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Exploring the Nuances of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 1 Diabetes Management

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Dr. Jessica Nelson
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Exploring the Nuances of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 1 Diabetes Management

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Potential Benefits and Risks of SGLT2 Inhibitors and GLP-1 Receptor Agonists

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Experts Susan Weiner, MS, RDN, CDCES, FADCES, and Joshua J. Neumiller, PharmD, CDCES, FADCES, FASCP, have recently discussed the potential benefits and risks of using SGLT2 inhibitors and GLP-1 receptor agonists in type 1 diabetes management. These drugs are increasingly being considered as add-on therapies to insulin for their potential benefits. These include improved glycemia, insulin-sparing effects, weight loss, and reductions in HbA1c. However, like all pharmaceuticals, it's crucial to understand the risks of using these agents off-label, including the risk of diabetic ketoacidosis, hypoglycemia, and other adverse effects.

Improved Cardiovascular Outcomes with GLP1RA or SGLT2i Addition

A cohort study in veterans with diabetes reported on ncbi.nlm.nih.gov supports the potential benefits of these drugs. The study tested the hypothesis that the incidence of MACE was lower with the addition of GLP1RA or SGLT2i compared to DPP4i for primary prevention. The results concluded that the addition of GLP1RA was associated with primary reductions of MACE and HF hospitalization compared with DPP4i use.

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Importance of Re-evaluating Glucose-Lowering Treatments

Another study in Denmark found that with increasing age, there was relatively less use of metformin, GLP-1 receptor agonists, and SGLT2 inhibitors. Instead, there was an increased use of basal insulin, DDP-4 inhibitors, and sulphonylureas. This research emphasizes the importance of frequently re-evaluating glucose-lowering treatments to avoid potential overtreatment of some older individuals with sulphonylureas or insulin.

The Role of Sleep in Diabetes Management

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Interestingly, a study found that lower sleep efficiency linked to higher HbA1c and insulin resistance in adolescents and young adults with type 1 diabetes. This study underscores the importance of addressing sleep-related factors as part of diabetes care and management strategies for overall health.

Understanding GLP-1 Receptor Agonists

Elsevier.health provides an overview of glucagon-like peptide 1 (GLP-1) receptor agonists. The page discusses their pharmacology, mechanism of action, therapeutic use, comparative efficacy, and adverse reactions. The clinical data demonstrates that GLP-1 receptor agonists help restore insulin secretory functions and improve glycemic control while reducing body weight in patients with T2DM.

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The Future of Diabetes Treatment in Children and Adolescents

Finally, an article discusses advancements in pharmacotherapy options for treating diabetes in children and adolescents. While the full content requires a subscription, it is evident the medical community is actively evolving its approach to managing diabetes in younger populations.

Conclusion

While the benefits of SGLT2 inhibitors and GLP-1 receptor agonists in managing type 1 diabetes are clear, it's equally important to understand the potential risks of their off-label use. In addition, re-evaluating glucose-lowering treatments frequently and addressing sleep-related factors are crucial aspects of diabetes care. As always, medical professionals should stay on top of the latest research and developments in the field to provide the best care for their patients.

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