Published online Apr 15, 2019. doi: 10.4239/wjd.v10.i4.234
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
Processing time: 51 Days and 20.8 Hours
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.