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Working Together Against Clinical Inertia: Using Combination Injectable Therapies in Type 2 Diabetes

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


Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP
Professor of Pharmacy Practice
MCPHS University
Boston, MA


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


Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP, discloses the following financial relationships or relationships to products or devices with a commercial interest related to the content of this activity: Consultant—Becton Dickinson; Speaker's Bureau—Novo Nordisk and Sanof US.

The following Program Chair and Reviewer, Dhiren K. Patel, PharmD, CDE, BC-ADM, BCACP, discloses the following financial relationships or relationships to products or devices with a commercial interest related to the content of this activity: Consultant—The Medicine Company, Regeneron, Sanofi US; Speaker's Bureau—Astra Zeneca, Boehringer Ingelheim, Merck, Novo Nordisk, Sanofi US.

Susanne Batesko, RN, BSN, 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.


acpePostgraduate Healthcare Education, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
UAN: 0430-0000-17-038-H01-P

Credits: 1.0 hour (0.10 ceu)
Published: April 24, 2017
Expires: May 31, 2018
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 April 24, 2017 through May 31, 2018, participants must 1) read the learning objectives and faculty disclosures; 2) view the educational activity; and 3) complete the post-test and evaluation form directly after the activity within a maximum of 60 days of participating in the activity. To answer the questions, click on your selected choice for each answer then proceed to the next question. Once completed, click on the Grade Exam button 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.


The purpose of this activity is to increase pharmacist knowledge regarding the combination of GLP-1 RAs and basal insulin as well as the fixed-ratio combination products that may soon be available. Pharmacists will understand the advantages of these agents in terms of safety, efficacy, place in therapy, and medication adherence. Learners will gain understanding into the problem of clinical inertia in T2DM and how combination therapy with the proper agents at the appropriate time can combat inertia and treatment failure. Pharmacists will learn counseling strategies that can be applied to multiple practice settings to address glycemic control, barriers to achieving goals, and factors contributing to nonadherence with patients through candid conversations.


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

  1. Recognize clinical inertia in type 2 diabetes and be able to recommend treatment combinations that will help patients overcome inertia
  2. Develop strategies to individualize combination treatment in patients with type 2 diabetes based on glycosylated hemoglobin, fasting plasma glucose, postprandial glucose, and risk of adverse effects
  3. Describe the complementary mechanisms and important safety and efficacy data for the combination of basal insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in patients type 2 diabetes
  4. Identify new fixed-ratio combination GLP-1 RA/basal insulin pen devices
  5. Assess patient adherence to type 2 diabetes therapies and help patients overcome barriers to achieving glycemic goals


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 evaluation of their patients' conditions, and possible contraindications on dangers in use, (review of any applicable manufacturer's product information) and comparison with 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.