Managing loss of glycemic control in middle-aged patients with diabetes: The role of GLP-1 receptor agonists in combination-therapy regimens

Abstract

Middle-aged patients with type 2 diabetes mellitus may have languished on monotherapy or a stable therapy for a substantial period without reconsideration of comorbidities or current control of glycated hemoglobin A1c (HbA1c). In many patients who lose glycemic control, postprandial hy-perglycemia has not been addressed. This is especially true when HbA1c levels are close to-but not at-goal. Glucagon-like peptide-1 receptor agonists are injectable agents that can be added to oral therapy to address postprandial hyperglycemia. These agents may be a useful alternative to insulin therapy as add-on therapy when dual oral therapy is no longer suffcient and additional glucose lowering is required. Compared with insulin, glucagon-like peptide-1 receptor agonists have provided comparable glucose low¬ering with less hypoglycemia and without weight gain. © 2014 American Osteopathic Association.