Adjunctive therapies in type 1 diabetes mellitus

Area of Science:

• Endocrinology
• Metabolic Diseases
• Pharmacology

Background:

• Type 1 diabetes mellitus (T1DM) involves immune-mediated beta-cell destruction, necessitating insulin therapy.
• Despite advancements, achieving optimal glycemic control in T1DM remains a significant clinical challenge.
• Adjunctive therapies are being explored to supplement insulin and improve T1DM management.

Purpose of the Study:

• To review the risks and benefits of adjunctive therapies for type 1 diabetes care.
• To highlight therapies that may enhance glycemic control and reduce insulin requirements.
• To assess the current landscape of FDA-approved and off-label adjunctive treatments in T1DM.

Main Methods:

• Literature search for clinical outcome studies of adjunctive therapies in T1DM.
• Inclusion of both FDA-approved and off-label therapeutic options.
• Review focused on metformin, pramlintide, GLP-1 receptor agonists, and SGLT2 inhibitors.

Main Results:

• Adjunctive therapies can improve glycemic control, decrease insulin dosage, and promote weight loss in T1DM.
• Potential risks include increased hypoglycemia, gastrointestinal issues, and diabetic ketoacidosis.
• Pramlintide is the sole FDA-approved adjunctive therapy; others warrant further investigation.

Conclusions:

• Adjunctive therapies offer potential benefits for T1DM management beyond insulin.
• Careful risk-benefit assessment is crucial for implementing these treatments.
• Further research is needed to establish the long-term safety and efficacy of non-FDA-approved adjunctive therapies in T1DM.