Non-insulin treatments for Type 1 diabetes: critical appraisal of the available evidence and insight into future directions

Diabetic Medicine : a Journal of the British Diabetic Association
L A Wright, I B Hirsch

Abstract

Intensive insulin therapy is the mainstay of treatment for people with Type 1 diabetes, but hypoglycaemia and weight gain are often limiting factors in achieving glycaemic targets and decreasing the risk of diabetes-related complications. The inclusion of pharmacological agents used traditionally in Type 2 diabetes as adjuncts to insulin therapy in Type 1 diabetes has been explored, with the goal of mitigating such drawbacks. Pramlintide and metformin result in modest HbA1c and weight reductions, but their use is limited by poor tolerability and, in the case of pramlintide, by frequency of injections and cost. The addition of glucagon-like peptide-1 receptor agonists to insulin results in improved glycaemic control, reduced insulin doses and weight loss, but this is at the expense of higher rates of hypoglycaemia and hyperglycaemia with ketosis. Sodium-glucose co-transporter-2 and dual sodium-glucose co-transporter-2 and -1 inhibitors also improve glucose control, but with reductions in weight and insulin requirements potentiating the risk of acidosis-related events and hypoglycaemia. The high proportion of people with Type 1 diabetes not achieving glycaemic targets, the negative clinical impact of intensive insulin therapy and...Continue Reading

References

May 1, 1987·The Journal of Clinical Investigation·L RossettiR A DeFronzo
Sep 30, 1993·The New England Journal of Medicine·UNKNOWN Diabetes Control and Complications Trial Research GroupC Siebert
Oct 1, 1995·Diabetic Medicine : a Journal of the British Diabetic Association·T ForstJ Beyer
Jul 9, 2004·The Journal of Clinical Endocrinology and Metabolism·John DupréThomas J McDonald
Oct 14, 2004·Diabetologia·S FourlanosL C Harrison
Sep 19, 2006·Diabetic Medicine : a Journal of the British Diabetic Association·A S A KhanA B Ahmed
May 31, 2007·Diabetes Care·Ping XuUNKNOWN Diabetes Prevention Trial-Type 1 Study Group
Jul 2, 2008·Diabetes Care·Lucy D MastrandreaTeresa Quattrin
Jun 6, 2009·Basic & Clinical Pharmacology & Toxicology·Iben Brock JacobsenHenning Beck-Nielsen
Mar 25, 2010·Diabetes Care·Vandana S RamanRubina A Heptulla
Jun 9, 2010·The Journal of Clinical Endocrinology and Metabolism·Emanuele Bosi
Jun 12, 2010·Diabetic Medicine : a Journal of the British Diabetic Association·B ConwayT J Orchard
Jun 14, 2013·The Journal of Clinical Endocrinology and Metabolism·Ruth S WeinstockUNKNOWN T1D Exchange Clinic Network
May 23, 2015·Diabetes Care·Kellee M MillerUNKNOWN T1D Exchange Clinic Network
Sep 18, 2015·The New England Journal of Medicine·Bernard ZinmanUNKNOWN EMPA-REG OUTCOME Investigators
Nov 19, 2015·The Journal of Clinical Endocrinology and Metabolism·John P BilezikianNorm Rosenthal
Feb 11, 2016·Diabetes Care·UNKNOWN Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Resear
Jun 14, 2016·The New England Journal of Medicine·Steven P MarsoUNKNOWN LEADER Trial Investigators
Jun 15, 2016·The New England Journal of Medicine·Christoph WannerUNKNOWN EMPA-REG OUTCOME Investigators
Sep 17, 2016·The New England Journal of Medicine·Steven P MarsoUNKNOWN SUSTAIN-6 Investigators
Jun 13, 2017·The New England Journal of Medicine·Bruce NealUNKNOWN CANVAS Program Collaborative Group

❮ Previous
Next ❯

Citations

Dec 19, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·B J AmmoriR A Malik
May 26, 2020·Paediatric Drugs·Luz CastellanosLynne L Levitsky
Mar 24, 2021·Reviews in Endocrine & Metabolic Disorders·Federico Boscari, Angelo Avogaro
Aug 28, 2020·Current Pharmaceutical Design·Pallavi Singh ChauhanJun-O Jin
Jun 17, 2021·Expert Opinion on Pharmacotherapy·Åke Sjöholm
Sep 10, 2019·Chemico-biological Interactions·Maria Rosa Trentin ZorzenonCecília Edna Mareze-Costa

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

CV Disorders & Type 2 Diabetes

This feed focuses on the association of cardiovascular diseases in patients with type 2 diabetes.

Autoimmune Diabetes & Tolerance

Patients with type I diabetes lack insulin-producing beta cells due to the loss of immunological tolerance and autoimmune disease. Discover the latest research on targeting tolerance to prevent diabetes.

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.

Related Papers

Drug Safety : an International Journal of Medical Toxicology and Drug Experience
Kjeld Hermansen, Lene S Mortensen
The Lancet. Diabetes & Endocrinology
Christian Seerup FrandsenSten Madsbad
© 2022 Meta ULC. All rights reserved