4.7 Review

Incretins beyond type 2 diabetes

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Review Pharmacology & Pharmacy

Recent developments in adjunct therapies for type 1 diabetes

Joseph G. G. Timmons et al.

Summary: Although there have been many advances in the treatment of type 1 diabetes, optimal glycemic control is still only achieved in a minority. Adjunct therapy, including insulin analogues, SGLT2 inhibitors, GLP-1 receptor agonists, and others, is being investigated as a strategy to improve outcomes in type 1 diabetes.

EXPERT OPINION ON INVESTIGATIONAL DRUGS (2023)

Review Endocrinology & Metabolism

Beyond the pancreas: contrasting cardiometabolic actions of GIP and GLP1

Rola Hammoud et al.

Summary: Glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP1) have incretin activity and play important roles in regulating glucose and lipid metabolism beyond the pancreas. They also have effects on weight loss, atherosclerosis, cardiorenal protection, and other physiological processes. Understanding the mechanisms of GIP and GLP1 action can lead to the development of new treatments for obesity and type 2 diabetes mellitus.

NATURE REVIEWS ENDOCRINOLOGY (2023)

Review Surgery

Sweet and simple as syrup: A review and guidance for use of novel antihyperglycemic agents for post-transplant diabetes mellitus and type 2 diabetes mellitus after kidney transplantation

S. Elise Lawrence et al.

Summary: Uncontrolled type 2 diabetes mellitus (T2DM) and post-transplant diabetes mellitus (PTDM) increase morbidity and mortality after kidney transplantation. Conventional strategies for diabetes management in this population include metformin, sulfonylureas, meglitinides and insulin. Limitations with these agents, as well as promising new antihyperglycemic agents, create a need and opportunity to explore additional options for transplant diabetes pharmacotherapy. Novel agents including SGLT2i, GLP1RA, and DPP4i demonstrate great promise for T2DM management in kidney transplant recipients, offering benefits in glucose control, renoprotection, cardiovascular health, weight loss, and reduced risk of hypoglycemia. Further research is needed to fully understand the role and application of these agents in this population.

CLINICAL TRANSPLANTATION (2023)

Article Endocrinology & Metabolism

Real-world Evidence of Efficacy and Safety of SGLT2 Inhibitors as Adjunctive Therapy in Adults With Type 1 Diabetes: A European Two-Center Experience

Ana Palanca et al.

Summary: This study evaluated the real-world efficacy and safety of combining sodium-glucose cotransporter 2 inhibitor (SGLT2i) with insulin in individuals with type 1 diabetes. The results showed significant reductions in HbA(1c), weight, and insulin requirements after 12 months of treatment. The greatest improvements were observed in individuals with higher baseline HbA(1c) and BMI. Adverse events, including genital infections and diabetic ketoacidosis, were reported in a subset of participants.

DIABETES CARE (2022)

Article Endocrinology & Metabolism

Liraglutide changes body composition and lowers added sugar intake in overweight persons with insulin pump-treated type 1 diabetes

Signe Schmidt et al.

Summary: Liraglutide treatment led to decreased fat and lean body mass, as well as reduced intake of added sugars, while no significant difference in total daily energy intake was observed between liraglutide- and placebo-treated participants.

DIABETES OBESITY & METABOLISM (2022)

Article Endocrinology & Metabolism

INnoVative trial design for testing the Efficacy, Safety and Tolerability of 6-month treatment with incretin-based therapy to prevent type 1 DIAbetes in autoantibody positive participants: A protocol for three parallel double-blind, randomised controlled trials (INVESTDIA)

Jukka Kero et al.

Summary: The study aims to evaluate the effects of the GLP-1 analogue liraglutide on early stages of type 1 diabetes. The innovative trial design allows for simultaneous investigation of the intervention in three different groups representing various stages of the disease.

DIABETIC MEDICINE (2022)

Article Endocrinology & Metabolism

Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Melanie J. Davies et al.

Summary: The American Diabetes Association and the European Association for the Study of Diabetes have updated the consensus statements on the management of hyperglycaemia in type 2 diabetes in adults. The new recommendations focus on social determinants of health, physical activity behaviors, and weight management.

DIABETOLOGIA (2022)

Article Endocrinology & Metabolism

Global incidence, prevalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study br

Gabriel A. Gregory et al.

Summary: This study developed a model based on available data to estimate the prevalence, incidence, associated mortality, and life expectancy of type 1 diabetes for 201 countries in 2021. The study also projected the prevalent cases in 2040. The burden of type 1 diabetes was found to be significant and expected to increase rapidly, particularly in resource-limited countries.

LANCET DIABETES & ENDOCRINOLOGY (2022)

Editorial Material Endocrinology & Metabolism

Impaired Awareness of Hypoglycemia in Type 1 Diabetes: A Report of An NIDDK Workshop in October 2021

Elizabeth R. Seaquist et al.

Summary: Hypoglycemia is a limiting factor in the treatment of type 1 diabetes, and the management of hypoglycemia remains uncertain. Repeated episodes of hypoglycemia lead to impaired awareness of subsequent events, increasing the risk of complications and mortality. A recent workshop brought together scientists from various fields to discuss the best ways to advance the understanding of impaired awareness of hypoglycemia and hypoglycemia management in diabetes patients.

DIABETES CARE (2022)

Article Pharmacology & Pharmacy

Subcutaneous adipose tissue composition and function are unaffected by liraglutide-induced weight loss in adults with type 1 diabetes

Anne-Marie Wegeberg et al.

Summary: Liraglutide treatment leads to weight loss without significant changes in subcutaneous adipose tissue composition, including cell size, distribution of CD163-positive cells, pericellular fibrosis, and serum levels of free fatty acids, CD163, leptin, and adiponectin. The weight loss induced by liraglutide does not correlate with changes in cell size or serum markers.

BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY (2021)

Article Endocrinology & Metabolism

Anti-interleukin-21 antibody and liraglutide for the preservation of β-cell function in adults with recent-onset type 1 diabetes: a randomised, double-blind, placebo-controlled, phase 2 trial

Matthias von Herrath et al.

Summary: This study aimed to investigate the combination of anti-interleukin-21 antibody and liraglutide for treating type 1 diabetes, and found that this combination therapy could preserve beta-cell function with a better safety profile compared to traditional immunomodulation methods.

LANCET DIABETES & ENDOCRINOLOGY (2021)

Review Endocrinology & Metabolism

Obesity in people living with type 1 diabetes

Bart Van der Schueren et al.

Summary: Although traditionally considered a disease of lean individuals, overweight and obesity are becoming more common in people with type 1 diabetes, leading to increased risk of diabetes-related and obesity-related complications such as cardiovascular disease, stroke, and cancer. Preventing and treating excessive bodyweight in people with type 1 diabetes is crucial to optimizing their health outcomes.

LANCET DIABETES & ENDOCRINOLOGY (2021)

Article Endocrinology & Metabolism

Efficacy and safety of liraglutide in type 1 diabetes by baseline characteristics in the ADJUNCT ONE and ADJUNCT TWO randomized controlled trials

Thomas F. Dejgaard et al.

Summary: In both the ADJUNCT ONE and ADJUNCT TWO trials, the efficacy and glycaemic safety of liraglutide did not depend on subgroups, with residual beta-cell function being identified as the only variable impacting the effect of GLP-1 RAs in T1D. This supports a role for GLP-1 RAs as adjuncts to insulin in T1D, warranting further study.

DIABETES OBESITY & METABOLISM (2021)

Review Pharmacology & Pharmacy

Risk of acute pancreatitis with incretin-based therapy: a systematic review and updated meta-analysis of cardiovascular outcomes trials

Awadhesh Kumar Singh et al.

EXPERT REVIEW OF CLINICAL PHARMACOLOGY (2020)

Article Endocrinology & Metabolism

Exenatide extended release in patients with type 1 diabetes with and without residual insulin production

Kevan C. Herold et al.

DIABETES OBESITY & METABOLISM (2020)

Review Endocrinology & Metabolism

SGLT inhibitors in type 1 diabetes: weighing efficacy and side effects

Birgit Janssens et al.

THERAPEUTIC ADVANCES IN ENDOCRINOLOGY AND METABOLISM (2020)

Article Pharmacology & Pharmacy

Liraglutide treatment reduced interleukin-6 in adults with type 1 diabetes but did not improve established autonomic or polyneuropathy

Christina Brock et al.

BRITISH JOURNAL OF CLINICAL PHARMACOLOGY (2019)

Review Endocrinology & Metabolism

Glucagon-like peptide 1 (GLP-1)

T. D. Mueller et al.

MOLECULAR METABOLISM (2019)

Review Endocrinology & Metabolism

SGLT2 inhibitors as adjunctive therapy for type 1 diabetes: balancing benefits and risks

Simeon I. Taylor et al.

LANCET DIABETES & ENDOCRINOLOGY (2019)

Article Endocrinology & Metabolism

The effects of add-on exenatide to insulin on glycemic variability and hypoglycemia in patients with type 1 diabetes mellitus

L. -l. Jiang et al.

JOURNAL OF ENDOCRINOLOGICAL INVESTIGATION (2018)

Article Endocrinology & Metabolism

Beyond glycaemic control: A cross-over, double-blinded, 24-week intervention with liraglutide in type 1 diabetes

Marie-Christine Dube et al.

DIABETES OBESITY & METABOLISM (2018)