Rationale for the use of combination injectable therapy in patients with type 2 diabetes who have high A1C (≥9%) and/or long duration (>8 Years): Executive summary

• Type of Material: Article
• Authors: Vivian A Fonseca, Tulane University; Minisha Sood, Fifth Avenue Endocrinology; Rodolfo Galindo, Emory University
• Language: English
• Date: 2021-04-01
• Publisher: American Diabetes Association
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the American Diabetes Association
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.2337/cd20-0121
• Title of Journal or Parent Work: Clinical Diabetes
• Volume: 39
• Issue: 2
• Start Page: 141
• End Page: 145
• Grant/Funding Information: The authors received writing/editorial support in the preparation of the videos and executive summary from Helen Jones, PhD, CMPP, on behalf of Evidence Scientific Solutions in Philadelphia, PA. This assistance was also funded by Sanofi US.; The production of this video series and associated materials was funded by Sanofi US, Bridgewater, NJ.
• Keywords: Patients; Injectable Therapy; Type 2 Diabetes
• Research Categories: Health Sciences, Public Health

Abstract

Recommended A1C targets for people with type 2 diabetes are between 6.5 and 8%; however, real-world data suggest that an increasing proportion of people with diabetes have suboptimal control, and ∼15% have an A1C level >9%. People with A1C >9% are at increased risk for micro- and macrovascular complications and require treatment intensification to improve glycemic control as early as possible. In a series of short videos now available on the Clinical Diabetes website, the authors discuss the pathophysiological changes that occur during the progression of type 2 diabetes, with particular focus on the key role of declining β-cell function. The authors review clinical characteristics—long diabetes duration and A1C ≥9%—that are indicative of diminishing β-cell function, and they discuss the clinical data that support the use of available treatment options for these individuals, consistent with current diabetes treatment guidelines.