Managing the Older Adult with T2DM: The Role of Fixed-Ratio GLP-1 Receptor Agonist/Insulin Combinations


Richard E. Pratley, MD
Samuel E. Crockett Chair in Diabetes Research
Medical Director – AdventHealth Diabetes Institute
Senior Investigator and Diabetes Program Lead, AdventHealth Translational Research Institute
Adjunct Professor of Medicine, Johns Hopkins University School of Medicine
Orlando, FL
Jay Shubrook, DO, FACOFP, FAAFP
Professor and Diabetologist
Director for Clinical Research
Director of Diabetes Service
Touro University California
Vallejo, CA

This CME activity will help participants identify the characteristics of older adults with type 2 diabetes that require special consideration, assess older patients with type 2 diabetes, and develop personalized pharmacotherapeutic strategies for older patients with type 2 diabetes, both in the community and in long-term care, that include the use of fixed-ratio GLP-1 receptor agonist/insulin combinations. The activity features a Situation Room, a unique online program which employs a patient simulation platform. The situation room provides interactive quizzing, testing, and training via immersion-focused 3D simulations of scenarios encountered by clinicians who care for older adults with type 2 diabetes. The experience will be customized based on who is using the simulation. One track will be aimed at geriatricians and endocrinologists, and the other will be aimed at PCPs, physician extenders and consultant pharmacists. A slide presentation will guide the learners in their selection of treatment strategies.

This educational activity is intended for geriatricians, endocrinologists, primary care clinicians (including physicians, nurse practitioners, physician assistants, nurses and consultant pharmacists), and managed care professionals caring for older adults with T2DM overall and in long-term care settings.

Learning Objectives

  • Discuss the characteristics and consequences of T2DM in older patients
  • Individualize treatment strategies for older patients with T2DM in long-term care facilities and in the community
  • Apply knowledge of the physiological rationale for combining GLP-1 receptor agonists and basal insulin analogs to treatment selection for older patients
  • Select older patients with T2DM who would benefit from fixed-ratio combinations of GLP-1 receptor agonists and basal insulin

Med Learning Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with the ACCME Essentials.


Med Learning Group designates this online activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Ultimate Medical Academy/CCM is accredited as a provider of nursing continuing professional education development by the American Nurses Credentialing Center’s Commission on Accreditation.

Awarded 1.0 contact hour of continuing nursing education of RNs and APNs.

Purpose: This program would be beneficial for nurses involved in caring for older adults with T2DM overall and in long-term care settings.

CNE Credits: 1.0 ANCC Contact Hour.

In accordance with the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support, educational programs sponsored by Med Learning Group must demonstrate balance, independence, objectivity, and scientific rigor. All faculty, authors, editors, staff, and planning committee members participating in an MLG-sponsored activity are required to disclose any relevant financial interest or other relationship with the manufacturers of any commercial products and/or providers of commercial services that are discussed in an educational activity.

Richard Pratley, MD discloses as of June 11, 2011 all services rendered by Richard E. Pratley, MD are paid directly to AdventHealth, a non-profit organization. Dr. Pratley does not receive any direct or indirect compensation for these services.

Jay Shubrook, DO, FACOFP, FAAFP is a consultant for Bayer and Novo Nordisk.

CME Content Review
The content of this activity was independently peer reviewed.
The reviewer of this activity has nothing to disclose.

CNE Content Review

The content of this activity was peer reviewed by a nurse reviewer.
Douglas Cox, MSN, MHA, RN
Ultimate Medical Academy/CCM – Lead Nurse Planner
The reviewer of this activity has nothing to disclose.

Staff Planners and Managers

The staff, planners, and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME/CE activity:

  • Matthew Frese, General Manager of Med Learning Group, has nothing to disclose.
  • Christina Gallo, SVP, Educational Development of Med Learning Group, has nothing to disclose.
  • Cindy Lampner, Medical Director of Med Learning Group, has nothing to disclose.
  • Ana Maria Albino, Senior Program Manager of Med Learning Group, has nothing to disclose.
  • Jessica Feygin, Program Coordinator of Med Learning Group, has nothing to disclose.
  • Douglas Cox, MSN, MHA, RN, UMA/CCM – LNP, has nothing to disclose.
  • Lauren Welch, MA, VP of Accreditation and Outcomes of Med Learning Group, has nothing to disclose.
  • Daniel Dasilva, Accreditation and Outcomes Coordinator of Med Learning Group, has nothing to disclose

Med Learning Group requires that faculty participating in any CME activity disclose to the audience when discussing any unlabeled or investigational use of any commercial product or device not yet approved for use in the United States.
During this lecture, faculty may mention the use of medications for both FDA-approved and non-approved indications.

There are no fees for participating and receiving CME/CE credit for this online activity. To receive CME/CE credit participants must:

  1. Read the CME/CNE information and faculty disclosures.
  2. Participate in the online activity.
  3. Submit the evaluation form to Med Learning Group.

You will receive your certificate upon completion as a downloadable file.

Med Learning Group makes every effort to develop CME activities that are science based. This activity is designed for educational purposes. Participants have a responsibility to use this information to enhance their professional development in an effort to improve patient outcomes. Conclusions drawn by the participants should be derived from careful consideration of all available scientific information. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.
For CME questions, please contact Med Learning Group at [email protected]
Contact this CME provider at Med Learning Group for privacy and confidentiality policy statement information at

Staff will be glad to assist you with any special needs. Please contact Med Learning Group prior to participating at [email protected]

Copyright © 2022 Med Learning Group. All rights reserved. These materials may be used for personal use only. Any rebroadcast, distribution, or reuse of this presentation or any part of it in any form for other than personal use without the express written permission of Med Learning Group is prohibited.


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