Recent developments in adjunct therapies for type 1 diabetes

Timmons, J. G. , Littlejohn, L., Boyle, J. G. and Petrie, J. R. (2022) Recent developments in adjunct therapies for type 1 diabetes. Expert Opinion on Investigational Drugs, 31(12), pp. 1311-1320. (doi: 10.1080/13543784.2022.2159806) (PMID:36655950)

Abstract

Introduction: There have been many recent advances in the treatment of type 1 diabetes (T1D) including in insulin formulations, continuous glucose monitoring (CGM) technology and automated insulin delivery. However, long-term optimal glycemic control is still only achieved in a minority. Areas covered: Adjunct therapy – the use of therapeutic agents other than insulin – is one strategy aimed at improving outcomes. An ideal adjunct agent would improve glycemic control, reduce weight (or weight gain), reduce insulin requirement and prevent complications (e.g. cardiorenal) without increasing hypoglycemia. The amylin analogue pramlintide has been licensed in the USA, while the sodium glucose co-transporter-2 inhibitor (SGLT2i) dapagliflozin, was briefly (2019 − 2021) licensed for type 1 diabetes in Europe and the UK. However, other agents from the type 2 diabetes (T2D) arena including metformin, other SGLT2is, glucagon-like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-IV (DPP-4) inhibitors have been investigated. Expert opinion: As evidence emerges for cardiorenal protection by SGLT2is and GLP-1RAs in T2D, it has become increasingly important to know whether people with T1D can also benefit. Here, we review recent trials of adjunct agents in T1D and discuss the efficacy and safety of these agents (alone and in combination) in an era in which continuous glucose monitoring is becoming standard of care.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Boyle, Dr James and Timmons, Dr Joseph and Littlejohn, Dr Lucy and Petrie, Professor John
• Authors: Timmons, J. G., Littlejohn, L., Boyle, J. G., and Petrie, J. R.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Expert Opinion on Investigational Drugs
• Publisher: Taylor & Francis
• ISSN: 1354-3784
• ISSN (Online): 1744-7658
• Published Online: 19 January 2023
• Copyright Holders: Copyright © 2023 The Author(s)
• First Published: First published in Expert Opinion on Investigational Drugs 31(12):1311-1320
• Publisher Policy: Reproduced under a Creative Commons license