Article (Scientific journals)
Pharmacotherapy of 'treatment resistant' type 2 diabetes.
Scheen, André
2017In Expert Opinion on Pharmacotherapy, 1, p. 1-13
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Keywords :
Combination therapy; DPP-4 inhibitor; GLP-1 receptor agonist; SGLT2 inhibitor; triple therapy; type 2 diabetes
Abstract :
[en] INTRODUCTION: Despite type 2 diabetes (T2D) management offers a variety of pharmacological interventions targeting different defects, numerous patients remain with persistent hyperglycaemia responsible for severe complications. Unlike resistant hypertension, treatment resistant T2D is not a classical concept although it is a rather common observation in clinical practice. Areas covered: This article proposes a definition for 'treatment resistant diabetes', analyses the causes of poor glucose control despite standard therapy, briefly considers the alternative approaches to glucose-lowering pharmacotherapy and finally describes how to overcome poor glycaemic control, using innovative oral or injectable combination therapies. Expert opinion: Before considering intensifying the pharmacotherapy of a patient with poorly controlled T2D, it is important to verify treatment adherence, target obesity and consider various non pharmacological improvement quality interventions. If treatment resistant diabetes is defined as not achieving glycated haemoglobin target despite oral triple therapy with a third glucose-lowering agent added to metformin-sulfonylurea dual treatment, the combination of a dipeptidyl peptidase-4 (DPP-4) inhibitor and a sodium glucose cotransporter type 2 (SGLT2) inhibitor may offer new opportunities before considering injectable therapies. Insulin basal therapy (+/- metformin) may be optimized by the addition of a SGLT2 inhibitor or a glucagon-like peptide-1 (GLP-1) receptor agonist.
Disciplines :
Endocrinology, metabolism & nutrition
Pharmacy, pharmacology & toxicology
Author, co-author :
Scheen, André  ;  Université de Liège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Pharmacotherapy of 'treatment resistant' type 2 diabetes.
Publication date :
2017
Journal title :
Expert Opinion on Pharmacotherapy
ISSN :
1465-6566
eISSN :
1744-7666
Publisher :
Taylor & Francis, United Kingdom
Volume :
1
Pages :
1-13
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 24 March 2017

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