Title:The Novel Use of GLP-1 Analogue and Insulin Combination in Type 2 Diabetes Mellitus
Volume: 6
Issue: 2
Author(s): Manash P. Baruah and Sanjay Kalra
Affiliation:
Keywords:
Basal insulin, FDC, GLP-1 analogue, GLP-1 and insulin combination, injectable FDC, insulin, type 2 DM, FDCGLP-1 analogue, insulin, GLP-1 , insulin Combination, anti-diabetic drugs, hypoglycemia
Abstract: Type 2 diabetes mellitus (T2DM) is a global public health problem. Due to the progressive nature of the disease,
a combination(s) of two or more drugs acting on different pathophysiological process is often necessary to achieve
early and sustained achievement of individualized glycemic targets. At the same time, choosing the safest option to avoid
hypoglycemia is of paramount importance. GLP-1 analogues are a relatively recent class of anti-diabetic drugs, and are
highly effective with an acceptable safety profile. Attempts have been made to combine GLP-1 analogues with basal insulin
for management of T2DM. Presently GLP-1 analogues like exenatide/long acting exenatide and liraglutide have been
co-administered with basal insulin like glargine and detemir respectively, and are approved by regulatory agencies. Currently
a fixed dose combination (FDC) of insulin degludec and liraglutide is under development. GLP-1 analogue and insulin
as FDC or by co-administration, is a rational method of controlling fasting and postprandial glucose effectively. The
efficacy and safety of this combination has been studied in a wide population with promising outcomes. Innovative use of
GLP-1 analogues beyond diabetes is also being attempted, and a variety of patents are filed or granted for the same. This
review summarizes the current status of GLP-1 and insulin combination in the management of T2DM and highlights the
new frontiers in research involving GLP-1. Patents on combination of GLP-1 and insulin which were granted earlier, and
the ones which have been applied for, are also discussed.