期刊
CURRENT OPINION IN ENDOCRINOLOGY DIABETES AND OBESITY
卷 28, 期 1, 页码 8-13出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MED.0000000000000602
关键词
adjunctive therapy; noninsulin therapy; type 1 diabetes
资金
- National Institutes of Health [1R01NR017190-01A1, 1R01DK116719-01A1]
Insulin is essential for type 1 diabetes management, but adjunctive therapies can positively impact glycemic control, reduce insulin requirements, and lead to weight loss. However, these therapies may also increase the risk of hypoglycemia and other side effects.
Purpose of review Insulin is the mainstay of treatment in people living with type 1 diabetes mellitus due to an immune-mediated loss of beta cells. Yet despite advances in insulin therapy and other technological advances, glycemic control remains difficult to achieve. Therefore, we aim to highlight risks and benefits of adjunctive therapies that may improve type 1 diabetes care. Recent findings We identified studies assessing clinical outcomes of adjunctive therapies that are both Food and Drug Administration (FDA)-approved and off-label in type 1 diabetes. Adjunctive therapies reviewed included metformin, pramlintide, glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 inhibitors. Although insulin is required in people living with type 1 diabetes mellitus, adjunctive therapies may positively impact glycemic control, reduce insulin requirements and lead to weight loss. In addition, the risk of hypoglycemia, gastrointestinal side effects and diabetes ketoacidosis may be increased with the use of these adjunctive therapies. Pramlintide is currently the only FDA-approved adjunctive therapy, whereas others require continued research to better understand risk-to-benefit ratio.
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