Type 1 Diabetes Treatment Options - PowerPoint PPT Presentation

Loading...

PPT – Type 1 Diabetes Treatment Options PowerPoint presentation | free to download - id: 8602ba-ZTRlM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Type 1 Diabetes Treatment Options

Description:

Treatment Options Part 5 ... on the Course of New-Onset Type 1 Diabetes Mellitus J Clin Res ... to improve glycemic variability and overall diabetic ... – PowerPoint PPT presentation

Number of Views:45
Avg rating:3.0/5.0
Slides: 12
Provided by: StanS164
Learn more at: http://www.diabetesincontrol.com
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Type 1 Diabetes Treatment Options


1
Type 1 Diabetes Treatment Options
Part 5
Stanley Schwartz
Mark Stolar
Emeritus, Univ of Pa
2
Potential Adjunctive Treatments for Type 1
Diabetes
  • Incretins
  • SGLT-2 Inhibitors
  • Insulin Sensitizers

3
Potential for Incretin Rx in T1DM
Drug Discovery Today Volume 17, Numbers 1/2
January 2012
4
Incretin Therapy in Type 1 DiabetesImproved
glycemic variability
Liraglutide

Vildigliptin
Data Suggests less dawn effect, less
variability, decrease insulin doses, less
hypoglycemia
5
Potential Adjunctive Treatments for Type 1
Diabetes
  • Incretins
  • SGLT-2 Inhibitors
  • Insulin Sensitizers

6
Mechanism of Action of SGLT-2 Inhibition
SGLT-2 Inhibition
7
SGLT-2 Inhibition in T1DM
In Clinical Practice SGLT-2 Inhibition has shown
benefits decreased variability, especially ppg
with appropriate reduction in insulin
dosing-less hypoglycemia However, few studies
done worry about potential for DKA with
increased glucagon as response to glycosuria
8
Potential Adjunctive Treatments for Type 1
Diabetes
  • Incretins
  • SGLT-2 Inhibitors
  • Insulin Sensitizers

9
Multiple Causes IR-Type 1 Patients can have
Insulin Resistance- Identify by Insulin need gt
50u/day
Central IR/ Appetite
Bromocriptine-QR
Weight Reduction Agents
Biome IR
Peripheral IR
Inflam- mation IR
Anti- Inflam.
Pro- Biotics, Pre-Biotics, Antibiotics
TZD (Pio-) Metformin

10
Metformin
Pioglitazone
  • Multiple studies show benefits, albeit to
    different degrees in different patients
  • Decreased HgA1c
  • Decreased Weight
  • Decreased Insulin requirements
  • Decreased FBS, PPG

Alternative Agents in Type 1 Diabetes in Addition
to Insulin Therapy Metformin, Alpha-Glucosidase
Inhibitors, Pioglitazone, GLP-1 Agonists, DPP-IV
Inhibitors, and SGLT-2 Inhibitors ,Michelle
DeGeeter, PharmD, CDE1, and Bobbie Williamson,
PharmD, BCACP, CDE1 ,Journal of Pharmacy
Practice1-16,2014,DOI 10.1177/0897190014549837
Effect of Pioglitazone on the Course of New-Onset
Type 1 Diabetes Mellitus J Clin Res Pediatr
Endocrinol 20135(4)236-239 DOI
10.4274/Jcrpe.981
11
Summary
  • DM control in T1DM decreases adverse outcomes
  • Albeit at risk of variability, hypo, weight gain
  • Standard basal-bolus care not ideal
  • Data exists for those that address
    hyperglucagonemia
  • Pramlintide on label
  • Incretins based therapy not approved for type 1
    Diabetes
  • Non-insulin mediated mechanism of lowering
    postprandial glucose in Type 1 diabetes through
    renal or motility modifying agents has potential
    to improve glycemic variability and overall
    diabetic control
About PowerShow.com