American Association of Clinical Endocrinologists' Comprehensive Diabetes Management Algorithm 2013 Consensus Statement - Executive Summary

Garber, Alan J.; Abrahamson, Martin J.; Barzilay, Joshua I.; Blonde, Lawrence; Bloomgarden, Zachary T.; Bush, Michael D.; Dagogo‐Jack, Samuel; Davidson, Michael; Einhorn, Daniel; Garvey, W. Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B.; Jellinger, Paul S.; McGill, Janet B.; Mechanick, Jeffrey I.; Rosenblit, Paul D.; Umpiérrez, Guillermo E.; Davidson, Michael

doi:10.4158/ep13176.cs

Cited by 222 publications

(194 citation statements)

References 105 publications

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“…Several prandial agents have been shown to help patients with T2D achieve HbA 1c targets when given in combination with basal insulin (4,(38)(39)(40)(41)(42)(43), and treatment intensification with a rapidacting insulin on top of basal insulin is commonly recommended for control of PPG excursions (2,44). However, more intensive insulin regimens are associated with hypoglycemia and weight gain, which can result in poor treatment acceptance and reduced compliance (45)(46)(47)(48).…”

Section: Monitoring Of Pancreatic Enzymesmentioning

confidence: 99%

Contrasting Effects of Lixisenatide and Liraglutide on Postprandial Glycemic Control, Gastric Emptying, and Safety Parameters in Patients With Type 2 Diabetes on Optimized Insulin Glargine With or Without Metformin: A Randomized, Open-Label Trial

et al. 2015

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OBJECTIVEThis mechanistic trial compared the pharmacodynamics and safety of lixisenatide and liraglutide in combination with optimized insulin glargine with/without metformin in type 2 diabetes (T2D). RESEARCH DESIGN AND METHODSThis was a multicenter, randomized, open-label, three-arm trial comparing lixisenatide 20 mg and liraglutide 1.2 and 1.8 mg once daily for 8 weeks in combination with insulin glargine after optimized titration. The primary end point was change from baseline to week 8 in incremental area under the postprandial plasma glucose curve for 4 h after a standardized solid breakfast (AUC PPG 0030-0430 h ). Changes from baseline in gastric emptying, 24-h plasma glucose profile, HbA 1c , fasting plasma glucose (FPG), 24-h ambulatory heart rate and blood pressure, amylase and lipase levels, and adverse events (AEs) were also assessed. 2) h · mg/dL] vs. liraglutide 1.8 mg; P < 0.001 for both), and gastric emptying was delayed to a greater extent than with liraglutide 1.2 and 1.8 mg (P < 0.001 for treatment comparisons). FPG was unchanged in all treatment arms. At week 8, mean 6 SD HbA 1c was 6.2 6 0.4% (44 6 5 mmol/mol), 6.1 6 0.3% (44 6 4 mmol/mol), and 6.1 6 0.3% (44 6 4 mmol/mol) for lixisenatide 20 mg and liraglutide 1.2 and 1.8 mg, respectively. At week 8, both liraglutide doses increased marginal mean 6 SE 24-h heart rate from baseline by 9 6 1 bpm vs. 3 6 1 bpm with lixisenatide (P < 0.001). Occurrence of symptomatic hypoglycemia was higher with lixisenatide; gastrointestinal AEs were more common with liraglutide. Lipase levels were significantly increased from baseline with liraglutide 1.2 and 1.8 mg (marginal mean 6 SE increase 21 6 7 IU/L for both; P < 0.05). CONCLUSIONSLixisenatide and liraglutide improved glycemic control in optimized insulin glargine-treated T2D albeit with contrasting mechanisms of action and differing safety profiles.

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Section: Monitoring Of Pancreatic Enzymesmentioning

confidence: 99%

Contrasting Effects of Lixisenatide and Liraglutide on Postprandial Glycemic Control, Gastric Emptying, and Safety Parameters in Patients With Type 2 Diabetes on Optimized Insulin Glargine With or Without Metformin: A Randomized, Open-Label Trial

et al. 2015

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“…Before insulin treatment, clinical guidelines generally recommend metformin as first‐line therapy for patients with T2DM, but the ideal drug sequence after metformin failure remains unclear 17, 18. Both sulphonylureas and dipeptidyl peptidase‐4 (DPP‐4) inhibitors are commonly prescribed with metformin as dual therapy for the treatment of T2DM.…”

Section: Introductionmentioning

confidence: 99%

Progression to insulin therapy among patients with type 2 diabetes treated with sitagliptin or sulphonylurea plus metformin dual therapy

Inzucchi

Tunceli

Qiu

et al. 2015

Diabetes Obesity Metabolism

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AimTo assess time to insulin initiation among patients with type 2 diabetes mellitus (T2DM) treated with sitagliptin versus sulphonylurea as add‐on to metformin.MethodsThis retrospective cohort study used GE Centricity electronic medical records and included patients aged ≥18 years with continuous medical records and an initial prescription of sitagliptin or sulphonylurea (index date) with metformin for ≥90 days during 2006–2013. Sitagliptin and sulphonylurea users were matched 1 : 1 using propensity score matching, and differences in insulin initiation were assessed using Kaplan–Meier curves and Cox regression. We used conditional logistic regression to examine the likelihood of insulin use 1–6 years after the index date for each year.ResultsPropensity score matching produced 3864 matched pairs. Kaplan–Meier analysis showed that sitagliptin users had a lower risk of insulin initiation compared with sulphonylurea users (p = 0.003), with 26.6% of sitagliptin users initiating insulin versus 34.1% of sulphonylurea users over 6 years. This finding remained significant after adjusting for baseline characteristics (hazard ratio 0.76, 95% confidence interval 0.65–0.90). Conditional logistic regression analyses confirmed that sitagliptin users were less likely to initiate insulin compared with sulphonylurea users [odds ratios for years 1–6: 0.77, 0.79, 0.81, 0.57, 0.29 and 0.75, respectively (p < 0.05 for years 4 and 5)].ConclusionsIn this real‐world matched cohort study, patients with T2DM treated with sitagliptin had a significantly lower risk of insulin initiation compared with patients treated with sulphonylurea, both as add‐on to metformin.

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“…Renal insufficiency is a common comorbidity in patients with type 2 diabetes, and the prevalence of chronic kidney disease (CKD) in patients with type 2 diabetes has been increasing (1), with the reported overall incidence of renal impairment in patients with type 2 diabetes ranging from 15 to 35% (based on estimated glomerular filtration rate [eGFR] ,60 mL/min/1.73 m 2 ) (2-4). Current treatment options for glycemic control are significantly limited for patients with type 2 diabetes and CKD (5,(8)(9)(10)(11), which often leads to the introduction of sulfonylurea and insulin therapy to maintain glycemic control. Further, therapeutic options for glycemic control can be associated with significant risks of hypoglycemia, weight gain, and fluid retention, which may add to the complexity of maintaining blood glucose, body weight, and blood pressure in this population (12)(13)(14)(15).…”

mentioning

confidence: 99%

Efficacy and Safety of the Once-Weekly GLP-1 Receptor Agonist Albiglutide Versus Sitagliptin in Patients With Type 2 Diabetes and Renal Impairment: A Randomized Phase III Study

et al. 2014

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OBJECTIVETo evaluate weekly subcutaneous albiglutide versus daily sitagliptin in renally impaired patients with type 2 diabetes and inadequately controlled glycemia on a regimen of diet and exercise and/or oral antihyperglycemic medications. RESEARCH DESIGN AND METHODSIn this phase III, randomized, double-blind, multicenter, 52-week study, the primary study end point was HbA 1c change from baseline at week 26 in patients with renal impairment, as assessed with estimated glomerular filtration rate and categorized as mild, moderate, or severe ( ‡60 to £89, ‡30 to £59, and ‡15 to £29 mL/min/1.73 m 2 , respectively). Secondary end points included fasting plasma glucose (FPG), weight, achievement of treatment targets, hyperglycemic rescue, and safety. RESULTSBaseline demographics were similar across treatment and renal impairment groups with overall mean age of 63.3 years, BMI of 30.4 kg/m 2 , HbA 1c of 8.2% (66 mmol/mol), and diabetes disease duration of 11.2 years. HbA 1c change from baseline at week 26 was significantly greater for albiglutide than sitagliptin (20.83% vs. 20.52%, P = 0.0003). Decreases in HbA 1c , FPG, and weight were seen through week 52. Time to hyperglycemic rescue through week 52 was significantly longer for albiglutide than sitagliptin (P = 0.0017). Results of safety assessments were similar between groups, and most adverse events (AEs) were mild or moderate. The incidences of gastrointestinal AEs for albiglutide and sitagliptin were as follows: overall, 31.7%, 25.2%; diarrhea, 10.0%, 6.5%; nausea, 4.8%, 3.3%; and vomiting, 1.6%, 1.2%, respectively. CONCLUSIONSOnce-weekly albiglutide therapy in renally impaired patients with type 2 diabetes provided statistically superior glycemic improvement with almost similar tolerability compared with daily sitagliptin therapy.

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American Association of Clinical Endocrinologists' Comprehensive Diabetes Management Algorithm 2013 Consensus Statement - Executive Summary

Cited by 222 publications

References 105 publications

Contrasting Effects of Lixisenatide and Liraglutide on Postprandial Glycemic Control, Gastric Emptying, and Safety Parameters in Patients With Type 2 Diabetes on Optimized Insulin Glargine With or Without Metformin: A Randomized, Open-Label Trial

Contrasting Effects of Lixisenatide and Liraglutide on Postprandial Glycemic Control, Gastric Emptying, and Safety Parameters in Patients With Type 2 Diabetes on Optimized Insulin Glargine With or Without Metformin: A Randomized, Open-Label Trial

Progression to insulin therapy among patients with type 2 diabetes treated with sitagliptin or sulphonylurea plus metformin dual therapy

Efficacy and Safety of the Once-Weekly GLP-1 Receptor Agonist Albiglutide Versus Sitagliptin in Patients With Type 2 Diabetes and Renal Impairment: A Randomized Phase III Study

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