Recent data from the Centers for Disease Control and Prevention demonstrate that the prevalence of type 2 diabetes in the United States has increased to more than 20 million individuals, with less than 10% of patients meeting their glycemic goals. While the proportion of patients achieving lipid and blood pressure control has improved in recent years, the proportion of those achieving glycemic control has declined. The availability of different insulin analogs and their associated treatment regimens, as well as the recent approval of new insulin formulations (including the first inhaled insulin) and novel agents, has compounded the complexities and difficulties that physicians and patients view as inherent to comprehensive diabetes therapy. This perceived complexity often results in unnecessary treatment delays or inappropriate insulin dosing.

A case-based approach that encompasses a discussion of such regimens, their appropriateness for particular patients, and their advantages and disadvantages would enable physicians to help patients achieve glycemic control and reduce the frustration both parties experience while trying to attain these goals. The cases presented in this educational program provide real-world situations that the physician/caregiver may encounter in his or her practice. Guideline- and evidence-based treatment recommendations provide physicians with a valuable resource to advance diabetes care for their patients.

The University of Medicine and Dentistry of New Jersey (UMDNJ)–Center for Continuing and Outreach Education designates these educational activities for a maximum of 0.75 AMA PRA Category 1 Credits™. Please note that the courses are accredited only for physicians (MD, DO, or equivalent). All other participants receive a certificate of completion.

AVAILABLE COURSES

A 58-Year-Old African American Man With a 9-Year History of Type 2 Diabetes

DESCRIPTION Roger T— is a 58-year-old African American man who received a diagnosis of type 2 diabetes mellitus (T2DM) 9 years ago. During a scheduled physical examination 9 months ago, basal insulin therapy was added to his existing oral antidiabetic drug (OAD) regimen. At Roger's 3-month follow-up visit, his glycosylated hemoglobin A1C (HbA1C) level was 7.4%. He missed his next 3-month follow-up appointment; it has now been 6 months since his last examination. At the current visit, Roger's fasting plasma glucose (FPG) level is 120 mg/dL.

	A 50-Year-Old African American Woman With Advanced Type 2 Diabetes
DESCRIPTION Helen G— is an obese 50-year-old African American woman who presents with progressively worsening numbness in her feet. She also reports fatigue and indicates that she is excessively thirsty and must urinate frequently, even after retiring for the night. Helen has elevated blood pressure but has not been examined by a physician in the past 4 years.

A 44-Year-Old Hispanic Man With a History of Type 2 Diabetes

DESCRIPTION Arturo J— is a 44-year-old Hispanic man who received a diagnosis of type 2 diabetes mellitus (T2DM) 5 years ago. His most recent glycosylated hemoglobin A1C (HbA1C) level was 7.9%. Arturo was asked to keep a fasting plasma glucose (FPG) diary for 2 weeks. Today, his FPG level is 219 mg/dL. Arturo has a family history of T2DM (both parents and an older brother). He has not received formal diabetes or nutrition education from a certified diabetes educator (CDE).

A 69-Year-Old Man With Poorly Controlled Type 2 Diabetes

DESCRIPTION John B— is a 69-year-old white man who received a diagnosis of type 2 diabetes mellitus (T2DM) 9 years ago. His most recent glycosylated hemoglobin A1C (HbA1C) concentration was 9.5%, prompting his physician to request that he keep a diary of self-monitored fasting plasma glucose (FPG) and 2-hour postprandial glucose (PPG) levels for 2 weeks. Today’s values are 220 mg/dL and 300 mg/dL, respectively.