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Combination Therapy with Insulins and GLP-1 Receptor Agonists

This activity is sponsored by Postgraduate Healthcare Education, LLC (PHE) and supported by an educational grant from Sanofi US.


Dhiren K. Patel, PharmD, CDE, BC-ADM, BCACP
Associate Professor of Pharmacy Practice
School of Pharmacy
MCPHS University
Clinical Pharmacy Specialist
VA Boston Healthcare System
Boston, MA


Erin L. St. Onge, PharmD
Assistant Dean/Campus Director
Clinical Associate Professor
University of Florida College of Pharmacy
Orlando, Florida


Dhiren K. Patel, PharmD, CDE, BC-ADM, BCACP, who also served as the Program Chair, has indicated the following relevant affiliations or financial relationships with a commercial interest related to the content of this activity: consultant for AstraZeneca; Advisory Board for AstraZeneca, Novo Nordisk and Sanofi; member of the speaker's bureau for Merck, Novo Nordisk and Sanofi.

Erin L. St. Onge, PharmD hereby states that she does not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

The following reviewer, Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP, states the following relevant affiliations or financial relationships with a commercial interest related to the content of this activity: consultant for Becton Dickinson; member of the speaker's bureau for Novo Nordisk and Sanofi.

The following reviewer, Michael Gabay, PharmD, JD, BCPS, hereby states that he does not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

Susanne Batesko, RN, BSN, and Robin Carrino, as well as the planners, managers, and other individuals, not previously disclosed, who are in a position to control the content of Postgraduate Healthcare Education (PHE) continuing education (CE) activities hereby state that they have no relevant conflicts of interest and no financial relationships or relationships to products or devices during the past 12 months to disclose in relation to this activity. We are committed to providing participants with a quality learning experience and to improve clinical outcomes without promoting the financial interests of a proprietary business.


Postgraduate Healthcare Education, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

UAN: 0430-0000-16-011-H01-P

Credits: 1.0 hours (0.10 ceu)
Published: May 12, 2016
Expires: June 15, 2017
Type of Activity: Knowledge
Media: Internet

Fee Information: There is no fee for this educational activity

Estimated time to complete activity: 60 minutes


This accredited activity has been designed for pharmacists.


During the period May 12, 2016 through June 15, 2017, participants must 1) read the learning objectives and faculty disclosures; 2) view the educational activity; and 3) complete the post-test and the evaluation form. To answer the questions, click on your selected choice for each answer then proceed to the next question. Once completed, click on Grade Exam 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 participation will be made available immediately. Click on the View Statement of Participation link and print the 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. To receive Credit, you must provide your date of birth and NABP number. All Credit information will be uploaded into CPE monitor within 30 days.


To inform and educate pharmacists in all practice settings about the role of combination injectable therapy with basal insulin + a glucagon-like peptide (GLP)-1 receptor agonist for elevated postprandial glucose levels. Other postprandial glucose control strategies, such as mealtime rapid-acting insulin, will also be discussed. Pharmacokinetic parameters and basic information about GLP-1 receptor agonists, including mechanism of action, dosage and administration, adverse effects, and drug interactions will be discussed.


Upon completion of this activity, participants will be better able to:

1. Apply the American Diabetes Association and American Association of Clinical Endocrinologists guidelines in the management of patients with type 2 diabetes, with a specific focus on basal insulin therapy and glucagon-like peptide-1 (GLP-1) receptor agonists;
2. Compare and contrast the clinical profiles of the different basal insulins and GLP-1 receptor agonists and understand the unique pharmacokinetic and pharmacodynamic profile of each product;
3. Evaluate current data related to fixed-ratio combinations of GLP-1 receptor agonists and basal insulin, as well as products in development or under review;
4. Describe the clinical rationale and expected benefits of using combination therapy with complementary mechanisms of action; and
5. Formulate evidence-based treatment regimens that optimize control of both fasting and postprandial glucose levels.


Please ensure the computer system 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 PowerPoint, Flash Player & HTML5

Disclosure of Unlabeled Use and Disclaimer

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Postgraduate Healthcare Education, LLC and Sanofi US. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without an evaluation of their patients' conditions and current medications, including the identification of possible contraindications regarding the dangers of use and a review of any applicable manufacturer's product information, as well as a comparison with the recommendations of other authorities.

The author, sponsor, and publisher of this continuing education activity have made all reasonable efforts to ensure that all information contained herein is accurate in accordance with the latest available scientific knowledge at the time of acceptance for publication. However, because information regarding drugs (their administration, dosages, contraindications, adverse reactions, interactions, special warnings, precautions, etc.) is subject to constant change, the reader is advised to check the manufacturer's package insert for information concerning recommended dosages and potential problems and cautions prior to dispensing or administering the drug. Special precautions should be taken when a drug is new, or highly toxic, or is unfamiliar to the dispenser or administrant. This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the U.S. Food and Drug Administration (FDA). Neither the publisher nor sponsor promotes the use of any agent outside of approved labeling. Statements made in this monograph have not been evaluated by the FDA. Nutritional products discussed are not intended for the diagnosis, treatment, cure, or prevention of any disease.