Purpose: To determine if case-based online medical education for diabetologists/endocrinologists (diabs/endos) and primary care physicians (PCPs) can improve knowledge and competence regarding the role of novel insulins and their fixed-ratio combinations (FRCs) in treatment strategies for patients with T2DM.

Methods: This educational initiative incorporates branching logic to individualize clinical problem-based learning via case-based instruction. Each of two patient cases included both clinical decision questions (CDQs) and knowledge assessment questions (KAQs). Tailored feedback and clinical consequences were provided for CDQs and percent of correct answers on second attempt after feedback was recorded. Pre- and post-assessment choices were compared for the KAQs and a paired 2-tailed t-test was used for statistical analysis. Effect sizes were calculated with Cohenߣs d. The activity launched March 24, 2017; data were collected until April 24, 2017.

Results: Participation in the activity significantly advanced knowledge/competence of diabs/endos (n=115) and PCPs (n=568). 43%-81% of diabs/endos and 27%-75% of PCPs answered a CDQ correctly on the first attempt while 16%-47% of diabs/endos and 19%-60% of PCPs improved their clinical decisions after receiving tailored feedback with an overall large effect size of 1.88 (diabs/endos) and 1.87 (PCPs). Correct responses of KAQs were 2%-13% higher for diabs/endos and 5%-28% for PCPs after activity completion with an overall small effect size of 0.085 (diabs/endos) and 0.1(PCPs).

Conclusions: Participation in this innovative, case-based CME activity resulted in improved competence and knowledge regarding the utility of novel insulins and their FRCs for patients with T2DM. Despite notable improvement, both diabs/endos and PCPs would benefit from additional education on the optimal integration of these novel insulin formulations into treatment regimens for their patients with T2DM.


A. Philis-Tsimikas: Research Support; Self; Dexcom, Inc.. Advisory Panel; Self; Dexcom, Inc., Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; Novo Nordisk A/S, Sanofi, Mylan. Stock/Shareholder; Spouse/Partner; Novo Nordisk A/S. Employee; Spouse/Partner; Ionis Pharmaceuticals, Inc.. Stock/Shareholder; Spouse/Partner; Esperion Therapeutics, Ionis Pharmaceuticals, Inc.. Advisory Panel; Self; AstraZeneca. G.A. Griffith: None. J. Trier: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.