title: Efficacy and safety of insulin-GLP-1 receptor agonists combination in type 2 diabetes mellitus: a systematic review.
abstract: Attaining optimal glycemic targets in patients with type 2 diabetes is often hard and compromised by the shortcomings of the several treatments. Areas covered: When glycemic levels are not adequately controlled, an association of GLP-1 receptor agonists and insulin therapy can be adopted. In order to assess the benefit/risk profile of this combination therapy, a literature search of randomized clinical trials was performed.Eighteen trials matched the inclusion criteria. In 10 studies, GLP-1 receptor agonists were added on to an existing regimen, whereas insulin added to an existing GLP-1 receptor agonists regimen occurred in 2 studies. Six studies compared GLP-1 receptor agonists with short acting insulin as a treatment strategy to intensify basal insulin therapy. Expert opinion: Clinical trials herein reviewed demonstrated the safety and the efficacy of combining GLP-1 receptor agonists with basal insulin, with most studies showing equal or slightly superior efficacy, as compared with the addition of prandial insulin, associated with weight loss and less hypoglycemia.
authors.affiliation: a Department of Experimental Medicine, Section of Pharmacology , Second University of Naples , Naples , Italy.
authors.forename: D
authors.initials: D
authors.lastname: Cimmaruta
authors.affiliation: b Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Endocrinology and Metabolic Diseases Unit , Second University of Naples , Naples , Italy.
authors.forename: M I
authors.initials: MI
authors.lastname: Maiorino
authors.affiliation: a Department of Experimental Medicine, Section of Pharmacology , Second University of Naples , Naples , Italy.
authors.forename: C
authors.initials: C
authors.lastname: Scavone
authors.affiliation: a Department of Experimental Medicine, Section of Pharmacology , Second University of Naples , Naples , Italy.
authors.forename: L
authors.initials: L
authors.lastname: Sportiello
authors.affiliation: a Department of Experimental Medicine, Section of Pharmacology , Second University of Naples , Naples , Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rossi
authors.affiliation: b Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, Endocrinology and Metabolic Diseases Unit , Second University of Naples , Naples , Italy.
authors.forename: D
authors.initials: D
authors.lastname: Giugliano
authors.affiliation: c Department of Clinical and Experimental Medicine , Second University of Naples , Naples , Italy.
authors.forename: K
authors.initials: K
authors.lastname: Esposito
authors.affiliation: a Department of Experimental Medicine, Section of Pharmacology , Second University of Naples , Naples , Italy.
authors.forename: A
authors.initials: A
authors.lastname: Capuano
mesh_terms: D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: GLP-1 RA insulin combination; HbA1c levels; hypoglycemia; type 2 diabetes mellitus