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

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

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.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Evidence-Based Medicine
  • Glucagon-Like Peptide Receptors / agonists*
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin / therapeutic use*
  • Treatment Outcome

Substances

  • Glucagon-Like Peptide Receptors
  • Hypoglycemic Agents
  • Insulin