Tight Control in Type 2 Diabetes: More Harm than Good?

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This module discusses why tight control may not be the best strategy for treating type 2 diabetes, reveals surprising facts about the benefits and harms of current treatments and strategies for diabetes care, and provides practical advice for counseling patients about healthful eating patterns and increasing physical activity. 

Target Audience

This activity is intended for physicians, nurses, pharmacists, and other healthcare professionals.

Learning Objectives

Upon completion of this module, the learner should be able to:

  • Discuss the risks and benefits of metformin, insulin, and other treatments for type 2 diabetes.
  • Describe the limitations of clinical evidence regarding tight control in patients with type 2 diabetes.
  • Implement new strategies for counseling patients about making lifestyle changes.

Disclaimer 

The material presented in this continuing medical education program is being made available for educational purposes and does not reflect the official views or policies of the DC Department of Health unless explicitly stated.

Course summary
Available credit: 
  • 1.50 ACPE Pharmacist
    The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • 1.50 ACPE Pharmacy technician
    The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • 1.50 AMA PRA Category 1 Credit™
    The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.50 Completion
Course opens: 
09/15/2020
Course expires: 
09/15/2023

Thomas Finucane, MD

Emeritus Professor, Division of Geriatric Medicine 
Gerontology Co-Director, Elder House Call Program JHBMC
John Hopkins University School of Medicine
 
Bio
Tom Finucane, is Emeritus Professor of Medicine at the Johns Hopkins University School of Medicine. Throughout his 3 decades there, he has seen patients with learners in the clinic, hospital, nursing home, rehabilitation center and chronic ventilator unit. He was chair of the hospital ethics committee at the Johns Hopkins Bayview Medical Center for 12 years. He continues to teach and write about the problems of overtreatment and undertreatment of frail older people. His special interests include urinary tract infection, aspiration pneumonia and tube feeding, nutrition support, type 2 diabetes mellitus, Alzheimer treatment, and more generally the dangers of aggressive pharmaceutical advertising.  He serves on the editorial board of the Journal of the American Geriatrics Society.
 

Adriane Fugh-Berman, MD

Professor, Department of Pharmacology and Physiology
Department of Family Medicine 
Georgetown University Medical Center
 
Bio
Dr. Fugh-Berman teaches courses on medicinal plants and evidence-based medicine at Georgetown University Medical Center. She directs PharmedOut, a GUMC project that advances evidence-based prescribing. Her research focuses on pharmaceutical marketing practices and the culture of medicine.
 

Stephen Lippman, MD, PhD

Endocrinologist and Molecular Biologist
 
Bio
Dr. Lippman worked most recently as an Endocrinologist in the Department of Veterans Affairs Northern California Health Care System and was a Clinical Assistant Professor of Medicine at the University of California, Davis School of Medicine.
 

Kofi Onumah, PharmD, RPh

Pharmacist Inspector, Pharmaceutical Control Division 
Director, The DC Center for Rational Prescribing 
District of Columbia Department of Health
 
Bio
Dr. Onumah serves as a Pharmacist Inspector with the District of Columbia Department of Health. Dr. Onumah also directs the DC Center for Rational Prescribing (DCRx). Dr. Onumah has practiced pharmacy in the pharmacy benefit management industry, as well as the community and long term care setting. Dr. Onumah has a genuine passion for evidence-based value add interventions that improve healthcare outcomes. Dr. Onumah also helped implement the District of Columbia Prescription Drug Monitoring Program.
 

Leonard Pogach, MD, MBA

National Director Medicine, Office of Specialty Care Services
Veterans Health Administration
 
Bio
Dr. Pogach has been the VA Co-lead of the VA/DoD Diabetes Guidelines since 1996. The 2017 Update was released in April 2017. He has also been the co-lead of the Federal Interagency Workgroup for the Department of Health and Human Services National Action Plan for Prevention of Adverse Drug Events-Diabetes Agent since its inception in 2012. He also has published extensively on methodology to improve upon existing “all-or-none” glycemic performance measures, and hypoglycemia as a public health issue among older adults. He has also served as an external Technical Advisor to AHRQ Evidence Reviews on Diabetes Medication. His passion is Shared Decision Making for persons with diabetes, medication safety, and de-intensification of unnecessary anti-glycemic management.
 

Caroline Trapp, DNP, ANP-BC, CDE, FAANP

Director of Diabetes Education and Care
Physicians Committee for Responsible Medicine
 
Bio
Dr. Trapp is the director of diabetes education and care at the Physicians Committee for Responsible Medicine (PCRM). She is a doctorally-prepared nurse practitioner with an internal medicine practice in Farmington Hills, Michigan, where she has specialized in the care of people with diabetes for more than 20 years. She is also an adjunct faculty member at the University of Michigan, and a fellow of the American Association of Nurse Practitioners. Dr. Trapp has found no intervention as powerful in the prevention and reversal of type 2 diabetes as a high-fiber, nutrient-dense, whole-foods, plant based dietary pattern. She has found this to be true from remote parts of the Navajo Nation in AZ, to urban areas of Detroit, MI. She encourages her colleagues and students to learn all they can about plants over pills to promote health.
 

Susan F. Wood, PhD

Professor, Department of Health Policy and Management
Director, Jacobs Institute of Women's Health 
The George Washington University Milken Institute School of Public Health
 
Bio
Dr. Wood's research focuses on women’s health and the use of scientific knowledge in public policy. She teaches courses in health policy and in women’s health at the GWU Milken Institute School of Public Health. She previously was Assistant Commissioner for Women's Health at the U.S. Food and Drug Administration (FDA), and directed the FDA Office of Women's Health from 2000 - 2005. Prior to the FDA, Dr. Wood was the Director of Policy and Program Development at the U.S. Department of Health and Human Services' Office on Women's Health.
 

Faculty Disclosures

 
In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, The George Washington University Office of CEHP requires that all individuals involved in the development of activity content disclose their relevant financial relationships and that all conflicts of interest be identified, resolved, and communicated to learners prior to delivery of the activity.
 
The following planners, upon submission of a disclosure form, made no disclosures of commercial relationships:
  • Kofi Onumah, PharmD, RPh
  • Leonard Pogach, MD, MBA
  • Caroline Trapp, DNP, ANP-BC, FAANP
  • Susan F. Wood, PhD
The following planners, upon submission of a disclosure form, disclosed the following potential conflicts:
  • Dr. Tom Finucane is a member of the Pharmacy and Therapeutics Committee for Anthem Inc.
  • Dr. Adriane Fugh-Berman discloses that she is a paid expert witness at the request of plaintiffs in litigation regarding pharmaceutical marketing practices. She is also a subcontractor to George Washington School of Public Health.
  • Dr. Stephen Lippman discloses that he has been a paid expert witness at the request of plaintiffs in litigation regarding pharmaceutical marketing practices.
The presenters for this course have declared no conflicts of interest

Physicians 

The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
 
The George Washington University School of Medicine and Health Sciences designates this enduring material for a maximum of 1.5 AMA Physician Recognition Award Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 

PHARMACISTS AND PHARMACY TECHNICIANS 

The George Washington University Hospital, Department of Pharmacy is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.
 
ACPE#: 0536-9999-20-012-H01-P
ACPE#: 0536-9999-20-012-H01-T
Release Date: September 15, 2020
Expiration Date: September 15, 2023
CE Credits: 1.5 (0.15 CEUs)

Available Credit

  • 1.50 ACPE Pharmacist
    The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • 1.50 ACPE Pharmacy technician
    The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
  • 1.50 AMA PRA Category 1 Credit™
    The George Washington University School of Medicine and Health Sciences is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.50 Completion
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