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Chapter-014e Insulin and GLP1 RA Combinations

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Varthakavi Premlata K
ISBN
9789351526476
DOI
10.5005/jp/books/12535_20
Edition
2/e
Publishing Year
2015
Pages
8
Author Affiliations
1. TN Medical College, Mumbai, Maharashtra, India, TNM College and BYL Nair Charitable Hospital, Dr AL Nair road Mumbai Central, Mumbai, Maharashtra, India, TNM College and BYL Nair Ch Hospital, Mumbai, Maharashtra, India
Chapter keywords
Type-2 diabetes mellitus, oral antidiabetic drugs, GLP-1-RA, hypoglycemia, postprandial glycemic control

Abstract

Type-2 diabetes mellitus (T2DM) results in reduced insulin secretion and there is a need for a proactive, multifactorial approach to manage T2DM. Combinations of oral antidiabetic drugs (OADs) are accepted as second line treatment step or as dual and triple combination therapy. Exogenous Insulin therapy deals only with secretory component of the pathophysiology of T2DM. Glucagon-like peptide-1receptor agonists repress the secretion and decrease the prandial glucose excursions. Positive result of the combination of GLP-1-RA and insulin was confirmed by several retrospective studies and proves for the different techniques are also discussed in this chapter. Effect on insulin dose, effect on body weight and effects on lipids and cardiovascular risk are discussed in this chapter. Hypoglycemia is found to be an unlikely adverse event when GLP-1-RAs are used alone. Unanswered issues regarding combination therapy should be discussed since they have great deal of promise in the future.

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