Non-insulin pharmacological therapies for treating type 1 diabetes

Research output: Contribution to journalReviewResearchpeer-review

Christian Seerup Frandsen, Thomas Fremming Dejgaard, Sten Madsbad, Jens Juul Holst

Introduction: Despite intensified insulin treatment, many persons with type 1 diabetes (T1D) do not achieve glycemic and metabolic targets. Consequently, non-insulin chemical therapies that improve glycemic control and metabolic parameters without increasing the risk of adverse events (including hypoglycemia) are of interest as adjunct therapies to insulin.Areas covered: In this review, the authors discuss the efficacy and safety of non-insulin therapies, including pramlintide, glucagon-like peptide-1 (GLP-1) receptor agonists, dipeptidyl peptidase-4 inhibitors (DPP-4), sodium-glucose cotransporter (SGLT1 and SGLT2) inhibitors, metformin, sulfonylureas, and thiazolidinediones as add-on therapies to insulin in T1D.Expert opinion: The current evidence shows that the efficacy of non-insulin therapies as add-on therapies to insulin is minimal or modest with an average HbA1c reduction of 0.2-0.5% (2-6mmol/mol). Indeed, the current focus is on the development of SGLT inhibitors as adjuncts to insulin in type 1 diabetes. Studies of subgroups with obesity, residual beta-cell function (including newly diagnosed patients) and patients prone to hypoglycemia could be areas of future research.
Original languageEnglish
JournalExpert Opinion on Pharmacotherapy
Volume19
Issue number9
Pages (from-to)947-960
ISSN1465-6566
DOIs
Publication statusPublished - 2018

    Research areas

  • Type 1 diabetes, T1DM, T1D, pramlintide, amylin, glucagon-like peptide-1, GLP-1RA, dipeptidyl peptidase-4 inhibitor, DPP-4, sodium-glucose cotransporters, SGLT-1, SGLT-2, metformin, sulfonylurea, SU, thiazolidinediones, TZD

ID: 213159433