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Part 4

Confronting Barriers and Cultural Differences in Order to Improve Adherence to T2DM Treatment

Free CME

Sponsorship Statement

This continuing medical education activity is sponsored by

Vindico Medical Education

Support Statement

This activity is supported by educational grants from

Lilly USA, LLC


Novo Nordisk

Target Audience

The intended audience for this activity is endocrinologists, primary care physicians, nurse practitioners, physician assistants and other healthcare professionals involved in the treatment of patients with Type 2 Diabetes Mellitus (T2DM).

Learning Objectives

At the conclusion of this series participants should be able to:

  • Compare oral, insulin-, and incretin-based therapies in terms of their safety, efficacy, and tolerability.
  • Individualize treatment by appropriately selecting, initiating and intensifying treatment with insulin and incretin-based therapies to achieve A1C goals in specific patients.
  • Treat T2DM aggressively using insulin-based therapy, and recognize and accommodate cultural differences among patients to better assist them in overcoming barriers to self management.


Importance of Individualizing Therapy in Managing T2DM

Robert R. Henry, MD Professor of Medicine Division of Endocrinology & Metabolism University of California, San Diego Chief, Section of Diabetes, Endocrinology and Metabolism Director, Center for Metabolic Research VA San Diego Healthcare System San Diego, CA

Comparing Oral, Insulin and Incretin-based Therapies: Safety, Efficacy, and Tolerability Individualizing T2DM Treatment Plans

Vivian A. Fonseca, MD, FRCP Professor of Medicine and Pharmacology Tullis-Tulane Alumni Chair in Diabetes Chief, Section of Endocrinology Tulane University Health Sciences Center New Orleans, LA

Selecting, Initiating and Intensifying Treatment with Insulin and Incretin-based Therapies

Steven V. Edelman, MD Professor of Medicine University of California San Diego Veterans Affairs Medical Center Founder and Director Taking Control of Your Diabetes San Diego, CA

Confronting Barriers and Cultural Differences in Order to Improve Adherence to T2DM Treatment

Jeffrey Unger, MD Director, Metabolic Studies Catalina Research Institute President, Unger Primary Care Medical Center Chino, CA


Vindico Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Vindico Medical Education designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This enduring material is approved for 1 year from the date of original release: September 9, 2013 to September 8, 2014. Questions regarding this CME activity? Please email

How To Participate in this Activity and Obtain CME Credit

To participate in this CME activity, you must read the objectives, answer the pretest questions, read the articles, complete the CME posttest, and complete and return the registration form and evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 66% of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, Vindico Medical Education will issue an AMA PRA Category 1 Credit(s)™ Certificate.

Planning Committee and Faculty

Robert R. Henry, MD Steven V. Edelman, MD Vivian A. Fonseca, MD, FRCP Jeffrey Unger, MD

External Reviewer

Ronald Codario, Jr., MD


In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears on this page. The authors disclose that they do have significant financial interests in any products or class of products discussed directly or indirectly in this activity, including research support.
  • Planning Committee and Faculty members report the following relationship(s):
    • Robert R. Henry, MD
      • Grant/Research Support: AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Sanofi-Aventis
      • Consultant: Boehringer Ingelheim, Intarcia, Isis, Eli Lilly, Novo Nordisk, Roche/Genentech, Sanofi-Aventis
      • Advisory Board: Amgen, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Elcelyx, Eli Lilly, Intarcia, Johnson & Johnson/Janssen, Merck, Novo Nordisk, Roche/Genentech, Sanofi-Aventis
    • Vivian A. Fonseca, MD, FRCP
      • Honoraria for Consulting Fees and Lectures: Abbott, AstraZeneca, Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Sankyo, Eli Lilly, GlaxoSmithKline, Novo Nordisk, PamLabs, Sanofi-Aventis, Takeda
      • Research Support (to Tulane): Abbott, Eli Lilly, Endo Barrier, Novo Nordisk, Pan American Laboratories, Rcata, Sanofi-Aventis
    • Steven V. Edelman, MD
      • Consulting Fee: Boehringer Ingelheim, Bristol-Myers Squibb, Lilly, Merck, Novo Nordisk, Sanofi
      • Speakers Bureau: Boehringer Ingelheim, Bristol-Myers Squibb, Lilly, Merck, Novo Nordisk, Sanofi
    • Jeffrey Unger, MD
      • Royalty: Lippincott Publishing
      • Consulting Fee: Abbott, Halozyme, Janssen, Novo Nordisk, Sanofi
      • Speakers Bureau: Janssen, Veritas
    • Ronald Codario, Jr., MD (External Reviewer)
      • No relevant financial relationships to disclose.
  • Vindico Medical Education staff report the following relationship(s):
    • No relevant financial relationships to disclose.
  • BetterCME staff report the following relationship(s):
    • Medical Director, Maya Mehta, MD, MBA and production staff of BetterCME have nothing to disclose.
  • Signed disclosures are on file at Vindico Medical Education, Office of Medical Affairs and Compliance.

Unlabeled and Investigational Usage

The audience is advised that this continuing medical education activity may contain references to unlabeled uses of FDA-approved products or to products not approved by the FDA for use in the United States. The faculty members have been made aware of their obligation to disclose such usage. All activity participants will be informed if any speakers/authors intend to discuss either non-FDA approved or investigational use of products/devices.

Copyright Statement

© 2013 Created and published by Vindico Medical Education, 6900 Grove Road, Building 100, Thorofare, NJ 08086-9447. Telephone: 856-994-9400; Fax: 856-384-6680. Printed in the USA. Copyright © 2013 Vindico Medical Education. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. The material presented at or in any of Vindico Medical Education continuing medical education activities does not necessarily reflect the views and opinions of Vindico Medical Education. Neither Vindico Medical Education nor the faculty endorse or recommend any techniques, commercial products, or manufacturers. The faculty/authors may discuss the use of materials and/or products that have not yet been approved by the US Food and Drug Administration. All readers and continuing education participants should verify all information before treating patients or utilizing any product.