Karras SN, Koufakis T, Zebekakis P, Kotsa K. Pharmacologic adjunctive to insulin therapies in type 1 diabetes: The journey has just begun. World J Diabetes 2019; 10(4): 234-240 [PMID: 31040899 DOI: 10.4239/wjd.v10.i4.234]
Corresponding Author of This Article
Spyridon N Karras, MD, PhD, Academic Fellow, Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 55535, Greece. karraspiros@yahoo.gr
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Apr 15, 2019; 10(4): 234-240 Published online Apr 15, 2019. doi: 10.4239/wjd.v10.i4.234
Pharmacologic adjunctive to insulin therapies in type 1 diabetes: The journey has just begun
Spyridon N Karras, Theocharis Koufakis, Pantelis Zebekakis, Kalliopi Kotsa
Spyridon N Karras, Theocharis Koufakis, Pantelis Zebekakis, Kalliopi Kotsa, Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 55535, Greece
Author contributions: Karras SN and Koufakis T conceived the study, reviewed the literature and drafted the manuscript; Zebekakis P and Kotsa K reviewed the literature and revised the manuscript; all authors approved the final version of the article.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Spyridon N Karras, MD, PhD, Academic Fellow, Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 55535, Greece. karraspiros@yahoo.gr
Telephone: +30-693-2412914
Received: February 24, 2019 Peer-review started: February 26, 2019 First decision: March 11, 2019 Revised: March 13, 2019 Accepted: March 26, 2019 Article in press: March 26, 2019 Published online: April 15, 2019
Abstract
Treatment of type 1 diabetes (T1D) is currently based exclusively on insulin replacement therapy. However, there is a need for better glycemic control, lower hypoglycemia rates, more effective weight management, and further reduction of cardiovascular risk in people with T1D. In this context, agents from the pharmaceutical quiver of type 2 diabetes are being tested in clinical trials, as adjunctive to insulin therapies for T1D patients. Despite the limited amount of relevant evidence and the inter-class variability, it can be said that these agents have a role in optimizing metabolic control, assisting weight management and reducing glycemic variability in people with T1D. Specific safety issues, including the increased risk of hypoglycemia and diabetic ketoacidosis, as well as the effects of these treatments on major cardiovascular outcomes should be further assessed by future studies, before these therapeutic choices become widely available for T1D management.
Core tip: Adjunctive to insulin therapies in type 1 diabetes (T1D) may have a role in optimizing metabolic control, assisting weight management and reducing glycemic variability. Specific safety issues should be further assessed by future studies, before these therapeutic choices become widely available for T1D management.
