Improving Patient Care Through Diabetes Self-Management Education with Davida F. Kruger, MSN, APN-BC, BC-ADM

CME/CE Information
References

Activity Progress
Pre-Activity Survey
Page 1
Post-Activity Survey
CME Evaluation/Print Certificate

Problem: This activity is closed.

Improving Patient Care Through Diabetes Self-Management Education with Davida F. Kruger, MSN, APN-BC, BC-ADM

Davida F. Kruger, MSN, APN-BC, BC-ADM

Release Date: October 16, 2015

Expiration Date: October 15, 2016 (THIS ACTIVITY IS NO LONGER AVAILABLE FOR CREDIT)

Continue to Activity

ACTIVITY DESCRIPTION

In less than 45 minutes, you can watch this on-demand, case-based activity from the proceedings of a CME/CE symposium at the American Diabetes Association’s 75th Scientific Sessions. Learn about:

The updated recommendations for diabetes self-management education and support and how to apply them in clinical practice
Identifying a management regimen and educational interventions for Susie, a patient with diabetes

LEARNING OBJECTIVES

Upon completion of this activity, the participant should be able to:

Describe the recommendations for diabetes self-management education and support in Type 2 Diabetes in the 2015 Joint Position Statement from the American Diabetes Association, American Association of Diabetes Educators, and Academy of Nutrition and Dietetics
Select diabetes management regimens that maximize glycemic control while minimizing adverse effects and considering patient comorbidities, preferences, and concerns

FACULTY

Davida F. Kruger, MSN, APN-BC, BC-ADM

Certified Nurse Practitioner

Henry Ford Health System

Division of Endocrinology, Diabetes, Bone and Mineral Disease

Detroit, MI

FACULTY BIOGRAPHY

Davida F. Kruger, MSN, APN-BC, BC-ADM, has been a certified nurse practitioner in diabetes for more then 30 years at Henry Ford Health System in Detroit, Michigan. Her role includes both clinical practice and research. She is board certified by the American Nurses Association Credentialing Center in primary care and by the American Association of Diabetes Educators in advanced diabetes management. She is Past Chair of the American Diabetes Association’s (ADA) Research Foundation and has served on the ADA’s Research Policy Committee. She is also Past President, Health Care and Education, of the ADA. She served as editor of Diabetes Spectrum from 2005 to 2008. Presently, she serves as the Editor-in-Chief of Clinical Diabetes.

Ms Kruger has been a principal investigator on numerous research projects and has written widely on diabetes care, authoring the book The Diabetes Travel Guide, 2^nd edition (2006). Her honors and awards include the Florence Nightingale Award for Excellence in Research, Henry Ford Health System Nursing Excellence Clara Ford Pillar award in Research and Education 2014, Wayne State University School of Nursing 2014 Alumna of the Year, and the following awards from the ADA: the Rachmiel Levine Medal for Service, Ross Hickey Award for Outstanding Service in Diabetes Research Funding, and Wendell Mayes, Jr, Medal for Outstanding Service in the Cause of Diabetes.

DISCLOSURE STATEMENTS

In accordance with the Accreditation Council for Continuing Medical Education (ACCME), Dannemiller requires that any person who is in a position to control the content of a CME activity must disclose all relevant financial relationships they have with a commercial interest.

The following faculty member has disclosures to be made:

Davida F. Kruger, MSN, APN-BC, BC-ADM

Speakers Bureau: Animas Corporation; Boehringer Ingelheim Pharmaceuticals, Inc; Bristol-Myers Squibb/AstraZeneca LP; Janssen Pharmaceuticals, Inc; Lilly USA, LLC; Novo Nordisk; Valeritas, Inc

Consultant/Advisory Board: Abbott Diabetes Care, Inc; Boehringer Ingelheim Pharmaceuticals, Inc; Janssen Pharmaceuticals, Inc; Lilly USA, LLC; Novo Nordisk; sanofi-aventis U.S. LLC

Grants/Research Support: Bristol-Myers Squibb/AstraZeneca LP; Dexcom, Inc; Halozyme Therapeutics, Inc; Helmsley Foundation; Lilly USA, LLC; Novo Nordisk

Dr Kruger does not discuss information related to non–FDA-approved or investigational use of a product/device.

The following have no financial relationships with commercial interests to disclose:

INDEPENDENT REVIEWER

In order to resolve conflict of interest, presentations of this activity were peer reviewed by an independent reviewer. The reviewer has no relationship with a commercial interest. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

Bernard Abrams, MD, Clinical Content Reviewer, has no financial relationships with commercial interests.

EDUCATIONAL PLANNING COMMITTEE

Dannemiller

Gordon Ringler, Dannemiller Director of Medical Education, has no financial relationships with commercial interests.

Spire Learning

Lauren Waters and Elysa Ripa, Program Directors; Jaime Symowicz, PhD, Senior Clinical Director; and Lisa Conklin, Group Director, Grants and Education, have no financial relationships with commercial interests.

DISCLAIMER

The content and views presented in this educational activity are those of the presenter and do not necessarily reflect those of Dannemiller, Spire Learning, Boehringer Ingelheim Pharmaceuticals, Inc. or Lilly USA, LLC. This material is prepared based upon a review of multiple sources of information, but it is not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

OFF-LABEL STATEMENT

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Further, participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

LEVELS OF EVIDENCE

Level of Evidence	Description
A	Clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered, including Evidence from a well-conducted multicenter trial Evidence from a meta-analysis that incorporated quality ratings in the analysis Compelling nonexperimental evidence; i.e., “all or none” rule developed by the Centre for Evidence-Based Medicine at the University of Oxford Supportive evidence from well-conducted randomized controlled trials that are adequately powered, including Evidence from a well-conducted trial at one or more institutions Evidence from a meta-analysis that incorporated quality ratings in the analysis
B	Supportive evidence from well-conducted cohort studies Evidence from a well-conducted prospective cohort study or registry Evidence from a well-conducted meta-analysis of cohort studies Supportive evidence from a well-conducted case-control study
C	Supportive evidence from poorly controlled or uncontrolled studies Evidence from randomized clinical trials with one or more major or three or more minor methodological flaws that could invalidate the results Evidence from observational studies with high potential for bias (such as case series with comparison with historical controls) Evidence from case series or case reports Conflicting evidence with the weight of evidence supporting the recommendation
E	Expert consensus or clinical experience

Source: ADA evidence-grading system for “Standards of Medical Care in Diabetes” in Diabetes Care. 2015;38(Suppl 1):S1-S93.

TARGET AUDIENCE

This activity is designed for endocrinologists, primary care physicians (PCPs), physician assistants (PAs), nurse practitioners (NPs), and nurses with an interest in the management of Type 2 diabetes (T2DM).

ACCREDITATION

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Dannemiller and Spire Learning. Dannemiller is accredited by the ACCME to provide continuing medical education for physicians.

Dannemiller designates this enduring activity for a maximum of .75 AMA PRA Category 1 Credits^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credits^TM. from organizations accredited by ACCME.

Dannemiller is approved as a provider of nurse practitioner continuing education by the American Association of Nurse Practitioners: AANP Provider Number 090419. This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards. It provides .75 credits of continuing education (which includes 0.25 hours of pharmacology).

METHOD OF PARTICIPATION

This activity has no fee and should take approximately 45 minutes to complete. Participants should first read the objectives and other introductory CME information, then complete the pre-assessment and participate in the online case activity. To receive credit for this activity, participants must complete the post-assessment with a passing score of 70% and then complete the evaluation. This credit is valid through October 15, 2016. In the event you have questions about this activity or are unable to print the certificate, please e-mail Lauren Waters at lwaters@spirelearning.com, and a certificate will be e-mailed within 2 weeks.

This educational activity is jointly provided by Dannemiller and Spire Learning.

This activity is supported by an independent educational grant from Boehringer Ingelheim Pharmaceuticals, Inc. and Lilly USA, LLC.

References for Improving Patient Care Through Diabetes Self-Management Education with Davida F. Kruger, MSN, APN-BC, BC-ADM

Sources/References:

ADA. Standards of Medical Care in Diabetes—2015. Diabetes Care. 2015;38(Suppl 1):S1-S93.

Apovian CM, et al. Pharmacological management of obesity: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2015;100:342-362.

Arnold MS, et al. Guidelines for facilitating a patient empowerment program. Diabetes Educ. 1995;21:308-312.

Braun A, et al. Effects of metabolic control, patient education and initiation of insulin therapy on the quality of life of patients with type 2 diabetes mellitus. Patient Educ Couns. 2008;73:50-59.

Derr RL, et al. Insulin-related knowledge among health care professionals in internal medicine. Diabetes Spectrum. 2007;20:177-185.

Duncan I, et al. Assessing the value of diabetes education. Diabetes Educ. 2009;35:752-760.

Funnell MM, et al. Self-management support for insulin therapy in type 2 diabetes. Diabetes Educ. 2004;30:274-280.

Garber AJ, et al. American Association of Clinical Endocrinologists’ comprehensive diabetes management algorithm 2013 consensus statement. Endocr Pract. 2013;19(suppl 2):1-48.

Inzucchi SE, et al. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2015;38:140-149.

Ismail-Beigi F, et al. Individualizing glycemic targets in type 2 diabetes mellitus: implications of recent clinical trials. Ann Intern Med. 2011;154:554-559.

James PA, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507-520.

Karter AJ, et al. Barriers to insulin initiation: the translating research into action for diabetes insulin starts project. Diabetes Care. 2010;33:733-735.

Nichols GA, et al. Treatment escalation and rise in HbA1c following successful initial metformin therapy. Diabetes Care. 2006;29:504-509.

ORIGIN Trial Investigators. Characteristics associated with maintenance of mean A1C 6.5% in people with dysglycemia in the ORIGIN Trial. Diabetes Care. 2013;36:2915-2922.

ORIGIN Trial Investigators. Basal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial. Diabetologia. 2014;57:1325-1331.

Peyrot M, et al. Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabet Med. 2005;22:1379-1385.

Peyrot M, et al. Resistance to insulin therapy among patients and providers: results of the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) study. Diabetes Care. 2005;28:2673-2679.

Phillips LS, et al. We can change the natural history of type 2 diabetes. Diabetes Care. 2014;37:2668-2676.

Phung OJ, et al. Early combination therapy for the treatment of type 2 diabetes mellitus: systematic review and meta-analysis. Diabetes Obes Metab. 2014;16:410-417.

Polonsky WH, et al. Psychological insulin resistance in patients with type 2 diabetes: the scope of the problem. Diabetes Care. 2005;28:2543-2545.

Powers MA, et al. Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care. 2015. Published online June 5, 2015.

Rubin RR, et al. Health care and patient-reported outcomes: results of the cross-national Diabetes Attitudes, Wishes and Needs (DAWN) study. Diabetes Care. 2006;29:1249-1255.

Siminerio LM, et al. US nurses’ perceptions of their role in diabetes care: results of the cross-national Diabetes Attitudes Wishes and Needs (DAWN) study. Diabetes Educ. 2007;33:152-162.

Skovlund SE, et al. The Diabetes Attitudes, Wishes, and Needs (DAWN) program: a new approach to improving outcomes of diabetes care. Diabetes Spectrum. 2005;18:136-142.

Improving Patient Care Through Diabetes Self-management Education click here.

Factors to Consider When Incorporating New Therapies Into a Patient’s Antihyperglycemic Regimen Resource Tool click here.

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes.

http://care.diabetesjournals.org/content/38/1/140.full.pdf+html.

AACE/ACE Comprehensive Diabetes Management Algorithm 2015.

http://journals.aace.com/doi/pdf/10.4158/EP15693.CS.

American Diabetes Association Standards of Medical Care in Diabetes 2015.

http://care.diabetesjournals.org/content/38/Supplement_1.toc.

Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics.

http://care.diabetesjournals.org/content/38/7/1372.full.pdf+htm.