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Review
. 2016 Sep;32(6):497-511.
doi: 10.1002/dmrr.2775. Epub 2016 Mar 30.

Treatment intensification in patients with inadequate glycemic control on basal insulin: rationale and clinical evidence for the use of short-acting and other glucagon-like peptide-1 receptor agonists

Francesco Giorgino  1 , Riccardo C Bonadonna  2 , Sandro Gentile  3 , Roberto Vettor  4 , Paolo Pozzilli  5
Affiliations
Review

Treatment intensification in patients with inadequate glycemic control on basal insulin: rationale and clinical evidence for the use of short-acting and other glucagon-like peptide-1 receptor agonists

Francesco Giorgino et al. Diabetes Metab Res Rev. 2016 Sep.

Abstract

A substantial proportion of patients with type 2 diabetes mellitus do not reach glycemic targets, despite treatment with oral anti-diabetic drugs and basal insulin therapy. Several options exist for treatment intensification beyond basal insulin, and the treatment paradigm is complex. In this review, the options for treatment intensification will be explored, focusing on drug classes that act via the incretin system and paying particular attention to the short-acting glucagon-like peptide-1 receptor agonists exenatide and lixisenatide. Current treatment guidelines will be summarized and discussed. © 2016 The Authors. Diabetes/Metabolism Research and Reviews Published by John Wiley & Sons Ltd.

Keywords: GLP-1 receptor agonist; algorithms; exenatide; intensification; latent autoimmune diabetes in adults (LADA); lixisenatide.

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Figures

Figure 1
Figure 1
Options for intensification of basal insulin treatment and strategies for the use of glucagon‐like peptide‐1 receptor agonists
Figure 2
Figure 2
Effects on (A) the 7‐point glycemic profile and (B) body weight of the combination of exenatide twice daily and basal insulin compared with basal insulin alone
Figure 3
Figure 3
Meta‐analysis showing the likelihood of patients reaching the composite endpoint of glycated haemoglobin levels <7% with no symptomatic hypoglycemia and no weight gain
See this image and copyright information in PMC

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