Glucagon‐like peptide‐1 receptor agonist prescribing patterns in adolescents with type 2 diabetes

Abstract

Type 2 diabetes (T2D) in youth is a more aggressive disease that is associated with earlier co-morbidities compared with T2D in adulthood. 1 Treatment guidelines for paediatric T2D first recommend lifestyle management and metformin, which rarely achieve meaningful body mass index (BMI) reduction. 2,3 Because of limited options for treatment, medications approved for adult T2D have been used in an 'off-label' fashion in adolescents. One such medication class is glucagon-like peptide-1 receptor agonists (GLP-1RAs), which stimulate

Euglycemic Diabetic Keto Acidosis in a Type 1 Diabetic Patient After Glucose Like Peptide-1 Administration: A Case Presentation

“… 7 Prescribing methods show an increasing number of prescriptions for GLP-1 agonists. 8 Patients, like the one seen in this case study, may develop unusual presentations due to comorbidities and drug interactions. It is important to recognize these alternate presentations of treatable conditions.…”

“… 18 With increasing prescriptions of GLP-1 agonists, and an increased rate of DKA adverse events associated with GLP-1 agonists patient presentations like this one may become more prevalent. 8 , 16 In addition, with GLP-1 agonist use and 26.8% of type 1 DM patients presenting as a first occurrence of DKA, this intersection of interacting pathologies may be unavoidably increasing the number of cases seen in emergency departments. 5 Misidentification can lead to mistreatment, possibly endangering patients and accruing unnecessary medical cost.…”

Metabolic Contributions to Pathobiology of Asthma

“…Pioglitazone, a thiazolidinedione, influences insulin sensitivity via modified fatty acid metabolism. Although metformin is a standard therapy for prediabetes and GLP-1R agonist use is increasing in children [ 43 , 44 ], their effectiveness in childhood obesity-related asthma is not known. Given their effectiveness in decreasing asthma burden in adults and known safety profile in children, we propose that these medication classes may serve as potential novel therapy for childhood obesity-related asthma.…”

G Protein-Coupled Receptors and the Rise of Type 2 Diabetes in Children

“…Adolescents treated with GLP1R agonists were less likely to be prescribed concomitant insulin within one year from diagnosis. Other demographic characteristics or prescriptions of other anti-obesity or anti-diabetes medications did not differ between groups [ 88 ]. Several authors emphasized the differences that exist between adults and pediatric patients and the need for clinical trials directed specifically at adolescents [ 89 ].…”