TY - JOUR
T1 - Combining GLP-1 Receptor Agonists and Basal Insulin in Older Adults with Type 2 Diabetes: Focus on Lixisenatide and Insulin Glargine
AU - Handelsman, Yehuda
AU - Muskiet, Marcel H. A.
AU - Meneilly, Graydon S.
PY - 2019
Y1 - 2019
N2 - Abstract: Estimates suggest that there are currently 122.8 million adults 65–99 years of age living with diabetes, of whom 90–95% are diagnosed with type 2 diabetes (T2D). Over the past two decades, a greater understanding of the complex and multifactorial pathogenesis of T2D has resulted in the development and introduction of new-generation classes of glucose-lowering therapies, which are now extensively endorsed by prevailing guidelines and are increasingly being used worldwide. These newer agents may further assist in the effective pharmacological management of T2D through the provision of patient-centered care that acknowledges multimorbidity and is respectful of and responsive to individual patient preferences and barriers. Given these considerations, the therapeutic approach in older patients with T2D is complex, particularly in those who have functional dependence, frailty, dementia, or who are at end-of-life. It is currently too early to draw conclusions on the long-term use of newer glucose-lowering agents in this population, as their efficacy and safety in older adults remains largely unknown. In this review, we will discuss considerations for the use of glucose-lowering treatments in older adults, with particular focus on the use of basal insulin and glucagon-like peptide-1 receptor agonists, and the rationale for the use of combination therapy comprising these agents. Finally, we will review clinical data from studies of the fixed-ratio combination of insulin glargine and lixisenatide in older patients with T2D. Funding: Sanofi US, Inc.
AB - Abstract: Estimates suggest that there are currently 122.8 million adults 65–99 years of age living with diabetes, of whom 90–95% are diagnosed with type 2 diabetes (T2D). Over the past two decades, a greater understanding of the complex and multifactorial pathogenesis of T2D has resulted in the development and introduction of new-generation classes of glucose-lowering therapies, which are now extensively endorsed by prevailing guidelines and are increasingly being used worldwide. These newer agents may further assist in the effective pharmacological management of T2D through the provision of patient-centered care that acknowledges multimorbidity and is respectful of and responsive to individual patient preferences and barriers. Given these considerations, the therapeutic approach in older patients with T2D is complex, particularly in those who have functional dependence, frailty, dementia, or who are at end-of-life. It is currently too early to draw conclusions on the long-term use of newer glucose-lowering agents in this population, as their efficacy and safety in older adults remains largely unknown. In this review, we will discuss considerations for the use of glucose-lowering treatments in older adults, with particular focus on the use of basal insulin and glucagon-like peptide-1 receptor agonists, and the rationale for the use of combination therapy comprising these agents. Finally, we will review clinical data from studies of the fixed-ratio combination of insulin glargine and lixisenatide in older patients with T2D. Funding: Sanofi US, Inc.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85074668279&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/31646466
U2 - https://doi.org/10.1007/s12325-019-01126-x
DO - https://doi.org/10.1007/s12325-019-01126-x
M3 - Review article
C2 - 31646466
SN - 0741-238X
VL - 36
SP - 3321
EP - 3339
JO - Advances in therapy
JF - Advances in therapy
IS - 12
ER -