Rationale, Recognition, and Recommendations: Expert Perspectives on Combining Basal Insulin and GLP-1 RAs to Intensify Treatment of T2DM

Current type 2 diabetes mellitus (T2DM) guidelines emphasize individualizing care, avoiding adverse effects (particularly hypoglycemia and weight gain), and intensifying therapy in a timely manner to maintain glycemic control and prevent or slow the development of complications. Intensifying antihyperglycemic therapy with injectable agents has been identified as an area of educational need for many healthcare providers (HCPs), including nurse practitioners (NPs) and physician assistants (PAs). This activity will review the rationale and current recommendations for basal insulin intensification, focusing on the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Information on the practical use of 2 recently approved basal insulin/GLP-1 RA fixed-ratio coformulations will also be presented. Because these coformulations may be an optimal therapeutic approach for some patients, NPs and PAs should be prepared to provide patients with information on these options, such as anticipated efficacy, adverse effects, and specifics of dosing and administration.

Program Format

This is an enduring activity from a live meeting occurring at the Metabolic & Endocrine Disease Summit West in August 2018. This engaging 90-minute webcast will provide NPs, PAs, and other HCPs with clinically relevant information regarding the intensification of basal insulin therapy, including the use of basal insulin/GLP-1 RA fixed-ratio coformulations. Throughout the activity, participants will have the opportunity to respond to audience questions and compare their answers with those provided by their colleagues during the live activity.

Intended Audience

This activity is intended for NPs, PAs, and other HCPs with a particular interest in the clinical diagnosis and treatment of common metabolic and endocrine diseases, especially those who provide care for adults with T2DM.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Summarize the rationale and current recommendations for intensifying basal insulin therapy for the treatment of T2DM
  • Assess the benefits and limitations of using GLP-1 RAs and basal insulin/GLP-1 RA fixed-ratio coformulations to intensify basal insulin therapy as part of individualized T2DM care
  • Discuss practical considerations for using GLP-1 RAs and basal insulin/GLP-1 RA fixed-ratio coformulations for individualized intensification of basal insulin therapy in T2DM management

CME and CE Accreditation and Credit Designation Statements

For Physicians

The Institute for Medical and Nursing Education, Inc. (IMNE), is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

IMNE designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For Physician Assistants
The American Academy of Physician Assistants (AAPA) has determined that AMA PRA Category 1 Credit(s)™ is acceptable to meet AAPA CME requirements for PAs.

For Nurse Practitioners and Nurses

IMNE is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC’s) Commission on Accreditation.

This educational program provides 1.25 contact hours of continuing education credit.

IMNE has determined that 1.0 hour of this program will satisfy ANCC’s pharmacotherapeutics contact hour requirement for ANCC certified Clinical Nurse
Specialists and Nurse Practitioners. The CEU certificate will reflect this credit.

Method of Participation

To receive a maximum of 1.25 AMA PRA Category 1 Credits™ or ANCC continuing nursing education credit, participants should:

  • Complete the activity pretest
  • Watch the educational program
  • Complete the activity post-test with a score of 80% or higher
  • Complete the activity evaluation

CME/CE certificates will be generated online.

CME/CE Credit Questions

If you have a question about continuing education credit, please contact IMNE:
Steve Weinman, RN, CHCP
Email: steve.weinman@imne.com
Phone: 1 609 936 7015


It is the policy of IMNE to ensure fair balance, independence, objectivity, and scientific rigor in all programming. All individuals involved in planning (eg, faculty, CME/CE provider staff, and educational partner staff) are expected to disclose any significant financial relationships with commercial interests over the past 12 months. It is also required that faculty identify and reference off-label product or investigational uses of pharmaceutical agents and medical devices.

Resolutions of conflict of interest have been made in the form of external peer review.

The following disclosures have been made:


James R Gavin III, MD, PhD—Program Chair
Speakers Bureau: AstraZeneca; Boehringer Ingelheim; Janssen; Novo Nordisk
Consultant: Abbott Diabetes Care; Intarcia; Janssen

Lucia M Novak, MSN, ANP-BC, BC-ADM, CDTC
Ms Novak has nothing to disclose.

IMNE Staff

All staff of IMNE in a position to influence content have filed statements of disclosure with the continuing education provider. Any conflicts of interest were identified and resolved prior to their involvement in planning this activity. These disclosures are available for review by contacting Steve Weinman at 1 609 936 7015 or steve.weinman@imne.com.

Amy Carbonara
Vice President
Ms Carbonara has nothing to disclose.

Amy Groves
Business Lead
Ms Groves has nothing to disclose.

Kim McFarland, PhD
Senior Medical Writer
Dr McFarland has nothing to disclose.

Steve Weinman, RN, CHCP
Director of Accreditation
Mr Weinman has nothing to disclose.

External CME/CE Reviewers
Martin Quan, MD
Dr Quan has nothing to disclose.

Darilyn Paul, APRN
Ms Paul has nothing to disclose.


This activity is designed for HCPs for educational purposes. Information and opinions offered by the faculty/presenters represent their own viewpoints. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information.

While IMNE makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision making before applying any information, whether provided here or by others, for any professional use.

Commercial Support Acknowledgment

This activity is supported by an educational grant from Sanofi US.

Minimum System Requirements

The following system requirements are recommended for the best presentation viewing experience:

  • Microsoft Windows Vista, Windows 7, or Mac OS X Mavericks, Yosemite, El Capitan
  • Display resolution of 1024 × 768 or greater
  • Sound card
  • Microsoft Internet Explorer 9 or higher on Windows
  • Safari 7 and higher on Mac
  • Chrome 46 and higher on Windows/Mac
  • Firefox 41 and higher on Windows/Mac
  • Broadband Internet connection

If you have any questions about viewing the activity, please contact tech support.