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Focus on the Individual Target: Adjusting Insulin Therapy for Type 2 Diabetes Through Transitions of Care – Case 2

Provided by The University of Tennessee College of Pharmacy, in cooperation with ASiM.
Supported by an educational grant from Novo Nordisk.


Basal insulin and rapid-acting mealtime insulin are increasingly common options for maintaining glycemic control in the long-term care (LTC) setting, where up to 34% of residents require treatment for type 2 diabetes mellitus (T2DM). Recent updates from the American Diabetes Association (ADA), American Geriatrics Society (AGS), and American Medical Directors Association (AMDA) Society for Post-Acute and LTC Medicine provide an evidence-based framework for initiating and intensifying insulin therapy in LTC residents. One of the major challenges of insulin therapy involves the safe transition of LTC residents to and from the hospital. The American Society of Health-System Pharmacists (ASHP) and American Pharmacists Association (APhA) have identified best practices around care transitions with a focus on medication management and reconciliation. Furthermore, pending legislative changes will establish new standards of care around hospital transitions for LTC facilities participating in Medicare and Medicare programs. Consultant pharmacists are uniquely positioned to ensure safe and effective T2DM treatment during care transitions. This case-based educational activity will address common challenges associated with the management of T2DM in the LTC setting, with a focus on best practices for maintaining optimal glycemic control.


The goal of this activity is to provide pharmacists with the most up-to-date clinical knowledge and strategies for the optimal assessment and management of residents with T2DM in the long-term care setting.


This enduring case activity is designed for consultant pharmacists who manage elderly patients with type 2 diabetes. No prerequisites required.


The University of Tennessee College of Pharmacy takes responsibility for the content, quality, and scientific integrity of this CPE activity. At the conclusion of this activity, the participant should be able to:

  • Apply algorithms for basal insulin dosing in conjunction with rapid-acting insulin to attain therapeutic goals.
  • Recognize the importance of effectively working within the healthcare team to ensure the proper quality and/or transition of care.


acpeThe University of Tennessee College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. Successful completion of this knowledge-based program will provide a statement for 0.5 contact hours of credit (0.5 CEUs) and will be available at the completion of the activity. Successfully completing the activity and receiving credit includes: 1) attending the session; 2) watching, listening to, and participating in the educational activity; 3) completing the self-assessment instrument with a score of at least 70%. UAN: 0064-0000-16-208-H01-P. CE credit will be submitted to the NABP CPE Monitor within 30 days.  It is recommended that you check your NABP CPE Monitor e-profile database 30 days after the completion of any CE activity to ensure that your credits are posted.


Pharmacists or pharmacy technicians with questions regarding their NABP e-Profile or CPE Monitor should refer to the FAQ section on the NABP website: http://www.nabp.net/programs/cpe-monitor/cpe-monitor-service. To receive credit for your participation in this activity, all pharmacists must include their NABP e-Profile ID number, along with their date and month of birth. If incorrect information is provided, this will result in "rejected" status from the CPE Monitor. It is the responsibility of the participant to notify The University of Tennessee (within the 60 day submission timeframe) of their corrected information. Otherwise, the completed CE will not be accepted by the CPE Monitor.

Please allow up to 30 days for your credit to appear on CPE Monitor.

Type of Activity: Knowledge

Published: June 30, 2016
Expires: June 30, 2017

Media: Internet

Fee Information: There is no fee for this educational activity.

Estimated time to complete activity: 30 minutes


Participants must complete the activity as described above in the Credit Designation Statement. To answer the questions, click on your selected choice for each answer then proceed to the next question. We recommend that you print a copy of your answers before you submit them to us. Once completed, click on Submit Post-test at the bottom of the page. Your post-test will automatically be graded. If you successfully complete the post-test (score of 70% or higher), your statement of CE credit will be made available immediately. Click on View Certificate and print the CE statement for your records. If you receive a score lower than 70%, you will receive a message notifying you that you did not pass the post-test. You will have 2 opportunities to pass the post-test.


As an accredited provider by the Accreditation Council for Pharmacy Education (ACPE), it is the policy of The University of Tennessee College of Pharmacy to require the disclosure of the existence of any significant financial interest or any other relationship a faculty member or a sponsor has with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. The Course Director and Participating Faculty reported the following:


Diane B. Crutchfield, PharmD, CGP, FASCP (Chair)
President, Pharmacy Consulting Care
Knoxville, Tennessee
Dr Crutchfield reports having no relevant financial or advisory relationships with corporate organizations related to this activity.

John R. White, Jr, PA-C, PharmD
Chair and Professor
Department of Pharmacotherapy
Washington State University, College of Pharmacy
Spokane, Washington
Dr White reports serving as a consultant for sanofi-aventis.


In accordance with ACPE Criteria for Quality, the audience is advised that authors in this CPE activity may include reference(s) to unlabeled, unapproved, or investigational uses of therapeutic agents or biomedical devices. The authors will inform the reader of when they discuss or reference an unapproved, unlabeled, or investigational use of therapeutic agent or biomedical device.


The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This activity is produced for educational purposes only. Use of The University of Tennessee College of Pharmacy name implies review of educational format, design, and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.


A participant, sponsor, faculty member, or other individual wanting to file a grievance with respect to any aspect of an activity sponsored or cosponsored by The University of Tennessee College of Pharmacy may contact the Associate Dean for Continuing Education in writing at gfarr@utasip.com. The grievance will be reviewed and a response will be returned within 45 days of receiving the written statement. If not satisfied, an appeal to the Dean of the College of Pharmacy can be made for a second level review.


The following is an interactive case simulation designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of 3 sections: an unaccredited pre-test, an interactive case study, and a CPE post-test, and evaluation. All 3 sections must be completed to receive CPE credit. A statement of credit will be available online immediately following successful completion of the activity.


Please ensure the computer you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac &/Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible.
  • Peripherals: Computer speakers or headphones
  • Monitor Screen Resolution: 320 x 480 or higher
  • Media Viewing Requirements: Adobe Reader, Microsoft Power Point, Flash Player & HTML5


Please click the button below for the available resources.



Focus on the Individual Target:
Adjusting Insulin Therapy for Type 2 Diabetes Through Transitions of Care – Case 2
John R. White, Jr, PA-C, PharmD