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Posted by on Dec 24, 2018 in Diabetes mellitus | 0 comments

In a nutshell

This study aimed to see if non-insulin diabetic drugs could improve weight loss and blood glucose control in patients with type 1 diabetes (T1D). The main finding of the study was that non-insulin diabetic drugs may be of some benefit to overweight patients with T1D.

Some background

T1D is treated with insulin. However, the side effects of insulin therapy include weight gain and hypoglycemia (blood sugar going dangerously low). Therefore, the number of people with T1D who are overweight is increasing. Being overweight can make it harder to control blood glucose and increases the risk of heart disease.

There are several different classes of non-insulin medications that lower blood sugar. These are mainly used in the treatment of type 2 diabetes (T2D). Some of these also help with weight loss. It is unknown whether adding non-insulin diabetic medications can help with weight loss and blood glucose control in overweight patients with T1D.

Methods & findings

This study analyzed the data from 32 different trials. These trials investigated the effect of different classes of non-insulin diabetic drugs on weight loss and blood sugar control in patients with T1D.

Amylin mimetics, SGLT-2 inhibitors, and GLP-1 inhibitors demonstrated the greatest improvement in body weight and blood sugar control.

Treatment with amylin mimetics (drugs that stop blood sugar spikes after meals) resulted in weight reduction and lower doses of insulin required. However, some trials showed increased nausea, vomiting and hypoglycemia with amylin mimetics.

SGLT2 inhibitors (drugs that remove glucose from the body through the urine) showed significant improvements in body weight and blood glucose control. However, there was a significantly increased risk of diabetic ketoacidosis (dangerous complication where blood sugar becomes too high and blood becomes acidic) with these medications.

GLP-1 receptor agonists (drugs that increase insulin release in the body) effectively reduced body weight and insulin doses and improved blood glucose control. However, there was an increase in the risk of gastrointestinal effects, hypoglycemia and diabetic ketoacidosis.

The bottom line

The authors concluded that adding non-insulin diabetic drugs may benefit overweight patients with T1D. However, this comes with a risk of dangerous side effects such as hypoglycemia and diabetic ketoacidosis.

The fine print

Amylin mimetics are the only non-insulin diabetic drug licensed in the treatment of T1D.

Published By :

The Annals of pharmacotherapy

Date :

Dec 05, 2018

Original Title :

Adjunct Antihyperglycemic Agents in Overweight and Obese Adults With Type 1 Diabetes.

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