetta, is the synthetic form of exendin-4, which

More information

What s New in Diabetes Treatment. Disclosures

What s New in Diabetes Treatment. Disclosures What s New in Diabetes Treatment Shiri Levy M.D. Henry Ford Hospital Senior Staff Physician Service Chief, West Bloomfield Hospital Endocrinology, Metabolism, Bone and Mineral Disorders Disclosures None

More information

Diabetes Medication Updates Erica Bukovich, PharmD, BC-ADM, CDE September 20, 2018

Diabetes Medication Updates Erica Bukovich, PharmD, BC-ADM, CDE September 20, 2018 Diabetes Medication Updates Erica Bukovich, PharmD, BC-ADM, CDE September 20, 2018 Learning Objectives Identify medication classes available for treatment of individuals with diabetes. Demonstrate understanding

More information

What the Pill Looks Like. How it Works. Slows carbohydrate absorption. Reduces amount of sugar made by the liver. Increases release of insulin

What the Pill Looks Like. How it Works. Slows carbohydrate absorption. Reduces amount of sugar made by the liver. Increases release of insulin Diabetes s Oral s - Pills These are some of the pills that are currently available in Canada to treat diabetes. Each medication has benefits and side effects you should be aware of. Your diabetes team

More information

Side Effects of: GLP-1 agonists DPP-4 inhibitors SGLT-2 inhibitors. Bryce Fukunaga PharmD April 25, 2018

Side Effects of: GLP-1 agonists DPP-4 inhibitors SGLT-2 inhibitors. Bryce Fukunaga PharmD April 25, 2018 Side Effects of: GLP-1 agonists DPP-4 inhibitors SGLT-2 inhibitors Bryce Fukunaga PharmD April 25, 2018 Objectives For each drug class: Identify the overall place in therapy Explain the mechanism of action

More information

Diabetes Mellitus II CPG

Diabetes Mellitus II CPG 1 Diabetes Mellitus II CPG Candidates for Screening Integrated Complex Care Patients: Check Yearly Prediabetes: Check Yearly No Diabetes Mellitus (DM) Risk Factors: Check at Age 45, Repeat Every 3 Years

More information

Drug Class Review Newer Diabetes Medications and Combinations

Drug Class Review Newer Diabetes Medications and Combinations Drug Class Review Newer Diabetes Medications and Combinations Final Update 2 Report July 2016 The purpose reports is to make available information regarding the comparative clinical effectiveness and harms

More information

Pharmacology Updates. Quang T Nguyen, FACP, FACE, FTOS 11/18/17

Pharmacology Updates. Quang T Nguyen, FACP, FACE, FTOS 11/18/17 Pharmacology Updates Quang T Nguyen, FACP, FACE, FTOS 11/18/17 14 Classes of Drugs Available for the Treatment of Type 2 DM in the USA ### Class A1c Reduction Hypoglycemia Weight Change Dosing (times/day)

More information

2/9/2016. The Evolving Armamentarium for Type 2 Diabetes: Incorporating New Classes in the Treatment of Our Patients. Objectives: Pharmacists

2/9/2016. The Evolving Armamentarium for Type 2 Diabetes: Incorporating New Classes in the Treatment of Our Patients. Objectives: Pharmacists WAYNE STATE UNIVERSITY COLLEGE OF PHARMACY & HEALTH SCIENCES FEBRUARY 28, 2016 The Evolving Armamentarium for Type 2 Diabetes: Clinical Assistant Professor, Department of Pharmacy Practice Ambulatory Care

More information

Pharmacologic Agents for Treatment of Type 2 Diabetes

Pharmacologic Agents for Treatment of Type 2 Diabetes Pharmacologic Agents for Treatment of Type 2 Diabetes SCAN Drugs Medication Biguanides 1 1 er uncoated tabs 500 mg & 750 mg Sulfonylureas 1 1 500 850 mg QD - TID 500 2000 mg glimepiride 1 1 1 8 mg glipizide

More information

Oral and Injectable Non-insulin Antihyperglycemic Agents

Oral and Injectable Non-insulin Antihyperglycemic Agents Appendix 5: Diabetes Education and Medical Management in Adults with Diabetes Oral and Injectable Non-insulin s This directive will be implemented by RPhs, RNs or RDs who have been deemed authorized implementers.

More information

Table 1. Antihyperglycemic agents for use in type 2 diabetes

Table 1. Antihyperglycemic agents for use in type 2 diabetes Table 1. Antihyperglycemic agents for use in type 2 diabetes DRUG IN ALPHA-GLUCOSIDASE INHIBITOR: inhibits pancreatic alpha-amyle and intestinal alpha-glucoside Acarbose (Glucobay) 0.6% Negligible Not

More information

Diabetes Update Bryan Heart Conference September 5, 2015 Shannon Wakeley, MD. Disclosures. Objectives 9/1/2015

Diabetes Update Bryan Heart Conference September 5, 2015 Shannon Wakeley, MD. Disclosures. Objectives 9/1/2015 Diabetes Update Bryan Heart Conference September 5, 2015 Shannon Wakeley, MD Disclosures I speak on behalf of the following companies: Astra Zeneca, Boehringer Ingelheim, Johnson & Johnson, Sanofi and

More information

Management of Type 2 Diabetes Mellitus. Heather Corn, MD, MS Endocrinology, Diabetes, and Metabolism

Management of Type 2 Diabetes Mellitus. Heather Corn, MD, MS Endocrinology, Diabetes, and Metabolism Management of Type 2 Diabetes Mellitus Heather Corn, MD, MS Endocrinology, Diabetes, and Metabolism Disclosures Working for Intermountain Healthcare Some of the views represented are the opinion of ABIM-certified

More information

Oral Medication for the Management of Diabetes Mechanism of. Duration of Daily Dosing Action

Oral Medication for the Management of Diabetes Mechanism of. Duration of Daily Dosing Action Glyburide (Micronase, Diabeta, Glynase) Glipizide (Glucotrol) Glipizide XL (Glucotrol XL) Glimepiride (Amaryl) Prandin (Repaglinide) Starlix (Nateglinide) 1.25, 2.5, 5mg tabs, Dosing: 2.5-20 mg 12- (Glynase:

More information

Antihyperglycemic Agents in Diabetes. Jamie Messenger, PharmD, CPP Department of Family Medicine East Carolina University August 18, 2014

Antihyperglycemic Agents in Diabetes. Jamie Messenger, PharmD, CPP Department of Family Medicine East Carolina University August 18, 2014 Antihyperglycemic Agents in Diabetes Jamie Messenger, PharmD, CPP Department of Family Medicine East Carolina University August 18, 2014 Objectives Review 2014 ADA Standards of Medical Care in DM as they

More information

Objectives. Recognize all available medical treatment options for diabetes. Individualize treatment and glycemic target based on patient factors

Objectives. Recognize all available medical treatment options for diabetes. Individualize treatment and glycemic target based on patient factors No disclosure Objectives Recognize all available medical treatment options for diabetes Individualize treatment and glycemic target based on patient factors Should be able to switch to more affordable

More information

4/9/2018 HOW TO REGULATE DIABETES MEDICATIONS. By Sarah Froemsdorf MSN, RNC, CDE, FNP DISCLOSURES NONE. Diagnosis

4/9/2018 HOW TO REGULATE DIABETES MEDICATIONS. By Sarah Froemsdorf MSN, RNC, CDE, FNP DISCLOSURES NONE. Diagnosis HOW TO REGULATE DIABETES MEDICATIONS By Sarah Froemsdorf MSN, RNC, CDE, FNP DISCLOSURES NONE Diagnosis 1 NORMAL BODY The normal pancreas releases one unit of insulin every hour all day. The normal pancreas

More information

Let s not sugarcoat it! Update on Pharmacologic Management of Type II DM

Let s not sugarcoat it! Update on Pharmacologic Management of Type II DM Let s not sugarcoat it! Update on Pharmacologic Management of Type II DM Gregory Castelli, PharmD, BCPS, BC-ADM Clinical Pharmacist UPMC St. Margaret Objectives By the end of this presentation, participants

More information

Antidiabetic Agents CHAPTER BIGUANIDES

Antidiabetic Agents CHAPTER BIGUANIDES ajt/shutterstock, Inc. CHAPTER 2 Antidiabetic Agents Charles Ruchalski, PharmD, BCPS BIGUANIDES For newly diagnosed patients with type 2 diabetes, the biguanide metformin is the drug of choice for initial

More information

Jonathan Stoehr, MD PhD Endocrinology, Diabetes, Metabolism and Nutrition Virginia Mason Medical Center Seattle, WA 2012 Virginia Mason Medical

Jonathan Stoehr, MD PhD Endocrinology, Diabetes, Metabolism and Nutrition Virginia Mason Medical Center Seattle, WA 2012 Virginia Mason Medical Jonathan Stoehr, MD PhD Endocrinology, Diabetes, Metabolism and Nutrition Virginia Mason Medical Center Seattle, WA There is no conflict of interest that could be perceived as prejudicing the impartiality

More information

DIABETES. overview of pharmacologic agents used in the management of. Overview 4/3/2014 OBJECTIVES. Injectable Agents

DIABETES. overview of pharmacologic agents used in the management of. Overview 4/3/2014 OBJECTIVES. Injectable Agents overview of pharmacologic agents used in the management of DIABETES Kyle Roberts, Pharm.D. PGY-1 Pharmacy Resident Saint Alphonsus RMC 1. List the different classes of diabetes medications, including the

More information

Diabetes 2016: Strategies for achieving optimal diabetes control

Diabetes 2016: Strategies for achieving optimal diabetes control PHASE Safety Net Community Benefit Diabetes 2016: Strategies for achieving optimal diabetes control Presented by: Lisa Gilliam, MD, PhD Clinical Leader Diabetes Program Kaiser Permanente Northern California

More information

Diabetes Treatment Guidelines

Diabetes Treatment Guidelines Diabetes Treatment Guidelines For more comprehensive information about current approaches to the diagnosis and treatment of diabetes, visit the American Diabetes Association Standards of Medical Care 2018

More information

GLP-1 (glucagon-like peptide-1) Agonists (Byetta, Bydureon, Tanzeum, Trulicity, Victoza ) Step Therapy and Quantity Limit Criteria Program Summary

GLP-1 (glucagon-like peptide-1) Agonists (Byetta, Bydureon, Tanzeum, Trulicity, Victoza ) Step Therapy and Quantity Limit Criteria Program Summary OBJECTIVE The intent of the GLP-1 (glucagon-like peptide-1) s (Byetta/exenatide, Bydureon/ exenatide extended-release, Tanzeum/albiglutide, Trulicity/dulaglutide, and Victoza/liraglutide) Step Therapy

More information

What s New in Type 2 Diabetes? 2018 Diabetes Updates

What s New in Type 2 Diabetes? 2018 Diabetes Updates What s New in Type 2 Diabetes? 2018 Diabetes Updates Gretchen Ray, PharmD, PhC, BCACP, CDE Associate Professor, UNM College of Pharmacy January 28, 2018 gray@salud.unm.edu OBJECTIVES Describe the most

More information

Date of Review: September 2016 Date of Last Review: September 2015

Date of Review: September 2016 Date of Last Review: September 2015 Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119

More information

How can we improve outcomes in Type 2 diabetes?

How can we improve outcomes in Type 2 diabetes? How can we improve outcomes in Type 2 diabetes? Earlier diagnosis Better patient education Stress central role of lifestyle management Identify and treat all risk factors Use rational pharmacological therapy

More information

Advanced Practice Education Associates. Endocrine

Advanced Practice Education Associates. Endocrine Advanced Practice Education Associates Endocrine Overview Diabetes Thyroid Disease 162 Copyright 2016 Advanced Practice Education Associates DIABETES MELLITUS What is the BMI cut point for screening adults

More information

Joshua Settle, PharmD Clinical Pharmacist Baptist Medical Center South ALSHP Fall Meeting September 30, 2016

Joshua Settle, PharmD Clinical Pharmacist Baptist Medical Center South ALSHP Fall Meeting September 30, 2016 Joshua Settle, PharmD Clinical Pharmacist Baptist Medical Center South jjsettle@baptistfirst.org ALSHP Fall Meeting September 30, 2016 Objectives Describe the current information concerning newly approved

More information

2018 Diabetes Summit Managing Diabetes: An Art and a Science

2018 Diabetes Summit Managing Diabetes: An Art and a Science 2018 Diabetes Summit Managing Diabetes: An Art and a Science Natasha Petry, PharmD, BCACP NDSU College of Health Professions, School of Pharmacy, Department of Pharmacy Practice Patient-Centered Medical

More information

FARXIGA (dapagliflozin) Jardiance (empagliflozin) tablets. Synjardy (empagliflozin and metformin hydrochloride) tablets. GLUCOPHAGE* (metformin)

FARXIGA (dapagliflozin) Jardiance (empagliflozin) tablets. Synjardy (empagliflozin and metformin hydrochloride) tablets. GLUCOPHAGE* (metformin) Type 2 Medications Drug Class How It Works Brand and Generic Names Manufacturers Usual Starting Dose The kidneys filter sugar and either absorb it back into your body for energy or remove it through your

More information

Images have been removed from the PowerPoint slides in this handout due to copyright restrictions. Insulins. Rapid Short Intermediate Long Mix

Images have been removed from the PowerPoint slides in this handout due to copyright restrictions. Insulins. Rapid Short Intermediate Long Mix Diabetes Medications Diabetes Medications Type 1 Insulin is needed Type 2 Oral Diabetes Medications Or Oral Diabetes Medications plus Insulin Or Insulin Alone Diabetes Medications Secretagogues Glipizide

More information

Multiple Small Feedings of the Mind: Diabetes. Sonja K Fredrickson, MD, BC-ADM March 7, 2014

Multiple Small Feedings of the Mind: Diabetes. Sonja K Fredrickson, MD, BC-ADM March 7, 2014 Multiple Small Feedings of the Mind: Diabetes Sonja K Fredrickson, MD, BC-ADM March 7, 2014 Question 1: Setting A1c Goals Describe the evidence based approach to determining the target HgbA1c in different

More information

6/1/2018. Lou Haenel, IV, DO, FACE, FACOI Endocrinology Roper St Francis Charleston, SC THE OMINOUS OCTET: HOW PATHOPHYSIOLOGY AND THERAPY MERGE

6/1/2018. Lou Haenel, IV, DO, FACE, FACOI Endocrinology Roper St Francis Charleston, SC THE OMINOUS OCTET: HOW PATHOPHYSIOLOGY AND THERAPY MERGE Lou Haenel, IV, DO, FACE, FACOI Endocrinology Roper St Francis Charleston, SC THE OMINOUS OCTET: HOW PATHOPHYSIOLOGY AND THERAPY MERGE 1 2 3 Sulfonylureas Glipizide Glyburide Glimeperide 4 Metformin Gold

More information

Diabetes Medications: Oral Anti-Hyperglycemic Medications

Diabetes Medications: Oral Anti-Hyperglycemic Medications Diabetes Medications: Oral Anti-Hyperglycemic Medications Medication Types 1. Biguanides 2. Sulfonylureas 3. Thiazolidinediones (TZDs) 4. Alpha-Glucosidase Inhibitors 5. D-Phenylalanine Meglitinides 6.

More information

New Therapies for Diabetes

New Therapies for Diabetes Type 2 diabetes is increasingly prevalent New Therapies for Diabetes Lynn Mack, M.D. Associate Professor Diabetes, Endocrinology, & Metabolism The Nebraska Medical Center lmack@unmc.edu No Conflicts of

More information

DM Fundamentals Class 4 Meds for Type 2

DM Fundamentals Class 4 Meds for Type 2 DM Fundamentals Class 4 Meds for Type 2 Beverly Thomassian, RN, MPH, BC ADM, CDE President, Diabetes Education Services Copyright 1999 2015, Diabetes Education Services, All Rights Reserved. Diabetes Meds

More information

Clinical Cases in Diabetes Management. Joseph Cook D.O.

Clinical Cases in Diabetes Management. Joseph Cook D.O. Clinical Cases in Diabetes Management Joseph Cook D.O. Objectives State the prevalence of Diabetes Mellitus in Ohio State the percentage of diabetic patients in the U.S. treated by Primary Care Physicians

More information

Joslin Diabetes Center Joslin Diabetes Forum 2013: The Impact of Comorbidities on Glucose Control Scenario 2: Reduced Renal Function

Joslin Diabetes Center Joslin Diabetes Forum 2013: The Impact of Comorbidities on Glucose Control Scenario 2: Reduced Renal Function Scenario 2: Reduced Renal Function 62 y.o. white man with type 2 diabetes for 18 years Hypertension and hypercholesterolemia Known proliferative retinopathy Current medications: Metformin 1000 mg bid Glyburide

More information

DM Fundamentals Class 4 Meds for Type 2

DM Fundamentals Class 4 Meds for Type 2 DM Fundamentals Class 4 Meds for Type 2 Beverly Thomassian, RN, MPH, BC ADM, CDE President, Diabetes Education Services Copyright 1999 2015, Diabetes Education Services, All Rights Reserved. Diabetes Meds

More information

Improving Patient Outcomes with Individualized Therapy in the Management of Type 2 Diabetes

Improving Patient Outcomes with Individualized Therapy in the Management of Type 2 Diabetes Improving Patient Outcomes with Individualized Therapy in the Management of Type 2 Diabetes Timothy S. Reid, M.D. Mercy Diabetes Center Janesville, WI Duality Statement Dr. Reid is a Speaker and Consultant

More information

What s New in Type 2 Diabetes? 2018 Diabetes Updates

What s New in Type 2 Diabetes? 2018 Diabetes Updates What s New in Type 2 Diabetes? 2018 Diabetes Updates Jessica Conklin, PharmD, PhC, BCACP, CDE, AAHIP Associate Professor, UNM College of Phar macy jeconklin@salud.unm.edu Luis Gonzales, PharmD, PhC UNM

More information

Collaborative Practice Agreement

Collaborative Practice Agreement Collaborative Practice Agreement [community pharmacy name] [address] [phone number] [physician practice] [address] [phone number] Effective: [date] Expiration: [date] 1 Table of Contents 1.0 Introduction...4

More information

Welcome to the PHASE Learning Community! October 31, 2018

Welcome to the PHASE Learning Community! October 31, 2018 Welcome to the PHASE Learning Community! October 31, 2018 Webinar Housekeeping 1. Dial in for audio: 303-248-0285, Access Code: 5617817 2. Lines are muted. You can chat in questions or unmute your line

More information

Newer Therapies for Type 2 Diabetes

Newer Therapies for Type 2 Diabetes Newer Therapies for Type 2 Diabetes Sandra Indacochea Sobel, MD Clinical Assistant Professor of Medicine Clinical Chief of Endocrinology, UPMC Mercy Division of Endocrinology, Diabetes, and Metabolism

More information

9/29/ Disclosure. Learning Objectives. Diabetes Update: Guidelines, Treatment Options & Trends

9/29/ Disclosure. Learning Objectives. Diabetes Update: Guidelines, Treatment Options & Trends + Diabetes Update: Guidelines, Treatment Options & Trends Melissa Max, PharmD, BC-ADM, CDE Assistant Professor of Pharmacy Practice Harding University College of Pharmacy + Disclosure Conflicts Of Interest

More information

Making Sense of New DM Therapies and Technologies

Making Sense of New DM Therapies and Technologies Making Sense of New DM Therapies and Technologies Sandra Indacochea Sobel, MD Clinical Assistant Professor of Medicine Clinical Chief of Endocrinology, UPMC Mercy Division of Endocrinology, Diabetes, and

More information

SGLT2 Inhibitors

SGLT2 Inhibitors Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: SGLT2 Inhibitors Page: 1 of 7 Last Review Date: June 22, 2018 SGLT2 Inhibitors Description Invokana

More information

3. Cardiovascular Disease?

3. Cardiovascular Disease? Swiss recommendations 2016 Swiss Society of Endocrinology and Diabetology 1. Deficiency? Basal Premixed- Basal + GLP-1 RA (Xultophy ) or Basal Bolus 2. egfr < 30 ml/min? 3. Cardiovascular Disease? 4. Heart

More information

2/17/2016. Objectives. Define. Hey Sugar! DMII Management in Hospice Care

2/17/2016. Objectives. Define. Hey Sugar! DMII Management in Hospice Care Hey Sugar! DMII Management in Hospice Care Michelle Huber, R.Ph., PharmD.,CGP Objectives Review treatment for hyperglycemia discussing how these medications work, hypoglycemia risk, special considerations.

More information

STEP THERAPY CRITERIA

STEP THERAPY CRITERIA CATEGORY DRUG CLASS BRAND NAME (generic) STEP THERAPY CRITERIA AMYLIN ANALOG: SYMLIN/SYMLINPEN (pramlintide acetate) ANTIDIABETIC AGENTS GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST (GLP-1): ADLYXIN (lixisenatide)

More information

NEW DIABETES CARE MEDICATIONS

NEW DIABETES CARE MEDICATIONS NEW DIABETES CARE MEDICATIONS James Bonucchi DO, ECNU, FACE Adult Medicine and Endocrinology Specialists Disclosures Speakers bureau Sanofi AZ BI Diabetes Diabetes cost ADA 2017 data Ever increasing disorder.

More information

Type 2 Diabetes Mellitus: Update on Pharmacotherapy 04/04/18

Type 2 Diabetes Mellitus: Update on Pharmacotherapy 04/04/18 Type 2 Diabetes Mellitus: Update on Pharmacotherapy 04/04/18 No conflicts of interest Objectives for this talk Update on non-insulin drug therapy fro type 2 DM Appropriate use of insulin in type 2 DM ADA

More information

DIABETES (1 of 5) Generic. Generic $0 $5 $5-10 $0 $0 $0. Generic $0 $5 $5-10. Generic. Generic $0 $5 $5-10 $0 $0 $0. Generic $0 $5 $5-10 $0 $0 $0

DIABETES (1 of 5) Generic. Generic $0 $5 $5-10 $0 $0 $0. Generic $0 $5 $5-10. Generic. Generic $0 $5 $5-10 $0 $0 $0. Generic $0 $5 $5-10 $0 $0 $0 Metformin DIABETES (1 of 5) Glucophage Glucophage XR ER $7 (500mg) $7 (500mg) $5 $5 500mg, 750mg only 500mg, 750mg only Sulfonylurea/Combinations Amaryl Glucotrol glimepiride glipizide $5 $5 Glucotrol

More information

Cardiovascular Benefits of Two Classes of Antihyperglycemic Medications

Cardiovascular Benefits of Two Classes of Antihyperglycemic Medications Cardiovascular Benefits of Two Classes of Antihyperglycemic Medications Nathan Woolever, Pharm.D., Resident Pharmacist Pharmacy Grand Rounds November 6 th, 2018 Franciscan Healthcare La Crosse, WI 2017

More information

Wayne Gravois, MD August 6, 2017

Wayne Gravois, MD August 6, 2017 Wayne Gravois, MD August 6, 2017 Americans with Diabetes (Millions) 40 30 Source: National Diabetes Statistics Report, 2011, 2017 Millions 20 10 0 1980 2009 2015 2007 - $174 Billion 2015 - $245 Billion

More information

Glucose Control drug treatments

Glucose Control drug treatments Glucose Control drug treatments It should be noted that glitazones are under suspicion of precipitating acute cardiac events and current recommendations contraindicate the use of glitazones in patients

More information

TABLE 1A: Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations

TABLE 1A: Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations 177 TABLE 1A: Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations Formulary

More information

3/22/2017. Type 2 Diabetes Pathophysiology and Pharmacology Review. Accreditation Statement

3/22/2017. Type 2 Diabetes Pathophysiology and Pharmacology Review. Accreditation Statement Type 2 Diabetes Pathophysiology and Pharmacology Review Joshua J. Neumiller, PharmD, CDE, FASCP Vice Chair & Associate Professor, Department of Pharmacotherapy Washington State University Spokane, WA This

More information

TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations

TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations 177 TABLE 1A : Formulary Coverage of Insulin Therapies & Indications for Use in Various Populations Formulary Coverage Indication for use with: INSULIN THERAPY NS NB NL PE ADULTS PEDIATRICS PREGNANCY BOLUS

More information

Physician Drug Reference Chart for Diabetes Antidiabetic Medications

Physician Drug Reference Chart for Diabetes Antidiabetic Medications Drug Class Compound Brand Name Mechanism of Action Advantages Disadvantages Alpha-glucosidase inhibitors Medium Cost by Bayer Healthcare, Pfizer, Takeda Research Acarbose Miglitol Voglibose Precose Glyset

More information

Dipeptidyl-Peptidase 4 (DPP-4) Inhibitors Drug Class Prior Authorization Protocol

Dipeptidyl-Peptidase 4 (DPP-4) Inhibitors Drug Class Prior Authorization Protocol Dipeptidyl-Peptidase 4 (DPP-4) Inhibitors Drug Class Prior Authorization Protocol Line of Business: Medicaid P&T Approval Date: February 21, 2018 Effective Date: April 1, 2018 This policy has been developed

More information

11/4/2014. Outline. Pharmacists Objectives. Diabetes Update: What s New in Pharmacy Technician Objectives. Overview: Type 2 Diabetes Mellitus

11/4/2014. Outline. Pharmacists Objectives. Diabetes Update: What s New in Pharmacy Technician Objectives. Overview: Type 2 Diabetes Mellitus Diabetes Update: What s New in 2014 Dr. Amy P. Witte, Pharm.D. Associate Professor, Pharmacy Practice UIW Feik School of Pharmacy CTSHP Fall Seminar La Cantera Hill Country Resort October 25, 2014 Pharmacists

More information

Clinical Practice Guidelines

Clinical Practice Guidelines Clinical Practice Guidelines Diabetes Objective The purpose is to guide the appropriate diagnosis and management of Diabetes. This guideline is designed to assist the clinician by providing a framework

More information

Diabetes Oral Agents Pharmacology. University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D

Diabetes Oral Agents Pharmacology. University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D Diabetes Oral Agents Pharmacology University of Hawai i Hilo Pre-Nursing Program NURS 203 General Pharmacology Danita Narciso Pharm D 1 Learning Objectives Understand the role of the utilization of free

More information

Diabetes Update 10/12/2017. Section #1 OBJECTIVE. Lab features to consider:

Diabetes Update 10/12/2017. Section #1 OBJECTIVE. Lab features to consider: Section #1 OBJECTIVE Diabetes Update Fall 2017 Lyle Myers BE ABLE TO DIFFERENTIATE TYPE 1 FROM TYPE 2 DIABETES Clinical features: - age at onset - body weight/bmi - family history - treatment history -

More information

INJECTABLE THERAPY FOR THE TREATMENT OF DIABETES

INJECTABLE THERAPY FOR THE TREATMENT OF DIABETES INJECTABLE THERAPY FOR THE TREATMENT OF DIABETES ARSHNA SANGHRAJKA DIABETES SPECIALIST PRESCRIBING PHARMACIST OBJECTIVES EXPLORE THE TYPES OF INSULIN AND INJECTABLE DIABETES TREATMENTS AND DEVICES AVAILABLE

More information

The Management of Diabetes in Primary Care Kelly Krawtz, PharmD, BCPS, BCACP

The Management of Diabetes in Primary Care Kelly Krawtz, PharmD, BCPS, BCACP The Management of Diabetes in Primary Care Kelly Krawtz, PharmD, BCPS, BCACP Objectives Explain the current pharmacologic options for the management of diabetes Describe the latest technologies available

More information

Ertugliflozin (Steglatro ) 5 mg daily. May increase to 15 mg daily. Take in the morning +/- food. < 60: Do not initiate; discontinue therapy

Ertugliflozin (Steglatro ) 5 mg daily. May increase to 15 mg daily. Take in the morning +/- food. < 60: Do not initiate; discontinue therapy Sodium-glucose Cotransporter-2 (SGLT2) s Inhibit SGLT in proximal renal tubules, reducing reabsorption of filtered glucose from tubular lumen Lowers renal threshold for glucose à increase urinary excretion

More information

Halting the Rise, Newest Non- Insulin Options for Lowering A1c

Halting the Rise, Newest Non- Insulin Options for Lowering A1c Halting the Rise, Newest Non- Insulin Options for Lowering A1c Alecia Rottinghaus, PharmD PGY-1 Pharmacy Resident Iowa City Veterans Affairs Health Care System January 29 th, 2019 Disclosures Alecia Rottinghaus

More information

Halting the Rise, Newest Non- Insulin Options for Lowering A1c

Halting the Rise, Newest Non- Insulin Options for Lowering A1c Halting the Rise, Newest Non- Insulin Options for Lowering A1c Alecia Rottinghaus, PharmD PGY-1 Pharmacy Resident Iowa City Veterans Affairs Health Care System January 29 th, 2019 Disclosures Alecia Rottinghaus

More information

YOU HAVE DIABETES. Angie O Connor Community Diabetes Nurse Specialist 25th September 2013

YOU HAVE DIABETES. Angie O Connor Community Diabetes Nurse Specialist 25th September 2013 YOU HAVE DIABETES Angie O Connor Community Diabetes Nurse Specialist 25th September 2013 Predicated 2015 figures are already met 1 in 20 have diabetes:1in8 over 60years old Definite Diagnosis is key Early

More information

Dept of Diabetes Main Desk

Dept of Diabetes Main Desk Dept of Diabetes Main Desk 01202 448060 Glucose management in Type 2 Diabetes in Adults The natural history of type 2 diabetes is for HbA1c to deteriorate with time. A stepwise approach to treatment is

More information

Very Practical Tips for Managing Type 2 Diabetes

Very Practical Tips for Managing Type 2 Diabetes Very Practical Tips for Managing Type 2 Diabetes Jean-François Yale, MD, FRCPC McGill University Health Centre, Montreal, Canada Jean-francois.yale@mcgill.ca www.dryale.ca OBJECTIVES DISCLOSURES The participant

More information

Managing Complex Diabetes Cases: Medication Update. Celia Levesque MSN, RN, CNS-BC, CDE, BC-ADM

Managing Complex Diabetes Cases: Medication Update. Celia Levesque MSN, RN, CNS-BC, CDE, BC-ADM Managing Complex Diabetes Cases: Medication Update Celia Levesque MSN, RN, CNS-BC, CDE, BC-ADM clevesqu@mdanderson.org Objectives Describe how each diabetes medication class is used to treat diabetes Differentiate

More information

The Many Faces of T2DM in Long-term Care Facilities

The Many Faces of T2DM in Long-term Care Facilities The Many Faces of T2DM in Long-term Care Facilities Question #1 Which of the following is a risk factor for increased hypoglycemia in older patients that may suggest the need to relax hyperglycemia treatment

More information

Exploring Non-Insulin Therapies in Type 1 Diabetes

Exploring Non-Insulin Therapies in Type 1 Diabetes Exploring Non-Insulin Therapies in Type 1 Diabetes Susan Cornell, BS, PharmD, CDE, FAPhA, FAADE Associate Professor Midwestern University - Chicago College of Pharmacy Disclosures Dr. Cornell: Advanced

More information

1/15/2018. Disclosures. Current Diabetes Medications. Objectives NON-INSULIN AGENTS. Diabetes Med Classes. Mealtime

1/15/2018. Disclosures. Current Diabetes Medications. Objectives NON-INSULIN AGENTS. Diabetes Med Classes. Mealtime Disclosures Current Diabetes Medications None Claire Baker, M.D. Diabetes & Endocrine Associates January 24, 2018 Objectives Identify categories of diabetes medications Understand the pharmacology of diabetes

More information

Initiating Injectable Therapy in Type 2 Diabetes

Initiating Injectable Therapy in Type 2 Diabetes Initiating Injectable Therapy in Type 2 Diabetes David Doriguzzi, PA C Learning Objectives To understand current Diabetes treatment guidelines To understand how injectable medications fit into current

More information

Type 2 Diabetes Mellitus hypoglycaemic agents

Type 2 Diabetes Mellitus hypoglycaemic agents Type 2 Diabetes Mellitus hypoglycaemic agents Name Metformin Drug Name (eg brand name) Metformin (Diaformin Diabex) Cost / PBS per 28d mth $10.24 (1.5g dly) 1000mg+500mg / $4.44+$5.80 Concerns? Lactic

More information

Multiple Factors Should Be Considered When Setting a Glycemic Goal

Multiple Factors Should Be Considered When Setting a Glycemic Goal Multiple Facts Should Be Considered When Setting a Glycemic Goal Patient attitude and expected treatment effts Risks potentially associated with hypoglycemia, other adverse events Disease duration Me stringent

More information

Exploring Non-Insulin Therapies in Type 1 Diabetes. Objectives. Pre-Assessment Question #1. Disclosures

Exploring Non-Insulin Therapies in Type 1 Diabetes. Objectives. Pre-Assessment Question #1. Disclosures Exploring Non-Insulin Therapies in Type 1 Diabetes Disclosures Dr. Cornell: Advanced Practitioner Advisory Board and Speakers Bureau: Novo Nordisk Susan Cornell, BS, PharmD, CDE, FAPhA, FAADE Associate

More information

SGLT2 Inhibitors

SGLT2 Inhibitors Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: SGLT2 Inhibitors Page: 1 of 7 Last Review Date: November 30, 2018 SGLT2 Inhibitors Description

More information

Drug Class Review Monograph GPI Class 27 Anti-diabetics

Drug Class Review Monograph GPI Class 27 Anti-diabetics Drug Class Review Monograph GPI Class 27 Anti-diabetics Review Time Frame: 11/2015 04/2017 Previous Class Review: 02/2016 Background: Antidiabetic drug classes include: Alpha-glucosidase inhibitors- slow

More information

Learning Objectives. Impact of Diabetes II UPDATES IN TYPE 2 DIABETES. David Doriguzzi, PA-C

Learning Objectives. Impact of Diabetes II UPDATES IN TYPE 2 DIABETES. David Doriguzzi, PA-C UPDATES IN TYPE 2 DIABETES David Doriguzzi, PA-C Learning Objectives Upon completion of this educational activity, the participant should be able to: Overcome barriers and attitudes that limit Clinician/Patient

More information

Diabetes Meds Update Disclaimer and Important Info. Objectives. Page 1. Copyright , Diabetes Education Services

Diabetes Meds Update Disclaimer and Important Info. Objectives. Page 1. Copyright , Diabetes Education Services Diabetes Meds Update 2016 Beverly Dyck Thomassian, RN, MPH, BC ADM, CDE President, Diabetes Education Services Disclaimer and Important Info This content is for educational purposes only. Please see Package

More information

Diabetes management in liver and kidney disease

Diabetes management in liver and kidney disease Diabetes management in liver and kidney disease Epidemiology 1 Clinical case A 59 year old man with alcoholic cirrhosis; portal hypertension; mild encephalopathy Fasting plasma glucose - 103, March 2016;

More information

Non-Insulin Diabetes Medications Summary

Non-Insulin Diabetes Medications Summary Non-Insulin Diabetes Medications Summary Medications marked with an asterisk (*) can cause hypoglycemia INSULIN SECRETAGOGUES Sulfonylureas* GLYBURIDE* (Diabeta) (Micronase) production. Side effects: Potential

More information

continuing education for pharmacists

continuing education for pharmacists continuing education for pharmacists 2016 AACE/ACE Guidelines on Type 2 Diabetes Management and New Glycemic Control Agents Amanda R. Kriesen, R.Ph., PharmD, and Erin Bastick, R.Ph., PharmD Volume XXXV,

More information

Clinical Pharmacotherapeutic Applications of the American Diabetes Association Standards of Care 2018

Clinical Pharmacotherapeutic Applications of the American Diabetes Association Standards of Care 2018 Clinical Pharmacotherapeutic Applications of the American Diabetes Association Standards of Care 2018 RACHEL NAIDA, PHARMD, CDE CLINICAL ASSOCIATE PROFESSOR UNIVERSITY OF NEW ENGLAND COLLEGE OF PHARMACY

More information

INSIGHTS PRACTICE INSULIN, PRIOR AUTHORIZATION, AND UTILIZATION MANAGEMENT DECEMBER 2017 DEVELOPED BY THE AMERICAN PHARMACISTS ASSOCIATION

INSIGHTS PRACTICE INSULIN, PRIOR AUTHORIZATION, AND UTILIZATION MANAGEMENT DECEMBER 2017 DEVELOPED BY THE AMERICAN PHARMACISTS ASSOCIATION PRACTICE DECEMBER 2017 INSIGHTS INSULIN, PRIOR AUTHORIZATION, AND UTILIZATION MANAGEMENT DEVELOPED BY THE AMERICAN PHARMACISTS ASSOCIATION SUPPORTED BY SANOFI Contents Introduction... 1 Diabetes Management

More information

Management of Diabetes

Management of Diabetes Management of Diabetes Mellitus: Which Drugs for Which Patients? Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine baron@medicine.ucsf.edu Disclosure No relevant financial relationships

More information

TREATMENTS FOR TYPE 2 DIABETES. Susan Henry Diabetes Specialist Nurse

TREATMENTS FOR TYPE 2 DIABETES. Susan Henry Diabetes Specialist Nurse TREATMENTS FOR TYPE 2 DIABETES Susan Henry Diabetes Specialist Nurse How can we improve outcomes in Type 2 diabetes? Earlier diagnosis Better patient education Stress central role of lifestyle management

More information

DIABETES UPDATE 2018

DIABETES UPDATE 2018 DIABETES UPDATE 2018 Jerome V. Tolbert, M.D., Ph.D. Assistant Professor of Medicine Icahn School of Medicine at Mt. Sinai Division of Endocrinology and Bone Diseases 317 East 17 th Street New York, New

More information

GLP-1 agonists. Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK

GLP-1 agonists. Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK GLP-1 agonists Ian Gallen Consultant Community Diabetologist Royal Berkshire Hospital Reading UK What do GLP-1 agonists do? Physiology of postprandial glucose regulation Meal ❶ ❷ Insulin Rising plasma

More information