8. Drug Updates

Effect of incretin-based therapies on β-cell function and insulin resistance

A metanalysis which looked into comparative effects of incretin-based therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dipeptidyl peptidase-4 inhibitors (DPP-4Is), on β-cell function and insulin resistance in patients with type 2 diabetes mellitus (T2DM) found that they not only reduces homeostasis model assessment for insulin resistance (HOMA-IR) and fasting plasma glucose (FPG) level but also improves HOMA for beta cell function (HOMA-β) and fasting C-peptide level. A total of 360 RCTs (74% at least double-blinded) with 157 696 patients were included. Incretin-based therapies were compared with six other classes of glucose-lowering drugs or with placebo. Compared with placebo, a significant increase in HOMA-β and fasting C-peptide was detected for GLP-1RAs and for DPP-4Is separately, while a significant reduction in HOMA-IR and FPG were found in favour of GLP-1RAs and DPP-4Is, respectively.

Authors suggested that although Grading of Recommendations Assessment, Development and Evaluation scores showed low to moderate evidence for most comparisons, incretin-based therapies seem to be suitable option for long-term treatment of T2DM and to preserve β-cell function

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Diabeloop’s Automated Insulin Delivery System obtains CE Mark

Diabeloop’s hybrid closed loop system, called ‘DBLG1,’ has received a CE mark to launch the automated insulin delivery (AID) system in Europe. Diabeloop is a French medical technology company that specializes in creating accessible innovations for the Type 1 diabetes community. DBLG1 system will include a Kaleido insulin pump worn on the body, the Dexcom G6 CGM, and Diabeloop’s own locked-down touchscreen controller. The controller will receive Dexcom CGM readings and trends, run them through an algorithm, and then tell the pump to adjust basal insulin accordingly. Additional key features include: Users can adjust the algorithm target between 100 – 130 mg/dl. A ‘Zen mode’ virtually ensures no lows over a short time period. Option to share and analyze data, potentially with a healthcare provider.

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