Advances in
Second generation basal insulins have demonstrated clinical advantages over first-generation insulins, including less nocturnal hypoglycemia and greater dosing flexibility. Fixed-ratio combinations of basal insulin and GLP-1 RA provide effective glycemic control with a reduced hypoglycemia risk, mitigation of weight gain, and improved tolerability in T2DM. For T1DM, adjunctive non-insulin glucose-lowering agents may enable patients to achieve glycemic control with lower insulin doses, less hypoglycemia, glucose variability and weight gain. Education is needed to identify patients benefitting most from these novel therapies.
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Associate Professor, Department of Medicine, Universitat Autonoma de Barcelona; Director, Saint Martí Primary Health Centres (Catalonian National Health Service); Chairman, Primary Care Diabetes Europe, Barcelona, Spain
Professor of Diabetes Medicine, Diabetes Research Unit, University of Leicester; Honorary Consultant Physician, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Chief Executive Officer, Principal Investigator, National Research Institute, Los Angeles, California, United States
Professor, Department of Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, Ontario, Canada
Head of Department, Professor of Primary Care Diabetes and Vascular Medicine, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom
Professor of Internal Medicine; Head, Division of Endocrinology and Diabetes, Städtisches Klinikum, Munich, Germany
Verne S. Caviness Distinguished Professor; Chief, Division of Endocrinology; Director, North Carolina Translational and Clinical Sciences Institute; Executive Associate Dean, Clinical Research; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Professor, Hannover Medical School, Director, Children's Hospital AUF DER BULT, Hannover, Germany
Professor
University of Dundee
Dundee, United Kingdom
Freemantle N, Chou E, Frois C, et al. Safety and efficacy of insulin glargine 300 u/mL compared with other basal insulin therapies in patients with type 2 diabetes mellitus: a network meta-analysis. BMJ Open. 2016;6:e009421.
Aroda V, Rosenstock J, Wysham C, et al. Efficacy and safety of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide in type 2 diabetes inadequately controlled on basal insulin and metformin: the LixiLan-L randomized trial. Diabetes Care. 2016;39:1972-1980.
Rosenstock J, Aronson R, Grunberger G, et al. Benefits of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide, versus insulin glargine and lixisenatide monocomponents in type 2 diabetes inadequately controlled with oral agents: the LixiLan-O randomized trial. Diabetes Care. 2016;39:2026-2035.
Anderson SL, Trujillo JM. Basal insulin use with GLP-1 receptor agonists. Diabetes Spectr. 2016; 29:152–160.
Dalal MR, Kazemi M, Ye F, et al. Hypoglycemia after initiation of basal insulin in patients with type 2 diabetes in the United States: implications for treatment discontinuation and healthcare costs and utilization. Adv Ther. 2017;34:2083-2092.
Zhou FL, Ye F, Gupta V, et al. Lower risk of hypoglycemia after switch to insulin glargine 300 U/Ml (Gla-300) vs other basal insulins in patients with type 2 diabetes (T2D) on basal insulin in real-world clinical settings (DELIVER 2 study). 2017 Endocrine Society Annual Meeting. Poster presentation LB SUN 81.
Zhou FL, Ye F, Gupta V, et al. Older adults with type 2 diabetes (T2D) experience less hypoglycemia when switching to insulin glargine 300 u/mL (Gla-300) versus other basal insulins (DELIVER 3 study). ADA 77th Scientific Sessions, 2017. Abstract 986-P.
Schultes B, Tentolouris N, Knudesen ST, et al. Switching to insulin degludec improves glycemic control in patients with T2D in a real-world setting. ADA 77th Scientific Sessions, 2017. Abstract 1010-P.
Rosenstock J, Ampudia-Blasco F, Giorgino F, et al. Simultaneous vs sequential combination of insulin glargine and lixisenatide in type 2 diabetes uncontrolled on metformin. Abstract presented at the 53rd Annual Meeting of EASD; September 11-15, 2017; Lisbon, Portugal. Abstract 795.
Frias JP, Domingo MP, Meneghini L, et al. Shorter time to glycemic control with fixed-ratio combination of insulin glargine and lixisenatide compared with insulin glargine treatment alone. Abstract presented at the 53rd Annual Meeting of EASD; September 11-15, 2017; Lisbon, Portugal. Abstract 803.
New Horizons in Type 1 Diabetes Management
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