Agenda
Talk 1:
Clinical Inertia: Challenges in Managing Type 2 Diabetes in a Primary Care Setting
Scott V. Joy, MD, FACP

Talk 2:
A Case-Based Look at Breaking the Cycle With Incretin-Based Therapies
Jack L. Leahy, MD

Talk 3:
Taking It to the Next Level: Pearls for Your Clinical Practice
Moderator: R. Daniel Pollom, MD
Panelists: Jack L. Leahy, MD, and Scott V. Joy, MD, FACP

Program Chair

Jack L. Leahy, MD
Professor of Medicine and Chief, Endocrinology, Diabetes and Metabolism Unit
University of Vermont College of Medicine
Colchester, Vermont

Faculty

Scott V. Joy, MD, FACP
Associate Professor of Medicine
Medical Director, Duke Primary Care at Pickett Road
Duke University Health System
Durham, North Carolina

R. Daniel Pollom, MD
Medical Director, Diabetes Care Center
Community Health Network
Indianapolis, Indiana

Activity Overview
Because of the alarming statistics of patients with type 2 diabetes who are not meeting therapeutic goals, there is a great need for education about the rationale for overcoming clinical inertia by advancing therapy. Incretin-based therapies, with their unique pathophysiology, have rapidly evolved into a therapeutic option that can fill this role. The symposium content, enhanced with an audience response system (ARS) and a case-based panel discussion, will concentrate on various critical aspects of successful type 2 diabetes disease management. Patient selection and strategies for advancement to incretin-based therapies are among the topics that will be discussed.

CME Webcast Information
A CME webcast is a recorded version of a live symposium. This CME webcast is based upon educational content presented in a live symposium held in Philadelphia, Pennsylvania on Thursday, April 23, 2009.

Date of Original Release: Thursday, April 23, 2009 (satellite symposium)
Release Date: June, 2009
Expiration Date: June 30, 2010

Estimated Time to Complete this Activity: 1.75 hours

CME Webcast
To obtain CME credit, each participant should: 1) view the content presented; 2) complete and submit the CME demographic and evaluation form; 3) complete the post test questions and get a passing mark of 70% or higher; 4) print the online CME certificate; 5) Only those who get a score of 70% or higher will receive credit.

This activity should take approximately 1.75 hours to complete. The expiration date for this activity is June 30, 2010. No credit will be granted after this date.

Intended Audience
This activity is intended for internal medicine physicians and other healthcare professionals (HCPs) who treat patients with type 2 diabetes.

Learning Format
This activity features recorded presentations from a live CME symposium. Throughout the activity, you will have the opportunity to answer questions about the content and evaluate your responses against those that your colleagues have submitted.

Learning Objectives
After participating in this activity, the participant should be able to:

• Describe the impact of clinical inertia on the management of type 2 diabetes 
• List at least 3 challenges of patient self-management and 3 HCP challenges that can promote clinical inertia in patients with type 2 diabetes 
• Describe how the clinical course of type 2 diabetes contributes to clinical inertia 
• State the importance of advancing therapy when indicated in the treatment of type 2 diabetes
• Compare the advantages and disadvantages of the available therapeutic options for management of patients with type 2 diabetes 
• Discuss the role of incretin-based therapies in the treatment of patients with type 2 diabetes

CME Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) by the Institute for Medical and Nursing Education, Inc (IMNE). IMNE is accredited by the ACCME to provide continuing medical education (CME) for physicians.

IMNE designates this educational activity for a maximum of 1.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in this activity.

For Nurses: The Institute for Medical and Nursing Education (IMNE) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC’s) Committee on Accreditation.

IMNE designates this educational activity for 1.75 contact hours (0.175 CEUs). Accreditation by the ANCC’s Committee on Accreditation refers to recognition of educational activities and does not imply approval or endorsement of any product.

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 contact hours received through participation in this activity.

Faculty Disclosures
In compliance with the ACCME, it is the policy of IMNE to ensure fair balance, independence, and scientific rigor in all programming. All individuals involved in planning (ie, CME provider staff, educational partner staff, and CME reviewers) are expected to disclose any significant financial relationships with commercial interests over the past 12 months. IMNE also requires that faculty identify and reference off-label or investigational uses of pharmaceutical products and medical devices.

In accordance with the ACCME Standards for Commercial Support, parallel documents from other accrediting bodies, and IMNE policy, identification and resolution of conflict of interest have been made in the form of external peer review of educational content.
The following disclosures have been made:

Faculty
Jack L. Leahy, MD
Speaker: Bristol-Myers Squibb; Daiichi Sankyo; Merck & Co, Inc; sanofi-aventis
Consultant: Bristol-Myers Squibb; Daiichi Sankyo; Merck & Co, Inc; Novo Nordisk Inc; sanofi-aventis

Scott V. Joy, MD, FACP
Consultant: Amylin Pharmaceuticals, Inc; Eli Lilly and Company

R. Daniel Pollom, MD
Advisory Board: Eli Lilly and Company; Novo Nordisk Inc 
Speakers Bureau: Eli Lilly and Company; Merck & Co; Novo Nordisk Inc

CME Provider and Educational Partner Staff
All staff of IMNE in a position to influence content have filed statements of disclosure with the CME provider. Any conflicts of interest were identified and resolved prior to their involvement in planning this activity. These disclosures are available for review by contacting Steve Weinman at 1 609 936 7015 or steve.weinman@imne.com.

Steve Weinman, RN
Executive Director (IMNE)
Nothing to disclose.

Amy Groves
Director, Program Development (IMNE)
Nothing to disclose.

Katie Fidanza
Program Executive (IMNE)
Nothing to disclose.

Kim McFarland, PhD
Senior Medical Writer (IMNE)
Freelance Writer: MediTech Media, Ltd  Stock Interests: Pfizer Inc, Procter & Gamble

CME Peer Reviewers
Robert Hash, MD
Texas A&M Health Science Center
College of Medicine
College Station,Texas
Nothing to disclose.

Martin Quan, MD
David Geffen School of Medicine
University of California, Los Angeles
Los Angeles, California
Nothing to disclose.

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

Disclaimer
This activity is designed for HCPs for educational purposes. Information and opinions offered by the faculty/presenters represent their own viewpoints. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information.

While IMNE makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Faculty Bios:

Scott V. Joy, MD, FACP
Associate Professor of Medicine Medical
Director, Duke Primary Care at Pickett Road
Duke University Health System
Durham, North Carolina

Scott V. Joy, MD, FACP is Associate Clinical Professor of Medicine in the Department of Medicine, and Clinical Chief of the Division of General Internal Medicine at Duke University Medical Center in Durham, North Carolina. Dr Joy received his medical degree from University of Pittsburgh School of Medicine in Pittsburgh, Pennsylvania. His postgraduate education included a residency in internal medicine at Allegheny General Hospital in Pittsburgh. He is board certified in internal medicine and is a fellow of the American College of Physicians.

Dr Joy’s research interests include process improvement in diabetes management and education, evaluation of new drug therapies for diabetes, clinical evaluation of postprandial hyperglycemia, and applications of technology into clinical practice. He has published articles and abstracts in such publications as Diabetes, Journal of Clinical Outcomes Management, The Annals of Pharmacotherapy, Journal of Pediatric Hematology and Oncology, Journal of General Internal Medicine, and M.D. News. He is a member of the Eastern North Carolina American Diabetes Association Leadership Council and is a current member of the North Carolina Diabetes Advisory Council.

Jack L. Leahy, MD
Professor of Medicine and Chief, Endocrinology, Diabetes and Metabolism Unit
University of Vermont College of Medicine
Colchester, Vermont

Jack L. Leahy, MD, is Professor of Medicine and Chief, Division of Endocrinology, Diabetes and Metabolism at the University of Vermont College of Medicine. Dr Leahy received his MD from the Medical College of Virginia, Richmond in 1977.

Dr Leahy currently serves as the Principal Investigator for several National Institutes of Healthfunded grants examining beta-cell compensation and failure. He has received several awards and honors for his teaching and research in the area of endocrinology, and most recently delivered the Dr Manuel Paniagua Memorial Lecture for the Sociedad Puertorriqueña de Endocrinologia y Diabetologia in 2006. Dr Leahy has authored over 60 publications and 16 book chapters in the area of diabetes and has also served as editor for several publications as well. He is currently co-editor for Diabetes, Year Book of Endocrinology.

He is active in professional endocrinology organizations, serving on the Advisory Panel for the American Diabetes Associations’s Insulin Therapy Initiative from 2002-2003, as well as the Planning Committee for the American Diabetes Association Annual National Meeting from 2004-2005. Currently, he is a member of the American Diabetes Association, American Association for the Advancement of Science, American Federation Clinical Research, European Association for the Study of Diabetes, and The Endocrine Society. 

R. Daniel Pollom, MD
Medical Director, Diabetes Care Center
Community Health Network
The Indiana Heart Hospital
Indianapolis, Indiana

Dr Pollom is an internist in private practice who specializes in the care of patients with diabetes. In addition, he serves as the Medical Director for Diabetes Services for the Community Health Network Diabetes Care Center and The Indiana Heart Hospital. The latter, part of a 5-hospital network in central Indiana, is an all-digital, state-of-the art facility that specializes in the care of patients with cardiovascular disease

Dr Pollom received his medical degree from Indiana University. He completed his internal medicine residency at Ball Memorial Hospital in Muncie, Indiana, and is board-certified in internal medicine. He is a physician leader and clinical advisor regarding tight glycemic control in the acute care setting. For the last 10 years, he has limited his outpatient office practice to the care of adolescent and adult patients with diabetes, providing both primary and specialty care.

Dr Pollom has had type1 diabetes since age 12 and has worn an insulin pump for more than 25 years. He is a national speaker on cardiovascular disease and diabetes, insulin pump and sensor technology, and intensive insulin and glucose management in the acute care setting.

PLEASE NOTE:
The following system requirements are recommended for the best presentation viewing experience:

• Microsoft Windows 2000, Windows XP, Windows 2003, Windows Vista, or Macintosh OS X
• Display resolution of 800 x 600 pixels or greater
• Windows-compatible sound card
• Microsoft Internet Explorer 6.0 SP1.
• Windows Media Player 9.0
• Broadband Internet connection (256 Kbps & above)

For a complete list of system requirements needed to view the webcast please click here (this link opens a pdf document). If you have any questions about viewing the webcast please contact us.