Needs Assessment:

The Butterfly Effect: Resurrection of the Beta Cell in Type 2 Diabetes
Type 2 diabetes is closely linked to the metabolic syndrome, a clustering of several cardiometabolic risk factors that includes obesity, hyperglycaemia, dyslipidaemia andelevated blood pressure. Although traditional approaches to the separate risk factors (risk factors for both cardiovascular disease and type 2 diabetes) have proven effective, increasing attention is now being directed at the management of "core" or central components, such as insulin resistance and beta cell function. Several studies of established diabetes therapeutics and data from some recently approved show potential for addressing these two important areas.

In most individuals who develop insulin resistance, the beta cells compensate by increasing the amount of insulin produced. This increased insulin is often sufficient to maintain normal glucose levels for a period of time, but over time the pancreas becomes increasingly unable to compensate. While insulin resistance does not progress, beta-cell response continues to decline. Ultimately, ongoing insulin resistance and reduced beta-cell response results in the development of type 2 diabetes.

Several diabetes drugs have been approved and marketed for insulin resistance, but beta cell dysfunction has been a more elusive target for drug development until recently. Therapies directed at beta cell abnormality have, to date, focused on stimulating beta cells to secrete more insulin rather than improving overall beta cell function.

Two new therapeutic classes have recently joined the market, incretin mimetics and DPP-IV inhibitors. Drugs in both classes have shown improvements in beta-cell function. Additionally, recent studies of TZDs, a class of drug already approved for insulin resistance, also demonstrated improvements in beta-cell function.

Healthcare professionals involved in treating patients with type 2 diabetes need to have an understanding of how the disease relates to concurrent, related conditions and approach treatment in a way to address them as a whole. This includes a detailed understanding of the role of insulin resistance and beta-cell failure in the development of type 2 diabetes. They also need to stay informed on any breakthroughs for addressing these core defects earlier in the development of the disease.

Educational Objectives:

At the end of the presentation, audience members should be able to:

1. Discuss the role of insulin resistance and beta-cell dysfunction in the development of type 2 diabetes.
2. Review the common treatment targets of type 2 diabetes, the metabolic syndrome, and cardiovascular disease.
3. Describe potential treatment regimens for patients with type 2 diabetes that address the central components of the metabolic syndrome.

Intended Audience:

This course is designed for primary care physicians, PAs, nurses, nurse practitioners, pharmacists, and other healthcare professionals who want to expand their knowledge and experience in diabetes management.

Accreditation Information:

Physicians
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 the Dannemiller Memorial Educational Foundation and MediKinetics LLC. The Dannemiller Memorial Educational Foundation is accredited by the ACCME to provide continuing medical education for physicians.

The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Pharmacists
  Purdue University is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This is a continuing education activity of Purdue, an equal access/equal opportunity university. To receive the 1.5 contact hours of continuing education credit, pharmacists must attend the entire program and complete all registration and evaluations at its conclusion. Approval is valid from the initial release date of September 5, 2007. The expiration date is September 30, 2008. Program #018-999-07-114-L01-P. A statement of credit will be mailed within 2 to 4 weeks of completing this activity.

Nurses
The Dannemiller Memorial Educational Foundation is an approved provider of the California Board of Registered Nursing. Provider approved by the California Board of Registered Nursing, Provider Number 4229 for 1.8 contact hours.

RNs outside California must verify with their licensing agency for approval of this course.

ADA Statement:

The Dannemiller Foundation and MediKinetics LLC fully comply with the legal requirements of the ADA and the rules and regulations thereof. If any participant in any of these educational activities is in need of accommodations, please contact us via e-mail at oferrell@medikinetics.net. Faculty disclosure will be provided during the meeting.