Effectively Addressing Severe Hypoglycemia: Implications, Treatment, and Communication
 
Release Date: June 27, 2018
Last Reviewed: June 25, 2018
Expiration Date: June 27, 2019
Time to Complete Activity:  1.0 hour

*This activity expired for credit on June 27, 2019 and is no longer available for credit 

 
Faculty
Anne Peters, MD (Chair)
Director, USC Clinical Diabetes Program
Professor of Clinical Medicine
Keck School of Medicine of USC
Los Angeles, CA
 
Javier Morales, MD
Associate Clinical Professor
Donald and Barbara Zucker School of Medicine
Hofstra Northwell University
Hempstead, NY
Vice President, Advanced Internal Medicine Group, P.C.
East Hills, NY
 
Jeff Unger, MD
Diplomate, American Board of Family Practice
Fellow, American Association of Clinical Endocrinologists
Assistant Clinical Professor of Family Medicine
UC Riverside School of Medicine
Director, Unger Concierge Primary Care Medical Group
Rancho Cucamonga, CA

Patient & Caregiver Faculty
Tim Moss
Patient
Corona, CA

Susan Moss
Caregiver
Corona, CA

This activity is provided by Paradigm Medical Communications, LLC.  
 
Target Audience
This activity has been designed to meet the educational needs of primary care clinicians, including physicians, nurse practitioners, PAs, nurses, and diabetes educators. It will also be of benefit to endocrinologists and other healthcare professionals interested in the management of hypoglycemia in diabetes patients.
 
Statement of Need
All patients with diabetes, including both type 1 and type 2, are at risk for hypoglycemia, or low blood glucose. Hypoglycemia is one of the most important complications related to antiglycemic agents, particularly insulin. Recurrent episodes of hypoglycemia are associated with increased cardiovascular risk for patients with diabetes. Severe hypoglycemia, requiring assistance for management, is a risk for recurrent episodes. Additionally, recurrent episodes of hypoglycemia may lead to the development of hypoglycemic unawareness—the inability for the individual to discern when they are experiencing a hypoglycemic episode. Severe hypoglycemia is a serious and potentially life-threatening event requiring immediate treatment and education to prevent recurrence. All clinicians who treat patients with diabetes would benefit from an educational activity that will help them better identify, treat, and educate patients who are most at risk for severe hypoglycemic episodes as well as provide information on new strategies designed to reduce or ameliorate their occurrence.
 
Learning Objectives
Upon proper completion of this activity, participants should be better able to:
  • Outline the pathophysiology and consequences of recurrent/severe hypoglycemia.
  • Describe guideline recommended management of severe hypoglycemia for both acute and prevention of recurrence.
  • Design education strategies for patients and their caregivers about hypoglycemia, including treatment and prevention of hypoglycemic events.
 
Table of Contents
  • Introduction to Hypoglycemia
  • Hypoglycemia and its Consequences
  • Glucose Variability
  • Guideline Recommendations for the Management of Hypoglycemia
  • New Technologies & Agents – Emerging Therapies: Ready to Use Glucagon Pen and Intranasal Glucagon
  • Helping Patients Help Themselves Through Education & Collaboration
  • Patient Resources
  • References
 
Physician Accreditation Statement
Paradigm Medical Communications, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
 
Physician Credit Designation Statement
Paradigm Medical Communications, LLC, designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
Nursing Continuing Education
Educational Review Systems, Inc. is an approved provider of continuing nursing education by the Alabama State Nursing Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.  Provider # 5-115.  This program is approved for 1 hour of continuing nursing education.
 
Educational Review Systems, Inc. is also approved for nursing continuing education by the state of California, the state of Florida and the District of Columbia.

This activity is jointly provided by Educational Review Systems, Inc. and Paradigm Medical Communications, LLC.     
                                                                                      
 
PA Continuing Education
PAs may claim a maximum of 1.0 Category 1 credit for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.
 
Nurse Practitioner Continuing Education
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.  Individuals are responsible for checking with the AANPCP for further guidelines. 
 
Disclosure of Commercial Support
This activity is supported by an educational grant from Lilly.
 
Instructions for Participation
To receive a CME/CNE certificate/statement of participation, you should:
  • Follow instructions to register or log in with your professional information and complete the pre-activity assessment
  • View the online activity in its entirety.
  • Complete and submit the online posttest and evaluation.
A certificate/statement of participation will be available for download/printing immediately following your successful completion of the posttest and evaluation.

For questions regarding CME/CNE credit, contact the Paradigm CME Department at (845) 398-5949.
 
There is no fee required for participation in this activity.

Hardware/Software Requirements
This certified CME/CNE activity is designed using HTML5 video. As you navigate the video using the supplied controls, the slides will sync to the speaker.
 
Supported Browsers:
For Desktops (Windows/Mac)
Internet Explorer 9 or higher, Firefox 28 or higher, Safari 5.1 or higher, Google Chrome 31 or higher, Opera 21 or higher
 
For Tablets (iPad/Android/Surface)
iOS Safari 4 or higher, Android 2.3 or higher, IE Mobile 10 or higher
 
Technical Support: If you have any technical problems or playback issues email us at contactus@paradigmmc.com.
 
Disclosures
In accordance with ACCME and ANCC requirements on disclosure, faculty and contributors are asked to disclose any relationships with commercial interests associated with the area of medicine featured in the activity. These relationships are described below.
 
Anne Peters, MD
Grant/Research Support: Dexcom, Inc.; MannKind Corporation
Retained Consultant: Abbott Diabetes Care, Inc.; Becton, Dickinson and Company; Bigfoot Biomedical, Inc.; Boehringer Ingelheim Pharmaceuticals, Inc.; Eli Lilly and Company; Lexicon Pharmaceutical, Inc.; Livongo Health; Merck & Co., Inc.; Novo Nordisk, Omada Health, Inc; sanofi-aventis U.S. LLC, Science 37, Inc.
Speakers Bureau: Novo Nordisk
 
Javier Morales, MD
Retained Consultant: Intarcia Therapeutics, Inc.; Eli Lilly and Company, Novo Nordisk
Speakers Bureau: Abbott Laboratories, Janssen Pharmaceuticals, Inc.; Eli Lilly and Company, Novo Nordisk
 
Jeff Unger, MD
Grant/Research Support: Abbott Diabetes Care, Inc., Eli Lilly and Company, GlaxoSmithKline, Janssen Pharmaceuticals, Inc., Novo Nordisk, sanofi-aventis U.S. LLC.
Retained Consultant: Abbott Diabetes Care, Inc.; Janssen Pharmaceuticals, Inc.; Novo Nordisk
Speakers Bureau: Janssen Pharmaceuticals, Inc.; Novo Nordisk
Royalty: Lippincott Williams & Wilkins

Tim Moss
No financial relationships to disclose.

Susan Moss
No financial relationships to disclose.
 
Paradigm Medical Communications, LLC, staff members have no financial relationships to disclose.

Educational Review Systems, Inc., staff members have no financial relationships to disclose.

Independent peer reviewer has no financial relationships to disclose.
 
Resolution of Conflict of Interest
Paradigm Medical Communications, LLC, and Educational Review Systems, Inc. have implemented a system to resolve conflicts of interest for each CME/CNE activity to help ensure content is objective, fair and balanced, independent, and aligned with the public interest. Conflicts, if any, are resolved through one or more processes. All CME/CNE content in this activity was independently reviewed to ensure that it is free of commercial bias, scientifically rigorous, aligned with the public interest, and compliant with all regulatory guidance and the ANCC Guidelines and ACCME’s Standards for Commercial Support of Continuing Medical Education.
 
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA.
 
Disclaimer
This CME/CNE activity represents the views and opinions of the individual faculty, and does not constitute the opinion or endorsement of, or promotion by, Paradigm Medical Communications, LLC, or Educational Review Systems, Inc. Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses.

If included, signed statements of informed consent granting permission for publication have been obtained for all photographs and videos in which an individual can be identified.
 
As an ACCME-accredited provider, Paradigm Medical Communications, LLC, activities must include a balanced view of therapeutic options. Use of generic names contributes to this impartiality. The use of trade names should not be viewed as an endorsement of specific products by Paradigm Medical Communications, LLC, or Educational Review Systems, Inc.
 
Terms of Use and Privacy Policy
Disclaimer
The materials provided for this activity are for informational purposes only, and should not be used for diagnosis or treatment of a health problem without consulting a licensed medical professional. Any views or opinions presented are solely those of the Faculty, and do not necessarily represent those of Paradigm Medical Communications, LLC, or Educational Review Systems, Inc. References to any entity, product, service, or source of information on this website should not be considered an endorsement, either direct or implied, by Paradigm Medical Communications, LLC or Educational Review Systems, Inc. Paradigm Medical Communications, LLC, and Educational Review Systems, Inc accepts no liability for the content referenced in this activity.
 
Privacy policy
Paradigm Medical Communications, LLC, and Educational Review Systems, Inc. are committed to protecting the privacy of those who participate in the activities (herein referred to as “website") located at www.paradigmmc.com. The information below describes the security of the website for safeguarding personal information and the rationale for collection and use of personal information.
 
Security/safeguarding personal information
This website has physical and procedural safeguards in place to prevent unauthorized access to personal information used to access this website.
 
Collection and use of your personal information
The submission of certain personally identifiable information is necessary to award and track the credits participants may earn after completing the program. Required items include first name, last name, degree, and email address. These items are necessary. Participants are also required to complete an evaluation of the CME/CNE activity. All evaluative information submitted is collected and retained, and used by Paradigm Medical Communications, LLC, and Educational Review Systems, Inc. to continuously improve the learning experience.
 
Paradigm Medical Communications, LLC, and Educational Review Systems, Inc. do not transfer, sell, or share personal information with outside parties. Paradigm Medical Communications, LLC, and Educational Review Systems, Inc. will not otherwise disclose personal information unless required to in a legal process. Paradigm Medical Communications, LLC, and Educational Review Systems, Inc. staff members review individual test results to the extent necessary to record and track participants’ credits.
 
Contact Us
If you have any questions or comments, please email us at contactus@paradigmmc.com.
 
© 2018 Paradigm Medical Communications, LLC, except where noted. Content may not be reproduced in whole or part without the express written permission of Paradigm Medical Communications, LLC.