Improving postprandial hyperglycemia in patients with type 2 diabetes already on basal insulin therapy: Review of current strategies: 改善既往已在使用基础胰岛素治疗的2型糖尿病患者餐后高血糖:当前治疗策略综述. Issue 2 (25th August 2017)

• Record Type: Journal Article
• Authors: Umpierrez, Guillermo E.; Bailey, Timothy S.; Carcia, Danielle; Shaefer, Charles; Shubrook, Jay H.; Skolnik, Neil
• Is Part Of: Journal of diabetes. Volume 10:Issue 2(2018)
• Page Start: 94
• Page End: 111
• Publication Date: 2017-08-25
• Subjects: diabetes mellitus type 2 -- glucagon‐like peptide‐1 -- insulin -- postprandial hyperglycemia; 2型糖尿病 -- 胰高血糖素样肽‐1 -- 胰岛素 -- 餐后高血糖; Diabetes -- Periodicals; 618.3646005
• DOI: 10.1111/1753-0407.12576
• Languages: English
• ISSNs: 1753-0393

Abstract

Abstract: A large number of patients with type 2 diabetes (T2D) on basal insulin do not reach their HbA1c goals and require additional therapy to address postprandial hyperglycemia. Guidelines from expert bodies have outlined several approaches to accomplish postprandial glucose (PPG) control, and recent literature suggests several more. This article provides strategies for primary care physicians caring for patients with T2D who do not achieve glycemic control with basal insulin alone. Current treatment guidelines and strategies for improving PPG control are reviewed, including the efficacy, safety, and cost‐effectiveness of rapid‐acting insulin (RAI) analogs, premixed insulin, glucagon‐like peptide‐1 (GLP‐1) receptor agonists (RAs), dipeptidyl peptidase 4 inhibitors, sodium–glucose cotransporter 2 inhibitors, and α‐glucosidase inhibitors. Other approaches, such as combinations of newer basal insulin plus RAI and a fixed‐ratio combination of basal insulin and a GLP‐1 RA, are also described. Abstract : Highlights This article provides an overview for primary care physicians of the strategies available for treating patients with type 2 diabetes who do not achieve glycemic control with basal insulin alone. Treatment guidelines from expert bodies and current evidence regarding the use of insulin and non‐insulin agents for improving postprandial hyperglycemia are reviewed, including their efficacy, safety, and cost‐effectiveness.