| Title |
Metabolic Control in Type 1 Diabetes: Is Adjunctive Therapy the Way Forward?
|
|---|---|
| Published in |
Diabetes Therapy, September 2018
|
| DOI | 10.1007/s13300-018-0496-z |
| Pubmed ID | |
| Authors |
Harriet Warnes, Rebecca Helliwell, Sam Matthew Pearson, Ramzi A. Ajjan |
| Abstract |
Despite advances in insulin therapies, patients with type 1 diabetes (T1DM) have a shorter life span due to hyperglycaemia-induced vascular disease and hypoglycaemic complications secondary to insulin therapy. Restricting therapy for T1DM to insulin replacement is perhaps an over-simplistic approach, and we focus in this work on reviewing the role of adjuvant therapy in this population. Current data suggest that adding metformin to insulin therapy in T1DM temporarily lowers HbA1c and reduces weight and insulin requirements, but this treatment fails to show a longer-term glycaemic benefit. Agents in the sodium glucose co-transporter-2 inhibitor (SGLT-2) class demonstrate the greatest promise in correcting hyperglycaemia, but there are safety concerns in relation to the risk of diabetic ketoacidosis. Glucagon-like peptide-1 agonists (GLP-1) show a modest effect on glycaemia, if any, but significantly reduce weight, which may make them suitable for use in overweight T1DM patients. Treatment with pramlintide is not widely available worldwide, although there is evidence to indicate that this agent reduces both HbA1c and weight in T1DM. A criticism of adjuvant studies is the heavy reliance on HbA1c as the primary endpoint while generally ignoring other glycaemic parameters. Moreover, vascular risk markers and measures of insulin resistance-important considerations in individuals with a longer T1DM duration-are yet to be fully investigated following adjuvant therapies. Finally, studies to date have made the assumption that T1DM patients are a homogeneous group of individuals who respond similarly to adjuvant therapies, which is unlikely to be the case. Future longer-term adjuvant studies investigating different glycaemic parameters, surrogate vascular markers and harder clinical outcomes will refine our understanding of the roles of such therapies in various subgroups of T1DM patients. |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 8 | 17% |
| Student > Bachelor | 8 | 17% |
| Other | 7 | 15% |
| Student > Master | 4 | 8% |
| Researcher | 3 | 6% |
| Other | 5 | 10% |
| Unknown | 13 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 35% |
| Pharmacology, Toxicology and Pharmaceutical Science | 5 | 10% |
| Immunology and Microbiology | 2 | 4% |
| Agricultural and Biological Sciences | 1 | 2% |
| Nursing and Health Professions | 1 | 2% |
| Other | 5 | 10% |
| Unknown | 17 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 April 2019.
All research outputs
#7,756,393
of 23,576,969 outputs
Outputs from Diabetes Therapy
#353
of 1,055 outputs
Outputs of similar age
#133,873
of 338,565 outputs
Outputs of similar age from Diabetes Therapy
#7
of 26 outputs
Altmetric has tracked 23,576,969 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,055 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.0. This one has gotten more attention than average, scoring higher than 64% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 338,565 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 53% of its contemporaries.
We're also able to compare this research output to 26 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.