Expert guidelines generally recommend dual therapy (metformin plus another agent) for patients with A1C values over 7.5%. If the A1C goal has not been achieved after 3 months of dual therapy, progression to triple therapy is recommended. Preferred options (in addition to metformin) for dual therapy include glucagon-like peptide-1 (GLP-1) agonists, sodium glucose transporter-2 (SGLT-2) inhibitors, and dipeptidyl peptidase- 4 (DPP-4) inhibitors. Since about half of the patients with diabetes in the community are not achieving adequate glycemic control, pharmacists have an excellent opportunity to impact and improve their care. They can advocate for medication changes to achieve optimal glycemic control and educate patients about diabetes goals, medication side effects, administration, and potential drug interactions.
SGLT-2 inhibitors are the newest class of diabetes medications, with 3 agents available: canagliflozin (Invokana®), dapagliflozin (Farxiga®), and empagliflozin (Jardiance®). This article will prepare community practitioners to support and educate patients who are already taking these medications, and recommend or initiate their use for patients who are good candidates.
- Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses
This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.
CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours. CE credit is automatically reported to CPE Monitor.
CE activities for Nurse Practitioners and Clinical Nurse Specialists:
This continuing education activity meets the requirements of:
The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
This is a pharmacotherapeutics/pharmacology CE activity.
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Requirements for CE Credit
- Discuss the mechanism of action of sodium-glucose co-transporter-2 (SGLT-2) inhibitors, their potential benefits in addition to glucose lowering, and their advantages/disadvantages compared with other agents.
- Name the 3 FDA-approved SGLT-2 inhibitors. Review their indications/role in therapy, contraindications, dosing, recommended monitoring, and drug interactions.
- Counsel patients about diabetes treatment goals, follow-up after starting a new medication, and adverse effects of SGLT-2 inhibitors.
Melody L. Hartzler, PharmD, RPh, AE-C, BCACP
The CE Activity developed by The Rx Consultant