Exposing the Corruption of the 2017 Endo Consensus on T2D
Feb 18, 2017 21:12:26 GMT -5
orlon, edvarney, and 9 more like this
Post by mango on Feb 18, 2017 21:12:26 GMT -5
CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2017 EXECUTIVE SUMMARY
Alan J. Garber, MD, PhD, FACE1; Martin J. Abrahamson, MD2; Joshua I. Barzilay, MD, FACE3; Lawrence Blonde, MD, FACP, FACE4; Zachary T. Bloomgarden, MD, MACE5; Michael A. Bush, MD6; Samuel Dagogo-Jack, MD, FACE7; Ralph A. DeFronzo, MD8; Daniel Einhorn, MD, FACP, FACE9; Vivian A. Fonseca, MD, FACE10; Je rey R. Garber, MD, FACP, FACE11; W. Timothy Garvey, MD, FACE12; George Grunberger, MD, FACP, FACE13; Yehuda Handelsman, MD, FACP, FNLA, FACE14; Irl B. Hirsch, MD15; Paul S. Jellinger, MD, MACE16; Janet B. McGill, MD, FACE17; Je rey I. Mechanick, MD, FACN, FACP, FACE, ECNU18; Paul D. Rosenblit, MD, PhD, FNLA, FACE19; Guillermo E. Umpierrez, MD, FACP, FACE20
* This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there were no randomized controlled trials or specifc U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf
In this thread I will be reviewing (exposing) one portion of this publication—prandial mealtime insulin
This is that portion:
• "Patients whose glycemia remains uncontrolled while receiving basal insulin alone or in combination with oral agents may require mealtime insulin to cover postprandial hyperglycemia. Rapid-acting analogs (lispro, aspart, or glulisine) or inhaled insulin are preferred over regular human insulin because the former have a more rapid onset and offset of action and are associated with less hypoglycemia (149). Prandial insulin should be considered when the total daily dose of basal insulin is greater than 0.5 U/ kg. Beyond this dose, the risk of hypoglycemia increases markedly without signi cant bene t in reducing A1C (150). The simplest approach is to cover the largest meal with a prandial injection of a rapid-acting insulin analog or inhaled insulin and then add additional mealtime insulin later, if needed. Several randomized controlled trials have shown that the stepwise addition of prandial insulin to basal insulin is safe and effective in achieving target A1C with a low rate of hypoglycemia (151-153). A full basal-bolus program is the most effective insulin regimen and provides greater exibility for patients with variable mealtimes and meal carbohydrate content, although this type of program has been associated with weight gain (153)."
• The name of the inhaled insulin, Afrezza, is not stated. A passive gesture was merely used in the two instances that mentioned 'inhaled insulin'. The author(s) clearly, and by clearly I actually mean deliberately, mentioned inhaled insulin as an afterthought that is easily overlooked/read-over.
• Afrezza is an ultra-rapid acting insulin treatment for improving glycemic control in patients with diabetes mellitus. Afrezza, the inhaled insulin, carries very unique and different PK/PD profiles than its injected analogue counterparts. These facts were not presented, acknowledged, or even provided in reference form. These guidelines are a failure as a result of that.
• THE "RELEVANT REFERENCES"
—Take note that some of the references throughout this official statement are ALSO the AUTHORS. Besides the obvious conflicts of interests which I will get into later, this fact, thus, already establishes an ethical duty being breached.
149. Hirsch IB. Insulin analogues. N Engl J Med. 2005;352: 174-183.
150. Arnolds S, Heise T, Flacke F, Sieber J. Common Standards of Basal Insulin Titration in T2DM. J Diabetes Sci Tech. 2013;7:771-788.
151. Owens DR, Luzio SD, Sert-Langeron C, Riddle MC. Effects of initiation and titration of a single pre-prandial dose of insulin glulisine while continuing titrated insulin glargine in type 2 diabetes: a 6-month ‘proof-of-con- cept’ study. Diabetes, obesity & metabolism. 2011;13: 1020-1027.
152. Lankisch MR, Ferlinz KC, Leahy JL, Scherbaum WA, Orals Plus A, group Ls. Introducing a simpli ed approach to insulin therapy in type 2 diabetes: a compari- son of two single-dose regimens of insulin glulisine plus insulin glargine and oral antidiabetic drugs. Diabetes Obes Metab. 2008;10:1178-1185.
153. Leahy JL. Insulin therapy in type 2 diabetes mellitus. Endocrinol Metab Clin North Am. 2012;41:119-144.
• None of the references actually REFERENCE anything even remotely related to an inhaled insulin (Afrezza). Nothing at all is available, referenced, mentioned, or illustrated.
• The vast differences that set the inhaled insulin, Afrezza, apart from the injected insulin analogues (that are highlighted and meaningfully presented and mentioned) were not established. This is a major problem. The authors have demonstrated their incompetence, ignorance, and a biased approach throughout, and especially in the small portion that covers the mealtime prandial insulins. Consequently, healthcare providers are not being educated properly and are left clueless as to what this inhaled insulin is, how it works, how it is different, and how it can be of benefit to the patient.
• Additionally, because of the author(s) lack of concern for describing the inhaled insulin from its counterparts, and the lack of concern for providing references to Afrezza for healthcare providers in this guideline, a large gap of knowledge has been omitted and unavailable for use.
• It is my own opinion that Afrezza was deliberately ignored and failed to be respectfully and properly acknowledged and addressed. There is no evidence to suggest any meaningful attempt was made by the author(s) otherwise. This consensus illustrates the author(s) agenda(s) which is evidenced by the absurd amount of affiliations with multiple Insulin Injection Monopoly counterparts.
Let's see what I am talking about here exactly.
• Author/Contributor Affiliations Whom also Self References in the Creation of Official Diabetic Consensus Statements
—Dr. Irl B. Hirsch reports that he is a consultant for Abbott Diabetes Care, Roche, Intarcia, and Valeritas.
—Dr. Irl B. Hirsch is an contributing author, and self references to 1 personal publication that coincidentally is in the mealtime prandial insulin section. Dr. Hirsch also has 2 other references used elsewhere of which Hirsch is an contributing author.
—"Rapid-acting analogs (lispro, aspart, or glulisine) or inhaled insulin are preferred over regular human insulin because the former have a more rapid onset and offset of action and are associated with less hypoglycemia (149)."
149. Hirsch IB. Insulin analogues. N Engl J Med. 2005;352: 174-183.
• Dr. Irl B. Hirsch—Insulin Analogues Reference
—This reference used for the establishment of the official "expert" opinion statement is one of which is outdated and not current with modern prandial insulins, as is evidenced by the account that Afrezza is no where to be found in this 2005 publication that Dr. IrI B. Hirsch so willingly and purposefully used. Thus, this author's statements are not valid.
—This reference lacks PK and PD profile comparisons of Afrezza with the author's acknowledged prandial injectable insulin analogues.
—How can any healthcare provider give a patient a prandial insulin if he/she is misinformed and uneducated on the present day comparisons of those prandial insulins?
• What Dr. Hirsch has to say:
—"Prandial insulin is given in an attempt to mimic the response of endogenous insulin to food intake. Normally, this response occurs in a robust first-phase secretion and then a more prolonged second-phase release into the portal circulation.7 A subcutaneous injection of insulin will never precisely replicate the second-phase release. The basal-insulin component mimics the relatively small but constant release of insulin that regulates lipolysis and the output of hepatic glucose. Finally, correction-dose insulin addresses premeal or between-meal hyperglycemia, independently of the prandial insulin."
—Amazing how Dr. Hirsch forgot to mention Afrezza's PK profile in this 2017 official statement. I believe Afrezza does what is highlighted above, so why is it not ever mentioned?
These are the people influencing how providers make decisions.
www.macpeds.com/documents/InsulinAnologues.pdf
• Mango sees this establishment unfit for carrying out any future guidelines and/or opinions and/or advice and/or statements regarding all things relevant to Diabetes. Mango also goes so far as to suggest not welcoming any influence concerning health from these people in general. That is mango's opinion, as is everything mango posts .
• Since the authors have a biased agenda that is in the favor of the pharmaceutical companies of which they are affiliated with as evidenced in the enormous disclosure section , they have failed ethically, and have also made it apparent that the patient is not in their best interests.
• Afrezza, also known as Technosphere Insulin Inhalation Powder, is composed of recombinant human insulin and an novel inert excipient called fumaryl diketopiperazine (FDKP). Afrezza is an ultra-rapid acting inhaled insulin with incredibly unique PK/PD profiles. Afrezza displays a more rapid onset and a shorter duration of action than the injectable regular human insulins and the injectable rapid-acting analog insulins. Afrezza is especially unique in that its pharmacokinetic (PK) profile essentially mirrors the endogenous secretion of mealtime insulin. No other insulin currently has this special characteristic.
• All Conflicts of Interests (You will not find MannKind listed, I can assure you of that)
DISCLOSURES
Dr. Jeffrey R. Garber reports that he does not have any relevant financial relationships with any commercial interests.
Dr. Alan J. Garber reports that he is a consultant for Novo Nordisk and Intarcia
Dr. W. Timothy Garvey reports that he is a consultant for AstraZeneca, Janssen, Eisai, Takeda, Novo Nordisk, Alexion, and Merck. He has also received research grants from Merck, Weight Watchers, Sanofi, Eisai, AstraZeneca, Lexicon, Pfizer, Novo Nordisk, and Elcelyx. Dr. Garvey is a shareholder in ISIS Pharmaceuticals, Novartis, Bristol Myers Squibb, Pfizer, Merck, and Eli Lilly.
Dr. Martin Julian Abrahamson reports that he is a consultant for Novo Nordisk, WebMD Health Services, and Health IQ.
Dr. Joshua I. Barzilay reports that he does not have any relevant financial relationships with any commercial interests.
Dr. Lawrence Blonde reports that he is a consultant for AstraZeneca, GlaxoSmithKline, Intarcia, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, and Sanofi. He is also a speaker for AstraZeneca, Janssen Pharmacueticals, Inc., Merck & Co., Inc., Novo Nordisk, and Sanofi. Dr. Blonde has received research grant support from AstraZeneca, Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co., Novo Nordisk, and Sanofi .
Dr. George Grunberger reports that he has received speaker honoraria from Eli Lilly, BI-Lilly, Novo Nordisk, Sanofi, Janssen, and AstraZeneca. He has received research funding from AstraZeneca, Eli Lilly, Lexicon, and Medtronic.
Dr. Zachary Bloomgarden reports that he is a consultant for AstraZeneca, Johnson & Johnson, Merck, Intarcia, and Novartis. He is also a speaker for Merck, AstraZeneca, and Johnson & Johnson. He is a stock shareholder for Allergan, Pfizer, Zimmer Biomet, and Novartis.
Dr. Yehuda Handelsman reports that he is a consultant for Amarin, Amgen, AstraZeneca, Boehringer Ingelheim (BI), Janssen, Eli Lilly, Eisai, Intarcia, Merck, Novo Nordisk, Sano , and Regeneron. He is a speaker for Amarin, Amgen, AstraZeneca, BI-Lilly, Janssen, Novo Nordisk, Sanofi, and Regeneron. Dr. Handelsman has also received grant support from Amgen, AstraZeneca, BI, Esperion, Grifols, Hamni, GlaxoSmithKline, Lexicon, Merck, Novo Nordisk, and Sanofi.
Dr. Michael A. Bush reports that he is an Advisory Board Consultant for Janssen and Eli Lilly. He is on the speaker’s bureau for Takeda, Eli Lilly, Novo Nordisk, AstraZeneca, and Boehringer Ingelheim.
Dr. Irl B. Hirsch reports that he is a consultant for Abbott Diabetes Care, Roche, Intarcia, and Valeritas.
Dr. Samuel Dagogo-Jack reports that he is a consultant for Merck, Novo Nordisk, Janssen, and Boehringer Ingelheim. He has received research grants from Amgen. Additionally, AstraZeneca, Novo Nordisk, and Boehringer Ingelheim have clinical trial contracts with the University of Tennessee for studies in which Dr. Dagogo-Jack serves as the Principal Investigator or Co-Investigator.
Dr. Paul S. Jellinger reports that he has received speaker honoraria from BI-Lilly, AstraZeneca, Novo Nordisk, Merck, and Amgen.
Dr. Ralph Anthony DeFronzo reports that he is on the Advisory Board for AstraZeneca, Novo Nordisk, Janssen, Boehringer Ingelheim, Intarcia, and Ecelyx. He is also a speaker for Novo Nordisk and AstraZeneca. Dr. DeFronzo has received research grant support from Boehringer Ingelheim, Takeda, Janssen, and AstraZeneca.
Dr. Janet B. McGill reports that she is a consultant for Boehringer Ingelheim, Janssen, merck, Novo Nordisk, Calibra, Dynavax, Valertias, and Intarcia. She is also a speaker for Janssen. Dr. McGill has received research grant support from Novartis, Dexcom, Bristol Myers Squibb, and Lexicon.
Dr. Daniel Einhorn reports that he is a consultant for Eli Lilly, Takeda, Novo Nordisk, Adocia, Sanofi, Epitracker, Janssen, Intarcia, Glysens, and Freedom-Meditech and has received research grant support from Novo Nordisk, Eli Lilly, AstraZeneca, Eisai, Janssen, and Sanofi. He is also a shareholder of Halozyme.
Dr. Paul D. Rosenblit reports that he is a consultant for AstraZeneca and a speaker for AstraZeneca (Bristol Myers Squibb), Boehringer Ingelheim, GlaxoSmithKline, Janssen, Merck, Novo Nordisk, and Takeda. He has also received research grant support from Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, GlaxoSmithKline, Ionis, Eli Lilly, Lexicon, Merck, Novo Nordisk, Orexigen, Pfizer, and Sanofi.
Dr. Vivian A. Fonseca reports that he is a consul- tant for Takeda, Novo Nordisk, Sanofi, Eli Lily, Pamlabs, AstraZeneca, Abbott, Boehringer Ingelheim, Janssen and Intarcia. He is a speaker for Takeda, AstraZeneca, and Sanofi. Dr. Fonseca has also received research grants from Novo Nordisk, Asahi, Eli Lilly, Abbott, Endo Barrier, Bayer, and Gilead.
Dr. Guillermo E. Umpierrez reports that he is a consultant for Sano and Glytec. He also received research grant support from Merck, Sanofi, Boehringer Ingelheim, AstraZeneca, and Novo Nordisk.
Dr. Jeffrey I. Mechanick reports that he is a consultant for Abbott Nutrition International.
Dr. Stephanie Adams reports that she does not have any relevant financial relationships with any commercial interests.
www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf
Alan J. Garber, MD, PhD, FACE1; Martin J. Abrahamson, MD2; Joshua I. Barzilay, MD, FACE3; Lawrence Blonde, MD, FACP, FACE4; Zachary T. Bloomgarden, MD, MACE5; Michael A. Bush, MD6; Samuel Dagogo-Jack, MD, FACE7; Ralph A. DeFronzo, MD8; Daniel Einhorn, MD, FACP, FACE9; Vivian A. Fonseca, MD, FACE10; Je rey R. Garber, MD, FACP, FACE11; W. Timothy Garvey, MD, FACE12; George Grunberger, MD, FACP, FACE13; Yehuda Handelsman, MD, FACP, FNLA, FACE14; Irl B. Hirsch, MD15; Paul S. Jellinger, MD, MACE16; Janet B. McGill, MD, FACE17; Je rey I. Mechanick, MD, FACN, FACP, FACE, ECNU18; Paul D. Rosenblit, MD, PhD, FNLA, FACE19; Guillermo E. Umpierrez, MD, FACP, FACE20
* This document represents the official position of the American Association of Clinical Endocrinologists and American College of Endocrinology. Where there were no randomized controlled trials or specifc U.S. FDA labeling for issues in clinical practice, the participating clinical experts utilized their judgment and experience. Every effort was made to achieve consensus among the committee members. Position statements are meant to provide guidance, but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf
In this thread I will be reviewing (exposing) one portion of this publication—prandial mealtime insulin
This is that portion:
• "Patients whose glycemia remains uncontrolled while receiving basal insulin alone or in combination with oral agents may require mealtime insulin to cover postprandial hyperglycemia. Rapid-acting analogs (lispro, aspart, or glulisine) or inhaled insulin are preferred over regular human insulin because the former have a more rapid onset and offset of action and are associated with less hypoglycemia (149). Prandial insulin should be considered when the total daily dose of basal insulin is greater than 0.5 U/ kg. Beyond this dose, the risk of hypoglycemia increases markedly without signi cant bene t in reducing A1C (150). The simplest approach is to cover the largest meal with a prandial injection of a rapid-acting insulin analog or inhaled insulin and then add additional mealtime insulin later, if needed. Several randomized controlled trials have shown that the stepwise addition of prandial insulin to basal insulin is safe and effective in achieving target A1C with a low rate of hypoglycemia (151-153). A full basal-bolus program is the most effective insulin regimen and provides greater exibility for patients with variable mealtimes and meal carbohydrate content, although this type of program has been associated with weight gain (153)."
• The name of the inhaled insulin, Afrezza, is not stated. A passive gesture was merely used in the two instances that mentioned 'inhaled insulin'. The author(s) clearly, and by clearly I actually mean deliberately, mentioned inhaled insulin as an afterthought that is easily overlooked/read-over.
• Afrezza is an ultra-rapid acting insulin treatment for improving glycemic control in patients with diabetes mellitus. Afrezza, the inhaled insulin, carries very unique and different PK/PD profiles than its injected analogue counterparts. These facts were not presented, acknowledged, or even provided in reference form. These guidelines are a failure as a result of that.
• THE "RELEVANT REFERENCES"
—Take note that some of the references throughout this official statement are ALSO the AUTHORS. Besides the obvious conflicts of interests which I will get into later, this fact, thus, already establishes an ethical duty being breached.
149. Hirsch IB. Insulin analogues. N Engl J Med. 2005;352: 174-183.
150. Arnolds S, Heise T, Flacke F, Sieber J. Common Standards of Basal Insulin Titration in T2DM. J Diabetes Sci Tech. 2013;7:771-788.
151. Owens DR, Luzio SD, Sert-Langeron C, Riddle MC. Effects of initiation and titration of a single pre-prandial dose of insulin glulisine while continuing titrated insulin glargine in type 2 diabetes: a 6-month ‘proof-of-con- cept’ study. Diabetes, obesity & metabolism. 2011;13: 1020-1027.
152. Lankisch MR, Ferlinz KC, Leahy JL, Scherbaum WA, Orals Plus A, group Ls. Introducing a simpli ed approach to insulin therapy in type 2 diabetes: a compari- son of two single-dose regimens of insulin glulisine plus insulin glargine and oral antidiabetic drugs. Diabetes Obes Metab. 2008;10:1178-1185.
153. Leahy JL. Insulin therapy in type 2 diabetes mellitus. Endocrinol Metab Clin North Am. 2012;41:119-144.
• None of the references actually REFERENCE anything even remotely related to an inhaled insulin (Afrezza). Nothing at all is available, referenced, mentioned, or illustrated.
• The vast differences that set the inhaled insulin, Afrezza, apart from the injected insulin analogues (that are highlighted and meaningfully presented and mentioned) were not established. This is a major problem. The authors have demonstrated their incompetence, ignorance, and a biased approach throughout, and especially in the small portion that covers the mealtime prandial insulins. Consequently, healthcare providers are not being educated properly and are left clueless as to what this inhaled insulin is, how it works, how it is different, and how it can be of benefit to the patient.
• Additionally, because of the author(s) lack of concern for describing the inhaled insulin from its counterparts, and the lack of concern for providing references to Afrezza for healthcare providers in this guideline, a large gap of knowledge has been omitted and unavailable for use.
• It is my own opinion that Afrezza was deliberately ignored and failed to be respectfully and properly acknowledged and addressed. There is no evidence to suggest any meaningful attempt was made by the author(s) otherwise. This consensus illustrates the author(s) agenda(s) which is evidenced by the absurd amount of affiliations with multiple Insulin Injection Monopoly counterparts.
Let's see what I am talking about here exactly.
• Author/Contributor Affiliations Whom also Self References in the Creation of Official Diabetic Consensus Statements
—Dr. Irl B. Hirsch reports that he is a consultant for Abbott Diabetes Care, Roche, Intarcia, and Valeritas.
—Dr. Irl B. Hirsch is an contributing author, and self references to 1 personal publication that coincidentally is in the mealtime prandial insulin section. Dr. Hirsch also has 2 other references used elsewhere of which Hirsch is an contributing author.
—"Rapid-acting analogs (lispro, aspart, or glulisine) or inhaled insulin are preferred over regular human insulin because the former have a more rapid onset and offset of action and are associated with less hypoglycemia (149)."
149. Hirsch IB. Insulin analogues. N Engl J Med. 2005;352: 174-183.
• Dr. Irl B. Hirsch—Insulin Analogues Reference
—This reference used for the establishment of the official "expert" opinion statement is one of which is outdated and not current with modern prandial insulins, as is evidenced by the account that Afrezza is no where to be found in this 2005 publication that Dr. IrI B. Hirsch so willingly and purposefully used. Thus, this author's statements are not valid.
—This reference lacks PK and PD profile comparisons of Afrezza with the author's acknowledged prandial injectable insulin analogues.
—How can any healthcare provider give a patient a prandial insulin if he/she is misinformed and uneducated on the present day comparisons of those prandial insulins?
• What Dr. Hirsch has to say:
—"Prandial insulin is given in an attempt to mimic the response of endogenous insulin to food intake. Normally, this response occurs in a robust first-phase secretion and then a more prolonged second-phase release into the portal circulation.7 A subcutaneous injection of insulin will never precisely replicate the second-phase release. The basal-insulin component mimics the relatively small but constant release of insulin that regulates lipolysis and the output of hepatic glucose. Finally, correction-dose insulin addresses premeal or between-meal hyperglycemia, independently of the prandial insulin."
—Amazing how Dr. Hirsch forgot to mention Afrezza's PK profile in this 2017 official statement. I believe Afrezza does what is highlighted above, so why is it not ever mentioned?
These are the people influencing how providers make decisions.
www.macpeds.com/documents/InsulinAnologues.pdf
• Mango sees this establishment unfit for carrying out any future guidelines and/or opinions and/or advice and/or statements regarding all things relevant to Diabetes. Mango also goes so far as to suggest not welcoming any influence concerning health from these people in general. That is mango's opinion, as is everything mango posts .
• Since the authors have a biased agenda that is in the favor of the pharmaceutical companies of which they are affiliated with as evidenced in the enormous disclosure section , they have failed ethically, and have also made it apparent that the patient is not in their best interests.
• Afrezza, also known as Technosphere Insulin Inhalation Powder, is composed of recombinant human insulin and an novel inert excipient called fumaryl diketopiperazine (FDKP). Afrezza is an ultra-rapid acting inhaled insulin with incredibly unique PK/PD profiles. Afrezza displays a more rapid onset and a shorter duration of action than the injectable regular human insulins and the injectable rapid-acting analog insulins. Afrezza is especially unique in that its pharmacokinetic (PK) profile essentially mirrors the endogenous secretion of mealtime insulin. No other insulin currently has this special characteristic.
• All Conflicts of Interests (You will not find MannKind listed, I can assure you of that)
DISCLOSURES
Dr. Jeffrey R. Garber reports that he does not have any relevant financial relationships with any commercial interests.
Dr. Alan J. Garber reports that he is a consultant for Novo Nordisk and Intarcia
Dr. W. Timothy Garvey reports that he is a consultant for AstraZeneca, Janssen, Eisai, Takeda, Novo Nordisk, Alexion, and Merck. He has also received research grants from Merck, Weight Watchers, Sanofi, Eisai, AstraZeneca, Lexicon, Pfizer, Novo Nordisk, and Elcelyx. Dr. Garvey is a shareholder in ISIS Pharmaceuticals, Novartis, Bristol Myers Squibb, Pfizer, Merck, and Eli Lilly.
Dr. Martin Julian Abrahamson reports that he is a consultant for Novo Nordisk, WebMD Health Services, and Health IQ.
Dr. Joshua I. Barzilay reports that he does not have any relevant financial relationships with any commercial interests.
Dr. Lawrence Blonde reports that he is a consultant for AstraZeneca, GlaxoSmithKline, Intarcia, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, and Sanofi. He is also a speaker for AstraZeneca, Janssen Pharmacueticals, Inc., Merck & Co., Inc., Novo Nordisk, and Sanofi. Dr. Blonde has received research grant support from AstraZeneca, Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co., Novo Nordisk, and Sanofi .
Dr. George Grunberger reports that he has received speaker honoraria from Eli Lilly, BI-Lilly, Novo Nordisk, Sanofi, Janssen, and AstraZeneca. He has received research funding from AstraZeneca, Eli Lilly, Lexicon, and Medtronic.
Dr. Zachary Bloomgarden reports that he is a consultant for AstraZeneca, Johnson & Johnson, Merck, Intarcia, and Novartis. He is also a speaker for Merck, AstraZeneca, and Johnson & Johnson. He is a stock shareholder for Allergan, Pfizer, Zimmer Biomet, and Novartis.
Dr. Yehuda Handelsman reports that he is a consultant for Amarin, Amgen, AstraZeneca, Boehringer Ingelheim (BI), Janssen, Eli Lilly, Eisai, Intarcia, Merck, Novo Nordisk, Sano , and Regeneron. He is a speaker for Amarin, Amgen, AstraZeneca, BI-Lilly, Janssen, Novo Nordisk, Sanofi, and Regeneron. Dr. Handelsman has also received grant support from Amgen, AstraZeneca, BI, Esperion, Grifols, Hamni, GlaxoSmithKline, Lexicon, Merck, Novo Nordisk, and Sanofi.
Dr. Michael A. Bush reports that he is an Advisory Board Consultant for Janssen and Eli Lilly. He is on the speaker’s bureau for Takeda, Eli Lilly, Novo Nordisk, AstraZeneca, and Boehringer Ingelheim.
Dr. Irl B. Hirsch reports that he is a consultant for Abbott Diabetes Care, Roche, Intarcia, and Valeritas.
Dr. Samuel Dagogo-Jack reports that he is a consultant for Merck, Novo Nordisk, Janssen, and Boehringer Ingelheim. He has received research grants from Amgen. Additionally, AstraZeneca, Novo Nordisk, and Boehringer Ingelheim have clinical trial contracts with the University of Tennessee for studies in which Dr. Dagogo-Jack serves as the Principal Investigator or Co-Investigator.
Dr. Paul S. Jellinger reports that he has received speaker honoraria from BI-Lilly, AstraZeneca, Novo Nordisk, Merck, and Amgen.
Dr. Ralph Anthony DeFronzo reports that he is on the Advisory Board for AstraZeneca, Novo Nordisk, Janssen, Boehringer Ingelheim, Intarcia, and Ecelyx. He is also a speaker for Novo Nordisk and AstraZeneca. Dr. DeFronzo has received research grant support from Boehringer Ingelheim, Takeda, Janssen, and AstraZeneca.
Dr. Janet B. McGill reports that she is a consultant for Boehringer Ingelheim, Janssen, merck, Novo Nordisk, Calibra, Dynavax, Valertias, and Intarcia. She is also a speaker for Janssen. Dr. McGill has received research grant support from Novartis, Dexcom, Bristol Myers Squibb, and Lexicon.
Dr. Daniel Einhorn reports that he is a consultant for Eli Lilly, Takeda, Novo Nordisk, Adocia, Sanofi, Epitracker, Janssen, Intarcia, Glysens, and Freedom-Meditech and has received research grant support from Novo Nordisk, Eli Lilly, AstraZeneca, Eisai, Janssen, and Sanofi. He is also a shareholder of Halozyme.
Dr. Paul D. Rosenblit reports that he is a consultant for AstraZeneca and a speaker for AstraZeneca (Bristol Myers Squibb), Boehringer Ingelheim, GlaxoSmithKline, Janssen, Merck, Novo Nordisk, and Takeda. He has also received research grant support from Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, GlaxoSmithKline, Ionis, Eli Lilly, Lexicon, Merck, Novo Nordisk, Orexigen, Pfizer, and Sanofi.
Dr. Vivian A. Fonseca reports that he is a consul- tant for Takeda, Novo Nordisk, Sanofi, Eli Lily, Pamlabs, AstraZeneca, Abbott, Boehringer Ingelheim, Janssen and Intarcia. He is a speaker for Takeda, AstraZeneca, and Sanofi. Dr. Fonseca has also received research grants from Novo Nordisk, Asahi, Eli Lilly, Abbott, Endo Barrier, Bayer, and Gilead.
Dr. Guillermo E. Umpierrez reports that he is a consultant for Sano and Glytec. He also received research grant support from Merck, Sanofi, Boehringer Ingelheim, AstraZeneca, and Novo Nordisk.
Dr. Jeffrey I. Mechanick reports that he is a consultant for Abbott Nutrition International.
Dr. Stephanie Adams reports that she does not have any relevant financial relationships with any commercial interests.
www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf
