Non-insulin pharmacological therapies for treating type 1 diabetes. (13th June 2018)

• Record Type: Journal Article
• Authors: Frandsen, Christian Seerup; Dejgaard, Thomas Fremming; Madsbad, Sten; Holst, Jens Juul
• Is Part Of: Expert opinion on pharmacotherapy. Volume 19:Number 9(2018)
• Page Start: 947
• Page End: 960
• Publication Date: 2018-06-13
• Subjects: Type 1 diabetes -- T1DM -- T1D -- pramlintide -- amylin -- glucagon-like peptide-1 -- GLP-1RA -- dipeptidyl peptidase-4 inhibitor -- DPP-4 -- sodium-glucose cotransporters -- SGLT-1 -- SGLT-2 -- metformin -- sulfonylurea -- SU -- thiazolidinediones -- TZD; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2018.1483339
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction : Despite intensified insulin treatment, many persons with type 1 diabetes (T1D) do not achieve glycemic and metabolic targets. Consequently, non-insulin chemical therapies that improve glycemic control and metabolic parameters without increasing the risk of adverse events (including hypoglycemia) are of interest as adjunct therapies to insulin. Areas covered : In this review, the authors discuss the efficacy and safety of non-insulin therapies, including pramlintide, glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 inhibitors (DPP-4), sodium-glucose cotransporter (SGLT1 and SGLT2) inhibitors, metformin, sulfonylureas, and thiazolidinediones as add-on therapies to insulin in T1D. Expert opinion : The current evidence shows that the efficacy of non-insulin therapies as add-on therapies to insulin is minimal or modest with an average HbA1c reduction of 0.2–0.5% (2–6 mmol/mol). Indeed, the current focus is on the development of SGLT inhibitors as adjuncts to insulin in type 1 diabetes. Studies of subgroups with obesity, residual beta-cell function (including newly diagnosed patients) and patients prone to hypoglycemia could be areas of future research.