Type 2 Diabetes in Practice An Expert Commentary with Farhad Zangeneh, MD, FACP, FACE A Clinical Context Report
Clinical Context: Type 2 Diabetes in Practice Expert Commentary Jointly Sponsored by: and
Clinical Context: Type 2 Diabetes in Practice Expert Commentary This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc., which was made possible, in part, through a collaboration with Eli Lilly and Company.
Type 2 Diabetes in Practice Clinical Context Series The goal of this series is to provide up-todate information and multiple perspectives on the pathogenesis, patient identification, symptoms, risk factors, and current and emerging treatments and best practices in the management of type 2 diabetes.
Type 2 Diabetes in Practice Clinical Context Series Target Audience Endocrinologists, cardiologists, diabetes educators, primary care physicians, nurses, nurse practitioners, physician assistants, pharmacists, and other healthcare professionals involved in the care of patients with type 2 diabetes.
Activity Learning Objective Upon successful completion of this educational program, participants should be able to: l Review the relevance and significance of the activity in the broader context of clinical care.
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Discussant Farhad Zangeneh, MD, FACP, FACE AACE Board of Directors, Member Consultant in Endocrinology/Medical Director Endocrine, Diabetes & Osteoporosis Clinic (EDOC) Sterling, Virginia
Disclosure Information Farhad Zangeneh, MD, has disclosed the following relevant financial relationships: Salary/Honoraria: Boehringer Ingelheim, Diachi Sankyo, Eli Lilly, GlaxoSmithKline, Merck, Novartis, Novo Nordisk, sanofiaventis, Santarus, and Takeda
Disclosure Information Dori F. Zaleznik, MD, Associate Clinical Professor of Medicine, Harvard Medical School, Boston; Chris Kaiser; and Dorothy Caputo, MA, BSN, RN, Nurse Planner, have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity. The staffs of Projects In Knowledge and MedPage Today have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.
Diabetes Drugs That Can Cause Hypoglycemia Insulin Sulfonylurea (glimepiride) Diabetes Drugs That Are Euglycemic Biguanide (metformin) GLP 1 inhibitors (exenatide, liraglutide) DPP 4 inhibitors (sitagliptin linagliptin) Alpha-glucosidase inhibitors (arcabose, precose) Thiazolidinediones (pioglitazone) Dopamine 2-agonists (cycloset) Selective Bile Acid Squestrants (colesevelam)
Signs of Hypoglycemia: <70 mg/dl Confusion Visual disturbances Nervousness or anxiety Heart palpitations Shakiness Sweating Hunger
Managing Diabetes Is Multidisciplinary Endocrinologists Primary care physicians Cardiologists Nephrologists Pharmacists Nurses
Even Patients Not Aware of Hypoglycemia They accept daily lows They have snack plans for these lows They don t report these to doctors If they did, treatment plan can be modified
Summary: At the end of this activity, participants will be able to: Recognize certain drugs put diabetics at a higher risk of hypoglycemia Identify drugs that will help maintain euglycemia Determine the signs and symptoms of hypoglycemia Develop ways to work across specialties to manage diabetes Discuss ways to better educate patients about avoiding hypoglycemia