Comparison of the effect on Hyperglycemia and the Adverse Effects among Different GLP-1 Receptor Agonists Added to Basal Insulin and between GLP-1 Receptor Agonists and Basal Insulin Versus Basal-Plus or Basal-Bolus Insulin in Type 2 Diabetes: A Meta-Analysis

2021 ◽  
pp. 147-163
Author(s):  
Andrey Emanuilov Manov ◽  
Ashan Thomas Hatharasinghe ◽  
Katrina Equinox Lopez
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Basal Insulin ◽  
Meta Analysis ◽  
Receptor Agonists ◽  
Bolus Insulin ◽  
Basal Bolus

GLP-1 receptor agonist added to insulin versus basal-plus or basal-bolus insulin therapy in type 2 diabetes: A systematic review and meta-analysis

2018 ◽  
Vol 35 (1) ◽  
pp. e3082 ◽  
Author(s):  
Marco Castellana ◽  
Angelo Cignarelli ◽  
Francesco Brescia ◽  
Luigi Laviola ◽  
Francesco Giorgino
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Receptor Agonist ◽  
Meta Analysis ◽  
Bolus Insulin ◽  
Basal Bolus

scholarly journals Management of Type 2 Diabetes – Methods for Addition of Prandial to Basal Insulin

2014 ◽  
Vol 10 (2) ◽  
pp. 124 ◽  
Author(s):  
Helena W Rodbard ◽  
Boris Karolicki ◽  
◽  
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Multiple Dose ◽  
Treatment Guidelines ◽  
Clinical Inertia ◽  
Dose Titration ◽  
Bolus Insulin ◽  
Basal Bolus

As glycaemic control deteriorates with the progression of type 2 diabetes, treatment guidelines advocate starting basal insulin therapy, and then progressing to a basal–bolus regimen as needed. Nevertheless, although timely intensification of therapy is important to minimise the risk of diabetic complications, considerable clinical inertia exists, not only in the initiation of insulin but also in the progression to multiple-dose insulin regimens. One barrier has been the lack of guidance about how to make the transition from basal-only to basal–bolus insulin therapy. In this review, we discuss how data from the recent FullSTEP study, along with other randomised studies, will help to bridge this gap. Prandial boluses can be added to basal insulin in a stepwise manner, using a straightforward, patient-led dose titration approach and simple estimation of which meal to add the initial prandial bolus to. Reducing the complexity of progression to multiple-dose insulin regimens and empowering patients will lessen the burden on clinicians, improve treatment satisfaction and facilitate timely implementation of treatment guidelines.

SAFETY AND EFFICACY OF DPP-4 INHIBITORS FOR THE MANAGEMENT OF HOSPITALIZED GENERAL MEDICINE AND SURGERY PATIENTS WITH TYPE 2 DIABETES

2020 ◽  
Vol 26 (7) ◽  
pp. 722-728 ◽  
Author(s):  
Cristina Lorenzo-González ◽  
Elena Atienza-Sánchez ◽  
David Reyes-Umpierrez ◽  
Priyathama Vellanki ◽  
Georgia M. Davis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Basal Insulin ◽  
General Medicine ◽  
Insulin Regimen ◽  
Oral Agents ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Bolus Insulin ◽  
Basal Bolus

Objective: DPP-4 inhibitors (DPP-4i) have been shown to be effective for the management of inpatient diabetes. We report pooled data from 3 prospective studies using DPP-4i in general medicine and surgery patients with type 2 diabetes (T2D). Methods: We combined data from 3 randomized studies comparing DPP-4i alone or in combination with basal insulin or a basal-bolus insulin regimen. Medicine (n = 266) and surgery (n = 319) patients admitted with a blood glucose (BG) between 140 and 400 mg/dL, treated with diet, oral agents, or low-dose insulin therapy were included. Patients received DPP-4i alone (n = 144), DPP-4i plus basal insulin (n = 158) or basal-bolus regimen (n = 283). All groups received correctional doses with rapid-acting insulin for BG >140 mg/dL. The primary endpoint was differences in mean daily BG between groups. Secondary endpoints included differences in hypoglycemia and hospital complications. Results: There were no differences in mean hospital daily BG among patients treated with DPP-4i alone (170 ± 37 mg/dL), DPP-4i plus basal (172 ± 42 mg/dL), or basalbolus (172 ± 43 mg/dL), P = .94; or in the percentage of BG readings within target of 70 to 180 mg/dL (63 ± 32%, 60 ± 31%, and 64 ± 28%, respectively; P = .42). There were no differences in length of stay or complications, but hypoglycemia was less common with DPP-4i alone (2%) compared to DPP-4i plus basal (9%) and basal-bolus (10%); P = .004. Conclusion: Treatment with DPP-4i alone or in combination with basal insulin is effective and results in a lower incidence of hypoglycemia compared to a basal-bolus insulin regimen in general medicine and surgery patients with T2D. Abbreviations: BG = blood glucose; BMI = body mass index; CI = confidence interval; DPP-4i = dipeptidyl peptidase-4 inhibitors; HbA1c = hemoglobin A1c; OR = odds ratio; T2D = type 2 diabetes

scholarly journals Switching From Insulin Bolus Treatment to GLP-1 RAs Added to Continued Basal Insulin in People With Type 2 Diabetes on Basal-Bolus Insulin

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. 2333-2335 ◽  
Author(s):  
Geremia B. Bolli ◽  
Francesca Porcellati ◽  
Juris J. Meier
Keyword(s):  
Type 2 Diabetes ◽  
Basal Insulin ◽  
Bolus Insulin ◽  
Basal Bolus
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