DIABETES AND THE ENDOCRINE PANCREAS I: Edited by David M. HarlanThe changing therapeutic armamentarium for patients with type 1 diabetesComee, Morgan; Peters, Anne Author Information MCPHS University, Keck School of Medicine, University of Southern California Correspondence to Morgan Comee, PharmD, CDE, MCPHS University 19 Foster St Worcester, MA 01609, USA. Tel: +1 508 373 5630; e-mail: [email protected] Current Opinion in Endocrinology & Diabetes and Obesity: April 2016 - Volume 23 - Issue 2 - p 106-110 doi: 10.1097/MED.0000000000000239 Buy Metrics Abstract Purpose of review This article evaluates the role of Sodium glucose co-transporter-2 (SGLT-2) inhibitor and Glucagon-like peptide-1 receptor agonist's (GLP-1 RA's)s in the treatment of type 1 diabetes (T1D). Recent findings Both agents help to produce a small reduction in HbA1C levels with accompanying weight loss. Submaximal doses of SGLT-2 inhibitors may reduce the risk for hypoglycemia as well as limit glycemic variability. However, SGLT-2 inhibitors appear to increase rates of ketone body production and diabetic ketoacidosis, and therefore must only be used in the setting of appropriate risk mitigation. GLP-1 RA's increased the risk for hypoglycemia in the largest clinical trial done to date (with a small fall in A1C), which lead to a cessation of the development of liraglutide as a treatment for T1D. Summary Off-label use of medications designed for individuals with type 2 diabetes in people with T1D has potential benefits as well as risks. If using an SGLT-2 inhibitor or a GLP-1 RA, it is important to have an informed, educated patient and follow a specific protocol. In the case of SGLT-2 inhibitors, clinical trials should help define how to use these agents more safely and effectively in T1D. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
