Managing Diabetes in the Frail, Multi-morbid Patient

Up to 1.0 AMA PRA Category 1 Credit™
Up to 1 AAFP Prescribed Credit Approved

Release Date: September 27, 2011
Expiration Date: September 27, 2012

Target Audience
Physicians and health care providers who care for frail, elderly diabetic patients (e.g. general internists, geriatricians, family physicians, hospitalists, pharmacists, nurse practitioners, physicians’ assistants and nurses).

Statement of Purpose
The latest ADA Standards for diabetes care confirm the findings of multiple trials and systematic reviews that state that for some populations, particularly frail elderly patients who may be at the end of life, tight control of glycosolated hemoglobin does not prolong life, decrease hospital admissions, decrease cardiovascular complications, or improve quality of life. In fact such tight control may render these frail patients at higher risk for falls and other misadventures.

Learning Objectives
Upon completion of this activity, you should be able to:

• Discuss the outcomes of recent studies describing the ineffectiveness of tight control protocols in managing diabetes for frail populations.

Agenda

• Introductions and discussion of scope and objectives
• A Review of the Updated Recommendations for Diabetes Care in the Elderly
• Putting the Recommendations into Practice
• Q & A

Faculty
Michael Fleming, MD, FAAFP
Dr. Fleming is Chief Medical Officer for Amedisys Home Health Services. He is a Clinical Associate Professor of Family Medicine at LSU Health Science Center in Shreveport, LA and Clinical Assistant Professor of Family and Community Medicine at Tulane University School of Medicine. Dr. Fleming has more than 29 years of medical field experience and is past President of the American Academy of Family Physicians and the Louisiana Academy of Family Physicians; and was founding President of the Louisiana Health Care Quality Forum. Dr. Fleming also serves as Chief Medical Officer of Antidote Education Company.

Peter Boling, MD
Director of Longterm Care & Geriatrics at the Virginia Commonwealth University, Medical College of Virginia, Richmond, VA.

John Buse, MD, PhD
Associate Professor of Medicine, Chief, Division of General Internal Medicine and Clinical Epidemiology, Director, Diabetes Care Center, University of North Carolina School of Medicine Chapel Hill, NC; Physician, UNC Diabetes Care Center, Durham, NC; Physician, First Health of the Carolinas Family Care Centers, Ellerbe, NC; Physician, Salem Center, Winston-Salem, NC.

Accreditation
ACCME: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Antidote Education Company and Amedisys. Antidote is accredited by the ACCME to provide continuing medical education for physicians.

Antidote Education Company designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AAFP: This Live activity, Managing Diabetes in the Frail, Multi-morbid Patient, with a beginning date of September 27, 2011, has been reviewed and is acceptable for up to 1.00 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AANP: This program is approved for 1.0 contact hours of continuing education by the American Academy of Nurse Practitioners. Program ID 1108228. This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards.

AAPA: AAPA accepts certificates of participation for educational activities certified for Prescribed credit from AAFP, and AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 1 hour of Category I credit for completing this program.

Method of Participation

• Read the learning objectives and faculty disclosures.
• Click on the link below to participate in the online activity. Answer any polling questions presented.
• Complete the post-test and evaluation presented at the end of the activity.

A statement of credit will be issued automatically upon receipt of a completed activity evaluation form and a completed post-test with a score of 80% or better. You will have 3 opportunities to successfully complete the post-test.

Disclosure
Antidote is committed to creating, developing, and operating high-quality, relevant, and practical continuing medical education activities that are in compliance with the ACCME's policies on commercial support and disclosure. Specifically, we are dedicated to ensuring that our events are planned and implemented free of the control of commercial interests and to identifying and resolving conflicts of interest of all persons in a position to control the content of an educational activity before the educational activity is delivered to our attendees. In addition, it is our standard practice to disclose all relevant financial relationships of our speakers in writing to our attendees before the beginning of an educational activity. The ACCME does not consider Amedisys to be a commercial interest.

Individuals in a position to control the content of this CME activity reported the following relevant financial relationships with commercial interests:

Michael Fleming, MD, FAAFP
Program development & Presenting Faculty
No relevant financial relationships to disclose
Dr. Fleming is employed by Amedisys

Peter Boling, MD
Presenting Faculty
No relevant financial relationships to disclose
Dr. Boling is a consultant to Amedisys

John Buse, MD, PhD
Presenting Faculty
Dr. Buse disclosed a number of relationships though without any direct financial benefit to him, but in contracts between his employer and the following companies:
Consultant: Amylin Pharmaceutical, Inc, Bayhill Therapeutics, Biodel, Boehringer Ingelheim, Catabasis, Diartis, Elcelyx, Eli Lilly and Co., Exsulin, Gl Dynamics, Hoffman-LaRoche Inc., LipoScience, Merck, Metabolon, Novan, Novo Nordisk Pharmaceuticals, Inc., Osiris Therapeutics, Inc., Orexigen, TransPharma in the area of diabetes.
Investigator: Amylin Pharmaceutical, Inc, Andromeda, Boehringer Ingelheim, Eli Lilly and Co., Halozyme, Inc., Hoffman-LaRoche Inc., Johnson & Johnson, Lexicon, Medtronic MiniMed, Inc., Novo Nordisk Pharmaceuticals, Inc., Pfizer, Inc., sanofi-aventis, Tolerex, Transition Therapeutics

Disclaimer:
The material presented at this course is being made available by Antidote Education Company for educational purposes only. This material is not intended to represent the only, nor necessarily best methods or procedures appropriate for the medical situations discussed, but rather is intended to present an approach, view, statement or opinion of the faculty which may be helpful to others who face similar situations. Opinions expressed in this activity are those of the faculty and not of Antidote or the joint sponsor.

Every effort has been made to assure the accuracy of the data presented at this course. Physicians may care to check specific details such as drug doses and contraindications in standard sources prior to clinical application.

Software Requirements:
An internet browser:
Internet Explorer 6.0 or newer, Firefox or Safari
Your browser must have cookies enabled and allow pop ups.

A media player:
Windows Media Player or Adobe Flash Player

It is HIGHLY recommended that you test your computer system to ensure you have the appropriate software and settings. To test your system, click the link below and then click the "System Test" button in the upper left side of the screen. This will run a compatibility check of your computer for the web seminar listing any issues of compatibility that could cause you not to be able to participate.

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