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GLP-1 Based Therapies for Type 2 Diabetes: Understanding Their Unique Pharmacology and Their Effects Beyond Glucose Control

This CME activity is sponsored by Med Learning Group. This CNE activity is sponsored by Ultimate Medical Academy/CCM.

This activity is supported by an educational grant from Eli Lilly & Company

Specialty: Diabetes

Release date: December 10, 2013

Valid through: October 31, 2014

Target Audience:

This activity is designed to meet the educational needs of endocrinologists, primary care physicians, nurses, pharmacists, and other healthcare practitioners caring for diabetes patients.

Program Overview:

p>GLP-1 based therapies represent a significant advancement in the treatment of T2DM due to their ability to target multiple pathophysiologies of the disease. Although the first GLP-1 receptor agonist (exenatide BID) was approved by the FDA in 2005 and the first DDP-4 inhibitor, sitagliptin, was approved the following year, the differences in pharmacokinetics and magnitude of effects between these two classes of incretin-based therapies are not completely understood by clinicians. In addition, a lack of consensus in the existing guidelines regarding the preferred choice of these agents in the treatment algorithm further complicate physicians' therapeutic decisions (Fineman 2012). Short-acting GLP-1 receptor agonists should be considered early in the disease and as part of combination therapy for patients close to glycemic goals when post-prandial glucose control is more important. Long-acting GLP-1 receptor agonists should be considered when fasting glucose elevations are the main problem, and when weight loss would be beneficial. DPP-4 inhibitors could be used in patients with mild to moderate fasting hyperglycemia, need to maintain bodyweight, or when subcutaneous injections or gastrointestinal side effects limit the use of GLP-1 receptor agonists.

Understanding the physiology of incretins; the pharmacokinetics differences between incretin-based therapies; their effects on FPG, PPG and bodyweight; and the efficacy and safety profile of these agents are all of fundamental importance to target glycemic disturbances. By targeting these specific areas, we can offer more individualized therapy for T2DM patients in order to improve glycemic control and delay disease progression.

Fineman MS, Cirincione BB, Maggs D, Diamant M. GLP-1 based therapies: differential effects on fasting and postprandial glucose. Diabetes Obes Metab. 2012 Aug;14(8):675-88.

Credit Types

1.0 AMA PRA Category 1™ Credit Hour

1.0 Nursing Contact Hour