Combination therapies in the management of type 2 diabetes: the use of insulin degludec/liraglutide

Molly G Minze,1 Lisa M Chastain2 1School of Pharmacy, Texas Tech University Health Sciences Center, Abilene, 2Department of Pharmacy Practice, School of Pharmacy, Texas Tech University Health Sciences Center, Dallas, TX, USA Abstract: The global burden of type 2 diabetes is estimated to currently affect over 350 million people worldwide and is anticipated to continue increasing over the next 20 years. Current treatment guidelines recommend the choice of pharmacotherapy based upon patient-specific parameters, with combination therapy for patients with a hemoglobin A1c level ≥9%. A new combination therapy of insulin degludec + liraglutide provides a long-acting basal insulin with a glucagon-like peptide agonist. In clinical trials, this combination product has reduced hemoglobin A1c and fasting plasma glucose more than the individual agents alone. Further advantages observed with this combination include weight loss and decrease in hypoglycemia compared to basal insulin alone. Keywords: insulin degludec, liraglutide, type 2 diabetes, basal insulin, glucagon-like peptide agonist, injectable therapie

Drug treatment of type 2 diabetes mellitus in patients for whom metformin is contraindicated

Brian K Irons,1 Molly G Minze21Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, Lubbock, 2Department of Pharmacy Practice, Texas Tech University Health Sciences Center School of Pharmacy, Abilene, TX, USAAbstract: Metformin is considered an initial drug of choice for type 2 diabetes mellitus by leading recommendations. When contraindications to its use exist or patients cannot tolerate it due to adverse effects, clinicians have a variety of other classes of agents to treat hyperglycemia associated with type 2 diabetes mellitus. Each class of agent has its own benefit and safety profile. There are numerous factors to consider when selecting another agent in lieu of metformin including, but not limited to, overall efficacy in A1c reduction, adverse effect profile, cost, and patient preference. The number of factors influencing the decision process presents challenges and often no one specific agent is ideal. Each pharmacotherapeutic class of agents alternative to metformin for the treatment of hyperglycemia in type 2 diabetes mellitus as initial monotherapy is reviewed.Keywords: type 2 diabetes mellitus, metformin, monotherapy, hyperglycemia, pharmacotherap

Drug treatment of type 2 diabetes mellitus in patients for whom metformin is contraindicated [Corrigendum]

Irons BK, Minze MG. Drug treatment of type 2 diabetes mellitus in patients for whom metformin is contraindicated. Diabetes Metab Syndr Obes. 2014;7:15–24.There is an error in the text on page 19:“Alpha-glucosidase inhibitors are infrequently used in the treatment of T2DM.3 These agents competitively inhibit the absorption of alpha-glucosidase along the brush border of the small intestine, which slows gut absorption of carbohydrates and ultimately reduces post-prandial blood glucose.34–36” should read as “Alpha-glucosidase inhibitors are infrequently used in the treatment of T2DM.3 These agents competitively inhibit the degradation of complex carbohydrates along the brush border of the small intestine, which slows gut absorption of metabolized carbohydrates and ultimately reduces post-prandial blood glucose.34–36”Read the original articl