Introduction: Therapy for type 1 diabetes (T1D) is mainly restricted to insulin treatment. The management of paediatric patients with T1D should tackle not only glucose control, but also insulin resistance, beta-cell preservation, quality of life and cardiovascular disease risk factors, which are increasingly recognized to occur in adolescents with T1D.
Areas covered: This review examines the recently published literature from PubMed on non-insulin agents for the management of T1D in paediatric patients.
Expert opinion: Few paediatric patients with T1D are achieving their metabolic targets. Current data support the need for new strategies and the consideration of additional therapies that not only may help patients, their families and their physicians to meet HbA1c targets, but also may preserve residual islet mass and good quality of life and prevent microvascular and macrovascular complications, thereby, reducing hypoglycaemic episodes. Non-insulin adjunctive therapies may improve not only glucose control, but also insulin sensitivity, in addition to preserving beta-cell function in T1D patients. Thus, more studies are required to define the potential role of these therapies in the management of paediatric patients.
Keywords: DPP-4 inhibitors; GLP-1 receptor agonists; Paediatric patients; SGLT-2 inhibitors; adolescents; beta cell function; children; insulin; metformin; type 1 diabetes.