Basal insulin intensification with GLP-1RA and dual GIP and GLP-1RA in patients with uncontrolled type 2 diabetes mellitus: A rapid review of randomized controlled trials and meta-analysis

Lisco, Giuseppe; Tullio, Anna De; Disoteo, Olga; Geronimo, Vincenzo De; Piazzolla, Giuseppina; Pergola, Giovanni De; Giagulli, Vito Angelo; Jirillo, Emilio; Guastamacchia, Edoardo; Sabbà, Carlo; Triggiani, Vincenzo

doi:10.3389/fendo.2022.920541

Cited by 9 publications

(9 citation statements)

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“…GLP-1RAs also provide cardiovascular and renal protection. As GLP-1RAs work efficaciously and safely, the prescription of this class of medications has gained success in T2D, even compared to other equally potent but more expensive and composite regimens, such as insulin therapy [ 177 , 178 , 179 ]. GLP-1RAs are expected to affect body composition significantly.…”

Section: Preventing Sarcopenia: a Therapeutic Target In Primary And S...mentioning

confidence: 99%

Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age

Lisco,

Disoteo,

De Tullio

et al. 2023

Nutrients

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Sarcopenia is an age-related clinical complaint characterized by the progressive deterioration of skeletal muscle mass and strength over time. Type 2 diabetes (T2D) is associated with faster and more relevant skeletal muscle impairment. Both conditions influence each other, leading to negative consequences on glycemic control, cardiovascular risk, general health status, risk of falls, frailty, overall quality of life, and mortality. PubMed/Medline, Scopus, Web of Science, and Google Scholar were searched for research articles, scientific reports, observational studies, clinical trials, narrative and systematic reviews, and meta-analyses to review the evidence on the pathophysiology of di-abetes-induced sarcopenia, its relevance in terms of glucose control and diabetes-related outcomes, and diagnostic and therapeutic challenges. The review comprehensively addresses key elements for the clinical definition and diagnostic criteria of sarcopenia, the pathophysiological correlation be-tween T2D, sarcopenia, and related outcomes, a critical review of the role of antihyperglycemic treatment on skeletal muscle health, and perspectives on the role of specific treatment targeting myokine signaling pathways involved in glucose control and the regulation of skeletal muscle metabolism and trophism. Prompt diagnosis and adequate management, including lifestyle inter-vention, health diet programs, micronutrient supplementation, physical exercise, and pharmaco-logical treatment, are needed to prevent or delay skeletal muscle deterioration in T2D.

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Section: Preventing Sarcopenia: a Therapeutic Target In Primary And S...mentioning

confidence: 99%

Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age

Lisco,

Disoteo,

De Tullio

et al. 2023

Nutrients

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“…Compared to GLP-1RAs, TZP reduces body weight from −1.68 kg to −7.16 kg depending on the dose (5 to 15 mg, respectively) [14]. Compared to basal insulin alone rigorously titrated using a treat-to-target approach, TZP added onto basal-insulin results in the best strategy to improve the study outcome with a composite endpoint of improved glucose control and weight loss [19]. The SURPASS-6 found similar results, in which TZP in add-on to insulin glargine U100 reduced body weight by 9 kg in mean (versus weight gain in basal-bolus users: +3.2 kg) [15].…”

Section: Tirzepatide and Body Weightmentioning

confidence: 99%

Is Tirzepatide the New Game Changer in Type 2 Diabetes?

Lisco,

Disoteo,

De Geronimo

et al. 2024

Endocrines

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Background: Tirzepatide (TZP) is a once-weekly glucagon-like peptide 1 (GLP-1) and glucose-dependent-insulinotropic-polypeptide (GIP) receptor co-agonist approved for T2D. TZP provides promising evidence in improving glucose control and weight loss in T2D and obesity across preclinical and human studies, including data from the SURPASS program. Aims: The goal of this paper was to review the evidence on TZP in terms of glucose control, body weight, and the progression of chronic diabetes-related complications and comorbidities. Results: The mean change in HbA1c ranged from −1.6% to −2.06% over placebo, from −0.29% to −0.92% over each GLP-1RAs, and from −0.7% to −1.09% over basal insulins. In SURPASS-6, TZP was more effective than insulin lispro U100 added to basal insulin in reducing HbA1c levels at the study end (−2.1% vs. −1.1%, respectively). Compared to placebo, TZP induces a significant weight loss: 7.5 (5 mg/week); 11 (10 mg/week); and 12 kg (15 mg/week). Compared to GLP-1RAs, TZP reduces body weight from −1.68 kg to −7.16 kg depending on the dose (5 to 15 mg, respectively). Compared to basal insulin alone rigorously titrated, TZP added onto basal-insulin results in the best strategy for the composite endpoint of improvement of glucose control and weight loss. In SURPASS-6, TZP compared to insulin lispro U100 in add-on to insulin glargine U100 reduced body weight by 9 kg in mean (versus weight gain in basal-bolus users: +3.2 kg). TZP has pleiotropic effects potentially dampening the individual cardiovascular risk, including a reduction in systolic arterial pressure by 4 to 6 mmHg and total cholesterol by 4–6% compared to baseline. A post hoc analysis of SURPASS-4 revealed that TZP, compared to glargine U100, delayed the rate of glomerular filtration decline (−1.4 mL/min vs. −3.6 mL/min, respectively), reduced the rate of urinary albumin excretion (−6.8% vs. +36.9%, respectively), and was associated with a lower occurrence of the composite renal endpoint (HR 0.58 [0.43; 0.80]). Conclusions: Consistent evidence indicates that TZP dramatically changes the clinical course of T2D in different clinical scenarios. The efficacy and safety of TZP on chronic diabetes-related comorbidities and complications seem promising, but ongoing trials will clarify the real benefits.

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“…Besides, the cardiovascular safety of other GLP-1 RAs was investigated in comparison to placebo in large prospective, randomized clinical studies; and either neutral effects or decreases in cardiovascular events have been observed [46]. Liraglutide, semaglutide (subcutaneous or oral), or dulaglutide did not differ from placebo in their respective cardiovascular outcome trials when HF was taken into account as an endpoint in its own right [9,22,23,36,38].…”

Section: Cardiovascular Outcomesmentioning

confidence: 99%

Untitled

2023

FARMACIA

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Co-existing diabetes and obesity, frequently described by the term "diabesity", is a major health problem associated with increased long-term complications and mortality. The management of "diabesity" could be challenging, because several antidiabetic drugs cause weight gain. Glucagon-like peptide receptor agonists (GLP-1 RAs) have been demonstrated to be effective agents for achieving glycaemic control in addition to reducing body weight in patients with type 2 diabetes. Oral semaglutide, the first oral formulation of a GLP-1 RA, is an important therapeutic option for individuals with a preference for oral therapy. This medication was created by co-formulating the semaglutide molecule with an absorption enhancer (SNAC) to overcome the difficulties of oral peptide administration. The introduction of an oral GLP-1 RA broadens the therapeutic choices for patients and represents an important milestone in the management of "diabesity". RezumatCoexistența obezității și a diabetului zaharat, descrise frecvent prin termenul "diabesity" sau "diabezitate", reprezintă o problemă majoră de sănătate asociată cu creșterea complicațiilor și a mortalității pe termen lung. Managementul "diabezității" ar putea fi o provocare, deoarece mai multe medicamente antidiabetice pot determina creștere în greutate. S-a demonstrat că agoniştii receptorilor glucagon-like peptide-1 (GLP-1 RA) sunt eficienți pentru obținerea controlului glicemic pe lângă reducerea greutății corporale în cazul pacienților cu diabet zaharat tip 2. Semaglutida orală, prima formularea orală a GLP-1 RA, este o opțiune terapeutică importantă pentru persoanele cu preferință pentru terapia orală. Acest medicament a fost creat prin co-formularea moleculei de semaglutidă cu un amplificator de absorbție (SNAC) pentru a depăși dificultățile administrării orale a peptidelor. Introducerea unui agonist de receptor GLP-1 cu administrare orală, lărgește opțiunile terapeutice pentru pacienți și reprezintă un medicament cheie în tratamentul "diabezității".

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Basal insulin intensification with GLP-1RA and dual GIP and GLP-1RA in patients with uncontrolled type 2 diabetes mellitus: A rapid review of randomized controlled trials and meta-analysis

Cited by 9 publications

References 73 publications

Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age

Sarcopenia and Diabetes: A Detrimental Liaison of Advancing Age

Is Tirzepatide the New Game Changer in Type 2 Diabetes?

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