Adjunctive therapy for glucose control in patients with type 1 diabetes

Kira Harris,1,2 Cassie Boland,1,3 Lisa Meade,1,4 Dawn Battise1,5 1Pharmacy Practice Faculty, Wingate University School of Pharmacy, Wingate, NC, USA; 2Clinical Pharmacy Specialist – Novant Health Family Medicine Residency Program, Cornelius, NC, USA; 3Clinical Pharmacy Specialist &ndas...

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Autores principales:	Harris K, Boland C, Meade L, Battise D
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	type 1 diabetes mellitus metformin amylin sodium-glucose cotransporter 2 (SGLT2) inhibitors glucagon-like peptide-1 receptor agonists dipeptidyl-peptidase 4 inhibitors Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/e5051def92b745d68c60c35f8ddc737b
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spelling	oai:doaj.org-article:e5051def92b745d68c60c35f8ddc737b2021-12-02T09:23:47ZAdjunctive therapy for glucose control in patients with type 1 diabetes1178-7007https://doaj.org/article/e5051def92b745d68c60c35f8ddc737b2018-04-01T00:00:00Zhttps://www.dovepress.com/adjunctive-therapy-for-glucose-control-in-patients-with-type-1-diabete-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Kira Harris,1,2 Cassie Boland,1,3 Lisa Meade,1,4 Dawn Battise1,5 1Pharmacy Practice Faculty, Wingate University School of Pharmacy, Wingate, NC, USA; 2Clinical Pharmacy Specialist – Novant Health Family Medicine Residency Program, Cornelius, NC, USA; 3Clinical Pharmacy Specialist – Novant Health Cotswold Family Medicine – Arboretum, Charlotte, NC, USA; 4Clinical Pharmacy Specialist – Piedmont HealthCare Endocrinology, Statesville, NC, USA; 5Clinical Pharmacy Specialist – Cabarrus Family Medicine – Harrisburg, Harrisburg, NC, USA Abstract: Type 1 diabetes mellitus (T1DM) is characterized by relative or absolute insulin deficiency. Despite treatment with insulin therapy, glycemic goals are not always met, and insulin therapy is sometimes limited by adverse effects, including hypoglycemia and weight gain. Several adjunctive therapies have been evaluated in combination with insulin in patients with T1DM to improve glycemic control while minimizing adverse effects. Pramlintide, an amylin analog, can improve glycemic control, primarily through lowering postprandial blood glucose levels. Patients may experience weight loss and an increased risk of hypoglycemia and require additional mealtime injections. Metformin provides an inexpensive, oral treatment option and may reduce blood glucose, especially in overweight or obese patients with minimal risk of hypoglycemia. Metformin may be more effective in patients with impaired insulin sensitivity. Glucagon-like peptide-1 receptor agonists reduce primarily postprandial blood glucose and insulin dose and promote weight loss. They are expensive, cause transient nausea, may increase risk of hypoglycemia and require additional injections. Sodium–glucose transport-2 inhibitors improve glycemic control, promote weight loss and have low risk of hypoglycemia with appropriate insulin adjustment; however, these agents may increase the risk of diabetic ketoacidosis in patients with T1DM. Patient-specific characteristics should be considered when selecting adjunctive therapy for patients with T1DM. Close monitoring, insulin dose adjustments and patient education are all important to ensure safe and effective use of these agents. Keywords: type 1 diabetes mellitus, metformin, amylin, sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, dipeptidyl-peptidase 4 inhibitorsHarris KBoland CMeade LBattise DDove Medical Pressarticletype 1 diabetes mellitusmetforminamylinsodium-glucose cotransporter 2 (SGLT2) inhibitorsglucagon-like peptide-1 receptor agonistsdipeptidyl-peptidase 4 inhibitorsSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 11, Pp 159-173 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 1 diabetes mellitus metformin amylin sodium-glucose cotransporter 2 (SGLT2) inhibitors glucagon-like peptide-1 receptor agonists dipeptidyl-peptidase 4 inhibitors Specialties of internal medicine RC581-951
spellingShingle	type 1 diabetes mellitus metformin amylin sodium-glucose cotransporter 2 (SGLT2) inhibitors glucagon-like peptide-1 receptor agonists dipeptidyl-peptidase 4 inhibitors Specialties of internal medicine RC581-951 Harris K Boland C Meade L Battise D Adjunctive therapy for glucose control in patients with type 1 diabetes
description	Kira Harris,1,2 Cassie Boland,1,3 Lisa Meade,1,4 Dawn Battise1,5 1Pharmacy Practice Faculty, Wingate University School of Pharmacy, Wingate, NC, USA; 2Clinical Pharmacy Specialist – Novant Health Family Medicine Residency Program, Cornelius, NC, USA; 3Clinical Pharmacy Specialist – Novant Health Cotswold Family Medicine – Arboretum, Charlotte, NC, USA; 4Clinical Pharmacy Specialist – Piedmont HealthCare Endocrinology, Statesville, NC, USA; 5Clinical Pharmacy Specialist – Cabarrus Family Medicine – Harrisburg, Harrisburg, NC, USA Abstract: Type 1 diabetes mellitus (T1DM) is characterized by relative or absolute insulin deficiency. Despite treatment with insulin therapy, glycemic goals are not always met, and insulin therapy is sometimes limited by adverse effects, including hypoglycemia and weight gain. Several adjunctive therapies have been evaluated in combination with insulin in patients with T1DM to improve glycemic control while minimizing adverse effects. Pramlintide, an amylin analog, can improve glycemic control, primarily through lowering postprandial blood glucose levels. Patients may experience weight loss and an increased risk of hypoglycemia and require additional mealtime injections. Metformin provides an inexpensive, oral treatment option and may reduce blood glucose, especially in overweight or obese patients with minimal risk of hypoglycemia. Metformin may be more effective in patients with impaired insulin sensitivity. Glucagon-like peptide-1 receptor agonists reduce primarily postprandial blood glucose and insulin dose and promote weight loss. They are expensive, cause transient nausea, may increase risk of hypoglycemia and require additional injections. Sodium–glucose transport-2 inhibitors improve glycemic control, promote weight loss and have low risk of hypoglycemia with appropriate insulin adjustment; however, these agents may increase the risk of diabetic ketoacidosis in patients with T1DM. Patient-specific characteristics should be considered when selecting adjunctive therapy for patients with T1DM. Close monitoring, insulin dose adjustments and patient education are all important to ensure safe and effective use of these agents. Keywords: type 1 diabetes mellitus, metformin, amylin, sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, dipeptidyl-peptidase 4 inhibitors
format	article
author	Harris K Boland C Meade L Battise D
author_facet	Harris K Boland C Meade L Battise D
author_sort	Harris K
title	Adjunctive therapy for glucose control in patients with type 1 diabetes
title_short	Adjunctive therapy for glucose control in patients with type 1 diabetes
title_full	Adjunctive therapy for glucose control in patients with type 1 diabetes
title_fullStr	Adjunctive therapy for glucose control in patients with type 1 diabetes
title_full_unstemmed	Adjunctive therapy for glucose control in patients with type 1 diabetes
title_sort	adjunctive therapy for glucose control in patients with type 1 diabetes
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/e5051def92b745d68c60c35f8ddc737b
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_version_	1718398155684315136

Adjunctive therapy for glucose control in patients with type 1 diabetes

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