GLP-1 Based Therapies for Type 2 Diabetes: Understanding Their Unique Pharmacology and Their Effects Beyond Glucose Control

Target Audience:

This activity is designed to meet the educational needs of endocrinologists, primary care physicians, nurses, pharmacists, and other healthcare practitioners caring for diabetes patients.

Program Overview:

GLP-1 based therapies represent a significant advancement in the treatment of T2DM due to their ability to target multiple pathophysiologies of the disease. Although the first GLP-1 receptor agonist (exenatide BID) was approved by the FDA in 2005 and the first DDP-4 inhibitor, sitagliptin, was approved the following year, the differences in pharmacokinetics and magnitude of effects between these two classes of incretin-based therapies are not completely understood by clinicians. In addition, a lack of consensus in the existing guidelines regarding the preferred choice of these agents in the treatment algorithm further complicate physicians' therapeutic decisions (Fineman 2012). Short-acting GLP-1 receptor agonists should be considered early in the disease and as part of combination therapy for patients close to glycemic goals when post-prandial glucose control is more important. Long-acting GLP-1 receptor agonists should be considered when fasting glucose elevations are the main problem, and when weight loss would be beneficial. DPP-4 inhibitors could be used in patients with mild to moderate fasting hyperglycemia, need to maintain bodyweight, or when subcutaneous injections or gastrointestinal side effects limit the use of GLP-1 receptor agonists.

Understanding the physiology of incretins; the pharmacokinetics differences between incretin-based therapies; their effects on FPG, PPG and bodyweight; and the efficacy and safety profile of these agents are all of fundamental importance to target glycemic disturbances. By targeting these specific areas, we can offer more individualized therapy for T2DM patients in order to improve glycemic control and delay disease progression.

Fineman MS, Cirincione BB, Maggs D, Diamant M. GLP-1 based therapies: differential effects on fasting and postprandial glucose. Diabetes Obes Metab. 2012 Aug;14(8):675-88.

Disclosure Of Unlabled Use:

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.


Med Learning Group makes every effort to develop CME activities that are scientifically based. This activity is designed for educational purposes. Participants have a responsibility to utilize 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.

To Obtain CME/CE Credits:

  • Read the learning objectives and faculty disclosures.
  • Participate in the activity.
  • Complete the post outcomes, post-test and activity evaluation
  • Physicians who successfully complete the post-test and evaluation will receive CME credit.
  • You must score 70% or higher on the post-test to receive credit for this activity.
  • All non-physician participants who successfully complete the post-test and evaluation will receive a certificate of participation.
  • All certificates will be emailed upon completion.

Course Viewing Requirements:

Internet Explorer 6 or greater (10 or above recommended), Firefox, Chrome or Safari 6 or greater.

MEDIUM: Internet

Estimated Time to Complete This Educational Activity: 60 minutes


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 Essential Areas and Elements.

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


Awarded 1.00 contact hour(s) of continuing nursing education of RNs and APNs.

Accreditation of this program does not imply endorsement by either Ultimate Medical Academy/CCM or ANCC

Credit Designation:

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

Faculty Listing:

Activity Leader:

Jack L. Leahy, MD
    Professor of Medicine
    Chief, Division of Endocrinology, Diabetes, and Metabolism
    University of Vermont College of Medicine
    Burlington, Vermont

CME Advisory Committee

Course Director/Course Reviewer

M. Susan Burke, MD, FACP
    Clinical Assistant Professor, Internal Medicine
    Thomas Jefferson University Medical School
    Senior Advisor, Internal Medicine Clinical Care Center
    Lankenau Hospital
    Wynnewood, Pennsylvania

Planning Committee

Kelly Kraines
    Director of CME/CE
    Med Learning Group

Christopher Drury
    The Quill Consulting

Margaret Governo, EdD, APRN BC
    CCM Lead Nurse Planner
    Ultimate Medical Academy


  • Diabetes


  • Describe the physiologic effects of incretin hormones on beta-cell dysfunction, glucose regulation and multi-organ systems
  • Explain the different mechanisms of action of GLP-1 receptor agonists and DPP-4 inhibitors and their capacity for controlling postprandial glucose and fasting plasma glucose
  • Contrast and compare the efficacy and safety of GLP-1 agonists and DPP-4 inhibitors in clinical trials

Financial Disclosure:

In accordance with the Accreditation Council for Continuing Medical Education (ACCME) Standards for Commercial Support, educational programs sponsored by Med Learning Group must demonstrate fair 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 manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services that are discussed in an educational activity.



Jack L. Leahy, MD
Disclosure: Dr. Leahy receives a Research Grant from Takeda Pharmaceuticals.  Dr. Leahy also receives Consulting Fees from Janssen, Merck & Co., Inc., Novo Nordisk, Sanofi, and Valeritas.

M. Susan Burke, MD
Disclosure: Dr. Burke receives Consulting Fees from Iroko and Merck & Co., Inc.

Planning Committee

The 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 activity:

Kelly Kraines of Med Learning Group has no relevant financial relationships to disclose.

Christopher Drury, of The Quill Consulting has no relevant financial relationships to disclose.

Margaret Governo, EdD, APRN BC has no relevant financial relationships to disclose.