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Reducing Type 1 Diabetes Mortality: Role for Adjunctive Therapies?

Abstract

Individuals with type 1 diabetes (T1D) frequently fail to achieve glycemic goals and have excess cardiovascular risk and premature death. Adjunctive agents may play a role in reducing morbidity, mortality, and the adverse sequelae of insulin treatment. A surge in type 2 diabetes drug development has revealed agents with benefits beyond glucose lowering, including cardiovascular risk reduction. Could these benefits translate to T1D? Specific trials for T1D demonstrate substantial hemoglobin (Hb)A1c reductions with sodium glucose cotransporter inhibitors (SGLTis) and glucagon-like peptide (GLP)1 agonists, and modest improvements with metformin, dipeptidyl peptidase-4 inhibitor (DPP4i), and pramlintide. Studies exploring cardiovascular risk reduction are warranted. This review synthesizes the emerging literature for researchers and clinicians treating people with T1D. Challenges in T1D research are discussed.

Type Journal
ISBN 1879-3061 (Electronic) 1043-2760 (Linking)
Authors Snaith, J. R.; Holmes-Walker, D. J.; Greenfield, J. R.
Responsible Garvan Author Prof Jerry Greenfield
Publisher Name TRENDS IN ENDOCRINOLOGY AND METABOLISM
Published Date 2020-01-04
Published Volume 31
Published Issue 2
Published Pages 150-164
Status Published in-print
DOI 10.1016/j.tem.2019.11.007
URL link to publisher's version https://www.ncbi.nlm.nih.gov/pubmed/31822381