What is the best adjunct therapy for Type 1 diabetes mellitus (T1DM)?
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Are oral hypoglycemic agents effective adjunct therapy for insulin-induced diabetes?
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What is the only treatment for type 1 diabetes?
Anyone who has type 1 diabetes needs lifelong insulin therapy. Types of insulin are many and include: Short-acting (regular) insulin. Rapid-acting insulin.
What new treatments are available for type 1 diabetes?
This is what new treatments – called immunotherapies – will be able to do, by reprogramming the immune system so that it no longer destroys beta cells. In the future, they could stop type 1 diabetes in its tracks or prevent the condition entirely.
What is type 1 diabetes and how is it treated?
If you have type 1 diabetes, you'll need to use insulin to treat your diabetes. You take the insulin by injection or by using a pump. If you have Type 2 diabetes, you may have to use insulin or tablets, though you might initially be able to treat your diabetes by eating well and moving more.
What is the best treatment for Type II diabetes?
Metformin is a tried and tested medicine that has been used for many decades to treat type 2 diabetes, and is recommended by most experts as first-line therapy. It is affordable, safe, effective, and well tolerated by most people. When metformin does not adequately control blood sugar, another medication must be added.Nov 5, 2020
What is the best medicine for type 1 diabetes?
Insulin. Insulin is the most common type of medication used in type 1 diabetes treatment. If you have type 1 diabetes, your body can't make its own insulin. The goal of treatment is to replace the insulin that your body can't make.
Is there any new treatment for diabetes?
Summary: Researchers have discovered a novel and druggable insulin inhibitory receptor, named inceptor. The blocking of inceptor function leads to an increased sensitisation of the insulin signaling pathway in pancreatic beta cells.Jan 27, 2021
How is type 1 diabetes permanently treated?
Right now, there's no cure for diabetes, so people with type 1 diabetes will need treatment for the rest of their lives....Diabetes Treatment Basicstake insulin as prescribed.eat a healthy, balanced diet with accurate carbohydrate counts.check blood sugar levels as prescribed.get regular physical activity.
How can type 1 diabetes be managed?
If you have type 1 diabetes, you'll need to take insulin shots (or wear an insulin pump) every day. Insulin is needed to manage your blood sugar levels and give your body energy. You can't take insulin as a pill. That's because the acid in your stomach would destroy it before it could get into your bloodstream.Mar 11, 2022
When is medication needed for diabetes?
Diabetes medications. If you can't maintain your target blood sugar level with diet and exercise, your doctor may prescribe diabetes medications that help lower insulin levels or insulin therapy.Jan 20, 2021
What is the best and safest medication for type 2 diabetes?
Metformin is still the safest and most effective type 2 diabetes medication, said Bolen.Apr 19, 2016
What is the latest treatment for type 2 diabetes?
FRIDAY, Sept. 20, 2019 (HealthDay News) -- A new pill to lower blood sugar for people with type 2 diabetes was approved by the U.S. Food and Drug Administration on Friday. The drug, Rybelsus (semaglutide) is the first pill in a class of drugs called glucagon-like peptide (GLP-1) approved for use in the United States.Sep 20, 2019
What is the safest medication for type 2 diabetes?
Official Answer. Most experts consider metformin to be the safest medicine for type 2 diabetes because it has been used for many decades, is effective, affordable, and safe. Metformin is recommended as a first-line treatment for type 2 diabetes by the American Diabetes Association (ADA).Jan 20, 2022
What is the GLP-1 receptor agonist?
The GLP-1 receptor agonists, or incretin mimetics, exenatide (BYETTA), exenatide ER (BYDUREON), albiglutide (TANZEUM), dulaglutide (TRULICITY), liraglutide (VICTOZA), and lixisenatide (ADLYXIN) are incretin-based antidiabetic therapies that are FDA-approved as adjunctive therapy to diet and exercise in adult patients with T2DM. Pramlintide (SYMLIN) is the only agent within the amylinomimetic medication class and is FDA-approved as adjunctive therapy in patients with T1DM or T2DM who use mealtime insulin therapy and who have failed to achieve desired glucose control despite optimal insulin therapy.
What RCTs are in progress?
Several RCTs designed to assess the impact of incretin-based therapy on CV outcomes are in progress, including trials with exenatide (EXSCEL, results expected in 2018), albiglutide (results expected in 2019), and dulaglutide (REWIND, results expected in 2019) (ClinicalTrials.gov, 2016).
Is lixisenatide a monotherapy?
Lixisenatide 20 mcg once daily was evaluated as monotherapy, in combination with OADs, and in combination with basal insulin (with or without OADs). Its efficacy was compared with placebo, exenatide, and insulin glulisine. The primary endpoint, the difference in change in HbA1c from baseline to trial end between the lixisenatide and comparator groups, was assessed at varying time points ranging between 12 and 26 weeks.
Does pramlintide lower HBA1C?
The safety and efficacy of pramlintide in patients with T1DM have been established in PC, RCTs when administered in addition to existing insulin regimens. In a 52-week, DB, MC, PC study, pramlintide significantly reduced HbA1c from baseline compared to placebo (-0.39% vs -0.12%; P=0.0071) and was also associated with a significant weight loss compared to placebo (P<0.001) (Whitehouse et al, 2002). In a second 52-week study, patients experienced a significant reduction in HbA1c when receiving pramlintide 60 mcg 3 times daily (-0.41 vs. -0.18%; P=0.012) and pramlintide 60 mcg 4 times daily (-0.39 vs -0.18%; P=0.013) at 26 weeks. Treatment with pramlintide 3 or 4 times daily continued to maintain reductions in HbA1c at 52 weeks compared to treatment with placebo (P=0.011 and P=0.001 for the 3- and 4 times daily dosing, respectively) (Ratner et al, 2004).
Is metformin a second line treatment?
According to current clinical guidelines, metformin remains the cornerstone of most T2DM treatment regimens. The incretin mimetics are recommended as a potential second-line treatment option to be added to metformin in patients not achieving glycemic goals. Clinical guidelines note a lower rate of hypoglycemia, established efficacy and safety profile when used in combination with metformin, demonstrated effectiveness in reducing PPG, and the potential for weight loss as advantages associated with the incretin mimetics compared to other antidiabetic agents. No one incretin mimetic is recommended or preferred over another in the general treatment algorithm; however, the ADA guidelines state that liraglutide and the SGLT2 inhibitor, empagliflozin, should be considered in patients with long-standing suboptimally controlled T2DM and established atherosclerotic CV disease, as they have been shown to reduce CV and all-cause mortality when added to standard care. Current clinical guidelines do not support the use of amylinomimetics in the management of T2DM. Among T1DM patients, the addition of pramlintide to first-line insulin therapy may be considered to enhance glycemic control and to assist with weight management (ADA, 2017; Garber et al, 2017; Inzucchi et al, 2015).
What is macrolide treatment?
A macrolide is an empirical option for the treatment of odontogenic infections in patients. allergic to β-lactam antibiotics. B. While there is a paucity of data demonstrating the efficacy of azithromycin in the.
What are the symptoms of odontogenic infections?
odontogenic infection into surrounding tissue with Signs and symptoms that include. lymphadenitis, trismus, difficulty swallowing or breathing; and less frequently, fever.
Abstract
To assess the efficacy and safety of the SGLT-2 inhibitors as adjunct therapy to insulin in T1DM, clinical trials indexed in PubMed, Cochrane Library, EMbase from inception through April 5, 2016. A meta-analysis was conducted on trials of SGLT-2 inhibitors in patients with T1DM on insulin therapy using RevMan 5.3 software.
Introduction
Diabetes mellitus (DM) is the seventh leading cause of mortality worldwide, with a continually increasing prevalence and incidence 1. Globally, in 2015 the disease prevalence was 415 million adults, with an estimated 318 million people at risk for development of DM, thereby rendering a large burden of disease for the foreseeable future 2.
Materials and Methods
An extensive search for clinical trials in PubMed, EMbase, the Cochrane Library and CENTRRAI (from inception through April 5, 2016) for the terms ‘SGLT2 inhibitor’, ‘Sodium-glucose cotransporter 2 inhibitor’, ‘dapagliflozin’, ‘BMS-512148’, ‘canagliflozin’, ‘JNJ-28431754’, ‘empagliflozin’, ‘BI-10773’, ‘ASP-1941’, ‘ipragliflozin’, ‘tofogliflozin’, ‘remogliflozin’, ‘GSK 189075’, ‘LX4211’, and ‘sergliflozin’ was performed.
Results
As is demonstrated in Fig. 1, a total of 371 articles were identified, 351 of which were determined to be irrelevant based on review of titles and abstracts. Thus, a total of 20 full-text articles were assessed for eligibility.
Discussion
The effective and safe use of oral hypoglycemic agents as adjunct therapy to insulin in T1DM has become a hot topic of interest in recent years. From reports of existing studies, there is an appreciation that any combination must be balanced against AEs, such as hypoglycemia, weight gain, and cardiovascular risk, among others.
Additional Information
How to cite this article: Chen, J. et al. The efficacy and safety of SGLT2 inhibitors for adjunctive treatment of type 1 diabetes: a systematic review and meta-analysis. Sci. Rep. 7, 44128; doi: 10.1038/srep44128 (2017).
Acknowledgements
This research was performed independently of any funding, as part of the institutional activity of the investigators. The authors thank Stanton RC and BioMed Proofreading for English expression polished.