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Endocrinology

A clinical review of GLP-1 receptor agonists: efficacy and safety in diabetes and beyond

Authors: Lalita Prasad-Reddy, Diana Isaacs

Many of the agents used to treat type 2 diabetes have undesirable adverse effects of hypoglycemia and weight gain. Glucagon-like peptide-1 (GLP-1) receptor agonists represent a unique approach to the treatment of diabetes. In this article the authors discuss the various GLP-1 receptor agonists available on the market, specifically focusing on their relative efficacy, safety, and clinical differences as well as their potential benefits in addition to glucose lowering in type 2 diabetes, and describe the adverse effects and toxicities seen with these agents.

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Resource use and outcomes associated with initiation of injectable therapies for patients with type 2 diabetes mellitus

Authors: Richard Brice, Sharon Shelley, Pankaj Chaturvedi, Divina Glah, Donna Ashley, Monica Hadi

Management of type 2 diabetes mellitus (T2DM) often requires intervention with oral and injectable therapies. Across National Health Service (NHS) England, injectable therapies may be initiated in secondary, intermediate or primary care. This original research set out to understand resource utilization, the pathways of care, clinical outcomes, and experience of patients with T2DM
initiated on injectable therapies.

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Sodium-glucose co-transporter 2 (SGLT2) inhibitors: a growing class of anti-diabetic agents

Authors: Eva M Vivian

Although several treatment options are available to reduce hyperglycemia, only about half of individuals with diagnosed diabetes mellitus (DM) achieve recommended glycemic targets. New agents that reduce blood glucose concentrations by novel mechanisms and have acceptable safety profiles are needed to improve glycemic control and reduce complications. This article reviews the evidence from clinical trials and suggests that SGLT2 inhibitors are a promising new treatment option for T2DM.

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Empagliflozin: a new sodium-glucose co-transporter 2 (SGLT2) inhibitor for the treatment of type 2 diabetes

Authors: Joshua J Neumiller

Type 2 diabetes is increasing in prevalence worldwide, and hyperglycemia is often poorly controlled despite a number of therapeutic options.

Unlike previously available agents, sodium-glucose co-transporter 2 inhibitors offer an insulin-independent mechanism for improving blood glucose levels, since they promote urinary glucose excretion by inhibiting glucose reabsorption in the kidney.

In this article, the author discusses empagliflozin and based on available data, it appears that this drug may be a useful option in a range of patients; however, clinical decisions will be better informed by the results of ongoing studies, in particular, a large cardiovascular outcome study (EMPA-REG OUTCOME™).

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Initial combination therapy for patients with type 2 diabetes mellitus: considerations for metformin plus linagliptin

Authors: Jeffrey Freeman

In this article the author discusses the implications for clinical practice of the results of a recent Phase III trial. He concludes that initial combination of linagliptin plus metformin which was found to be weight neutral, well tolerated and associated with a low frequency of hypoglycaemia, may have advantages for a large proportion of patients with type 2 diabetes, particularly those with a relatively high HbA1c at diagnosis.

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