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

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Ethan Sulliva
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Exploring the Use of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Type 1 Diabetes

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Understanding SGLT2 Inhibitors and GLP-1 Receptor Agonists in the Context of Type 1 Diabetes

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As the world of diabetes management evolves, the use of non-insulin agents such as SGLT2 inhibitors and GLP-1 receptor agonists are increasingly entering the conversation, especially in relation to type 1 diabetes. A recent discussion between Susan Weiner, MS, RDN, CDCES, FADCES, and Joshua J. Neumiller, PharmD, CDCES, FADCES, FASCP, provides crucial insights into the potential benefits and risks of these agents.

Navigating the Potential Benefits and Risks

Despite the potential benefits of SGLT2 inhibitors and GLP-1 receptor agonists, there are several risks associated with their use. The effectiveness of these agents in preventing major adverse cardiac events (MACE) for those without pre-existing cardiovascular disease remains uncertain. This uncertainty underlines the importance of an individualized approach to treatment, taking into consideration the specific needs and circumstances of each patient.

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Insights from Recent Studies

A retrospective cohort study of US veterans from 2001-2019 provides further insight into this topic. The study found that the addition of GLP-1 receptor agonists was associated with lower MACE and heart failure compared to dipeptidyl peptidase 4 inhibitors. Interestingly, the study did not find a significant association between SGLT2 inhibitors and MACE prevention. This highlights the need for further research to fully understand the role of these agents in diabetes management and cardiovascular disease prevention.

The Off-Label Use of These Drugs

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Despite the uncertain benefits and potential risks, there has been an increase in the off-label use of these drugs. This trend underscores the need for further research and evidence-based guidelines to ensure the safe and effective use of SGLT2 inhibitors and GLP-1 receptor agonists in patients with type 1 diabetes.

A Glimpse into the Future: Teplizumab

Looking ahead, the FDA-approved teplizumab, an anti-CD3 antibody, shows promise in delaying the onset of type 1 diabetes in at-risk individuals. As we continue to explore the potential of non-insulin agents in diabetes management, the development of such therapies provides hope for improved prevention and treatment strategies in the future.

Conclusion

In conclusion, the use of SGLT2 inhibitors and GLP-1 receptor agonists in type 1 diabetes presents potential benefits, but also comes with certain risks. It is crucial that healthcare professionals remain informed about the latest research and developments in this area, to ensure that patients receive the most effective and appropriate care. As we look to the future, therapies like teplizumab offer exciting possibilities for delaying disease onset and improving the lives of those at risk of developing type 1 diabetes.

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