Early and intensive management of type 2 diabetes has been shown to delay disease progression, reduce the risk of cardiorenal complications and prolong time to treatment failure. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are being increasingly recognized for their potential in early disease management, with recent guideline updates recommending second-line use of this injectable drug class along-side oral glucose-lowering drugs.
GLP-1RAs target at least six of the eight core defects implicated in the pathogenesis of type 2 diabetes and offer significant glycaemic and weight-related improvements over other second-line agents in head-to-head trials. In addition, placebo-controlled clinical trials have shown cardiovascular protection with GLP-1RA use. Even so, this therapeutic class is underused in primary care, largely owing to clinical inertia and patient-related barriers to early intensification with GLP-1RAs. Fortunately, clinicians can overcome barriers to treatment acceptance through patient education and training, and management of treatment expectations.
This review comments on global and Australian guideline updates and evidence in support of early intensification with this therapeutic class, and provides clinicians with practical advice for GLP-1RA use in primary care.
To read more, visit: https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14953
This paper was co-authored by Associate Professor Roy Rasalam. Roy recently joined the new AusTrials site in Melbourne as the Principal Investigator. You can read more about Roy here: https://austrials.com.au/associate-professor-roy-rasalam-joins-austrials-sunshine/