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Javier Visit 1: A 54-year-old male with diabetes referred for insulin initiation


Javier Visit 1: A 54-year-old male with diabetes referred for insulin initiation

Topic: Diabetology
Relevant Terms: CVD Risk Reduction, Hypoglycemia, Macrovascular Risk, Microvascular Risk
Primary Audience: Primary care providers and other healthcare professionals who treat adults with diabetes
Launch Date: 06-May-10
Credits: 0.5 AMA PRA Category 1 Credit
Expiration Date: The accreditation for this activity has expired.

Learning Objectives

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

  1. Identify appropriate patients for insulin initiation
  2. Recognize the impact of insulin therapy on diabetes goals and microvascular risk reduction
  3. Describe recent data on insulin therapy and macrovascular risk reduction
  4. Choose the appropriate insulin initiation options for specific patient scenarios
  5. Manage CVD risk in diabetes patients that require insulin


    Charles Choe, MD
    Assistant Clinical Professor of Medicine
    Division of Endocrinology & Metabolism
    University of California, San Diego
    JoAnn M. Clark, APRN-C, CDE, GNP, FNP, MSN, RN
    University of California, San Diego
    Lori Daniels, MD, MAS, FACC 
    Assistant Professor of Medicine
    Division of Cardiology
    University of California, San Diego

    The University of California, San Diego School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. 

    AMA: The University of California, San Diego School of Medicine designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
    BRN: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 Credits™ issued by organizations accredited by the ACCME. For the purpose of relicensure, the California Board of Registered Nursing accepts AMA PRA Category 1 Credits™ (report up to 0.5 hours of credit and list "CME Category 1" as the provider number).
    Pharmacist: The California Board of Pharmacy accepts as continuing education for pharmacists coursework which meets the standard of relevance to pharmacy practice and is accepted as continuing education by the Medical Board of California.

    It is the policy of the University of California, San Diego School of Medicine to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. All conflicts of interest will be resolved prior to an educational activity being delivered to learners through one of the following mechanisms 1) altering the financial relationship with the commercial interest, 2) altering the individual's control over CME content about the products or services of the commercial interest, and/or 3) validating the activity content through independent peer review. All persons are also required to disclose any discussions of off label/unapproved uses of drugs or devices. Persons who refuse or fail to disclose will be disqualified from participating in the CME activity.

    The Faculty Board, consisting of Charles Choe, MD, JoAnn Clark, NP, CDE, and Lori Daniels, MD have indicated they have no financial relationships with commercial interests relative to the content of this educational activity.

    The CME staff, project managers, planning committee, CME committee reviewers, and peer reviewers do not have any relevant financial relationships to disclose.
    This educational activity may contain discussion of unlabeled and/or investigational uses of agents that are not approved by the FDA. Please consult the prescribing information for each product.
    The views and opinions expressed in this activity are those of the faculty and do not necessarily reflect the views of the University of California, San Diego.

    Statement of Need
    The content of this educational activity was determined by rigorous assessment of educational need and includes surveys, program feedback, expert faculty assessment, literature review, medical practice, chart review, and new medical knowledge.

    Cultural and Linguistic Competency 
    This activity is in compliance with California Assembly Bill 1195 which requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency. Cultural competency is defined as a set of integrated attitudes, knowledge, and skills that enables health care professionals or organizations to care effectively for patients from diverse cultures, groups, and communities. Linguistic competency is defined as the ability of a physician or surgeon to provide patients who do not speak English or who have limited ability to speak English, direct communication in the patient's primary language. Cultural and linguistic competency was incorporated into the planning of this activity. Additional resources on cultural and linguistic competency and information about AB1195 can be found on the UCSD CME website at
    This activity is supported by educational grants from Novo Nordisk and sanofi-aventis.