Fixed-Dose Combination Therapy in Type 2 Diabetes Mellitus

Blonde, Lawrence; Juan, Zinnia T. San; Bolton, Peggy M.

doi:10.4158/ep14259.ra

Cited by 24 publications

(23 citation statements)

References 45 publications

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“…The present study demonstrates that with the advancement in diabetes therapeutics and with the advent of new classes of medications, the complexity of pharmacotherapy, particularly as combination therapy, is becoming more important for residents. Treatment of type 2 diabetes mellitus often requires combinations of anti-hyperglycemic medications with complementary mechanisms of action [44]; for example, most residents in the present study find combination pharmacotherapy, particularly for insulin and use of newer classes of medication, the most challenging educational issue. Newer classes of anti-diabetes medication, such as incretin-based therapies and SGLT2 inhibitors, have the potential to be used not only for monotherapy but also in combination with any of the existing classes of glucose-lowering agents, including insulin [45].…”

Section: Combination Pharmacotherapy and Different Classes Of Medicatmentioning

confidence: 89%

Challenges in Pharmacotherapeutics Education for Diabetes in Real-World Clinical Settings: Views From Family Medicine and Internal Medicine Residents

Farahani¹

2015

CIM

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Purpose: Pharmacotherapy for diabetes in real-world clinical settings is very complex and is posing a challenge for residents in training. The purpose of this study was to explore the views of residents in Canada regarding educational priorities for pharmacotherapy in diabetes management.Methods: A questionnaire was developed to explore different domains of pharmacotherapy in diabetes management, including different clinical settings, combination pharmacotherapy with different classes of medications and patients' characteristics, including comorbidities and cardiovascular risk factors. The questionnaire and the letter of invitation was sent to residents through their program directors. The results were gathered through an online survey system. Due to the study design, response rate could not be determined. For data analysis, SPSS Software was used for statistical analysis. Chi-square testing was utilized for comparisons of proportions.Results: Thirty-four residency programs in Canada were contacted and 165 residents completed the study. A significant number of the residents (59%) viewed combination pharmacotherapy for diabetes management as the most important educational priority (p < 0.001). Regarding insulin therapy, combination of insulin with another class of agents was recognized as the most important educational priority by 51% of residents (p < 0.001). Among all classes of medication for blood glucose management the education on the use of newer class of medication such as GLP1 agonists, DPP4 inhibitors and SGLT2 inhibitors was recognized as a priority by 77% of residents (p < 0.001). Conclusion:This study provides new data and insights into residents' views on diabetes pharmacotherapy. Educational curriculums may incorporate these views from residents on the educational priorities that were identified in this study.TRAINEE SECTION

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Section: Combination Pharmacotherapy and Different Classes Of Medicatmentioning

confidence: 89%

Challenges in Pharmacotherapeutics Education for Diabetes in Real-World Clinical Settings: Views From Family Medicine and Internal Medicine Residents

Farahani¹

2015

CIM

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“…The lower doses of the two agents in an FDC product may offer greater efficacy in combination than that provided by higher or maximal doses of monotherapy [38][39][40], or of coadministered dual therapy [37]. Importantly, single-pill FDCs may offer cost advantages over multiple-pill combinations (see following sections) [6,12,35].…”

Section: Approaches To Combination Therapy: Advantages and Disadvantagesmentioning

confidence: 99%

“…add-on) with metformin include oral agents (DPP-4 inhibitors, SGLT2 inhibitors, sulfonylureas, TZDs), injectable glucagonlike peptide 1 (GLP-1) agonists, or basal insulin [10]. Many drug classes are available in the United States as FDC products containing metformin immediate release or metformin extended release [6], including combinations with DPP-4 inhibitors (sitagliptin [41,42], linagliptin [43], saxagliptin [44], and alogliptin [45]), sulfonylureas (glipizide [46] and glyburide [47]), SGLT2 inhibitors (dapagliflozin [48], canagliflozin [49], empagliflozin [50]), a meglitinide (repaglinide [51]), and a TZD (pioglitazone [52,53]). …”

Section: Metformin-based Combination Therapiesmentioning

confidence: 99%

“…Non-metformin oral combinations are also available [6], although fewer in number, and may be used in patients who are unable to tolerate metformin, or added for patients who do not achieve glycemic control with metformin. Combinations of TZDs plus sulfonylureas demonstrate efficacy in lowering HbA1 c [70,71], and an FDC containing both classes is available for clinical use [72].…”

Section: Non-metformin-based Combination Therapiesmentioning

confidence: 99%

“…If healthcare professionals are to have any chance of controlling the burden of T2DM, then interventions to limit or reduce its associated pathophysiologic defects (DeFronzo's "ominous octet" [4]) are vital [5]. However, treatment with a single glucoselowering agent can only address limited targets [6] and does not provide adequate glycemic control in many cases [7,8].…”

Section: Introductionmentioning

confidence: 99%

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Use of oral combination therapy for type 2 diabetes in primary care: Meeting individualized patient goals

Lavernia¹,

Adkins²,

Shubrook

2015

Postgraduate Medicine

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The management of type 2 diabetes mellitus (T2DM) by primary care physicians (PCPs) has become increasingly complex due to limitations on consultation time, an increasing array of drug treatment options, and issues of comorbidities and polypharmacy. Diabetes is a progressive condition and treatment with a single glucose-lowering agent can only address limited pathophysiologic targets and does not provide adequate glycemic control in many cases. Consequently, most patients with T2DM will eventually require treatment with multiple glucoselowering medications. Oral combination therapy in T2DM may be given as multiple-pills, or as single-pill, fixed-dose combinations (FDCs), the latter of which offer convenience, ease of administration, and a reduction in the medication burden. Therefore, FDCs can potentially improve patients' treatment adherence and optimize achievement and maintenance of glycemic targets. However, cost factors also need to be considered. An understanding of the issues associated with the use of combination therapy in T2DM will help PCPs to guide patient-centered decision making and promote the effective management of T2DM.

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Future Drug Treatments for Type 2 Diabetes

Bailey

2016

Textbook of Diabetes

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Fixed-Dose Combination Therapy in Type 2 Diabetes Mellitus

Cited by 24 publications

References 45 publications

Challenges in Pharmacotherapeutics Education for Diabetes in Real-World Clinical Settings: Views From Family Medicine and Internal Medicine Residents

Challenges in Pharmacotherapeutics Education for Diabetes in Real-World Clinical Settings: Views From Family Medicine and Internal Medicine Residents

Use of oral combination therapy for type 2 diabetes in primary care: Meeting individualized patient goals

Future Drug Treatments for Type 2 Diabetes

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