Program Overview

Activity Description

Among people with type 2 diabetes who have severe pancreatic β-cell dysfunction, exogenous insulin treatment is essential for controlling glycemia and reducing risks of disease-related complications and mortality. Conventional human insulin preparations can be limited by their slow absorption and inability to adequately match the complex basal-bolus pattern of physiologic insulin activity. The development of insulin analogues, including premixed formulations that are designed to mimic physiologic insulin activity, has advanced diabetes management and afforded patients more convenient treatment options. Until recently, however, the benefits and harms of premixed insulin analogues had not been compared with outcomes of other insulin therapies and noninsulin oral antidiabetic agents. In 2008, under the auspices of the Agency for Healthcare Research and Quality (AHRQ), a systematic review on this topic was published.

This e-JMCP article is intended to familiarize health care professionals with the methods and key findings from AHRQ's comparative effectiveness research and systematic review on premixed insulin analogues. In addition, the article offers reflections on how the findings might be applied in clinical and managed care settings.

Learning Objectives

At the conclusion of this activity, the participant should be able to:

• Compare the effectiveness, safety, and adherence outcomes of using premixed insulin analogues versus other insulin preparations for achieving optimal glycemic control in type 2 diabetes
• Differentiate the effectiveness and safety of premixed insulin analogues across various subpopulations of patients with type 2 diabetes
• Interpret the effectiveness and safety of premixed insulin analogues in patients receiving oral diabetes medications and with different blood glucose patterns or intensities of control
• Apply AHRQ's systematic review findings on premixed insulin analogues to making patient-centered treatment and management decisions

Target Audience

This CME activity is designed to meet the educational needs of physicians, pharmacists, nurses, and case managers who manage patients with diabetes.

Method of Participation

To receive a certificate for this activity, you should:

• Complete the learner assessment pretest
• View the entire activity online
• Complete an online evaluation & post-test
• Print your certificate online

The estimated time to complete this activity, including review of the materials, is 2.5 hours.

Term of Approval

March 31, 2011 through March 30, 2013. Original release date: March 31, 2011

Acknowledgement of Support

There is no fee for this CME/CE activity. This activity is sponsored by PRIME Education, Inc (PRIME^®) and funded under contract HHSA290201000006G from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (HHS).

Faculty Biographies and Disclosures

Accreditation/Credit Designation

This program is no longer accredited.

Faculty Disclosures

Disclosure Policy

PRIME Education Inc (PRIME^®) endorses the standards of the ACCME, as well as those of the AANP, ANCC and ACPE, that require everyone in a position to control the content of a CME/CE activity to disclose all financial relationships with commercial interests that are related to the content of the CME/CE activity. CME/CE activities must be balanced, independent of commercial bias and promote improvements or quality in healthcare. All recommendations involving clinical medicine must be based on evidence accepted within the medical profession.

A conflict of interest is created when individuals in a position to control the content of CME/CE have a relevant financial relationship with a commercial interest which therefore may bias his/her opinion and teaching. This may include receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, stocks or other financial benefits.

PRIME^® willidentify, review and resolve all conflicts of interest that speakers, authors, course directors, planners, peer reviewers, or relevant staff disclose prior to an educational activity being delivered to learners. Disclosure of a relationship is not intended to suggest or condone bias in any presentation but is made to provide participants with information that might be of potential importance to their evaluation of a presentation. Disclosure information for speakers, authors, course directors, planners, peer reviewers, and/or relevant staff are provided with this activity.

Presentations that provide information in whole or in part related to non FDA approved uses of drugs and/or devices will disclose the unlabeled indications or the investigational nature of their proposed uses to the audience. Participants should refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. Participants should verify all information and data before treating patients or employing any therapies prescribed in this educational activity. The opinions expressed in the educational activity are those of the presenting faculty and do not necessarily represent the views of PRIME^®, the ACCME, AANP, ACPE, ANCC and other relevant accreditation bodies.

Content validation methods are consistently utilized by PRIME^® to ensure that all program content is evidence-based, fair-balanced, and developed with scientific rigor and integrity. All clinical recommendations are based on evidence accepted within the medical profession. All scientific research referred to, reported or used to support a clinical recommendation conforms to accepted standards of experimental design, data collection and analysis. In addition to review of content by course directors and expert faculty, content is also validated through independent peer reviewers selected for their expertise in the content area, as well as their experience in the intended audience. All peer reviewers, planners, course directors, faculty and relevant staff utilized by PRIME^® complete disclosures which are related to their role in the educational activity.

Accessibility

PRIME^®is committed to providing access to our CME programs for individuals with disabilities as identified in Section 508 of the Rehabilitation Act for all web-based programs. This website is 508 compliant.

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Post-Test & Evaluation

Clinician & Consumer Summaries on Premixed Insulin Analogues

Download these free summaries for your reference and/or patient handouts. You may also order bulk copies free of charge from the AHRQ Publication Clearinghouse below.

Clinician Summary

Premixed Insulin Analogues: A Comparison With Other Treatments for Type 2 Diabetes

Consumer Summary

Premixed Insulin for Type 2 Diabetes: A Guide for Adults

Spanish Summary

Insulina premezclada para la diabetes tipo 2: Guía para adultos

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