Have you considered adding medications designed for people with type 2 diabetes (e.g., metformin, GLP-1s, SGLT-2s) to your diabetes care regimen (i.e., in addition to insulin)?
Since the discovery of insulin in 1921, people with type 1 diabetes have relied on injected insulin, along with careful attention to diet and exercise, to manage their blood glucose levels. Based on clinical outcomes, it's clear that insulin alone is rarely enough to achieve an HbA1c in the recommended target range. Thankfully, there are new drugs that are poised to help.
In recent years, several new classes of drugs have become available to help people with type 2 diabetes. Two interesting classes are GLP-1 agonists and SGLT2 inhibitors. Both of these classes of drugs have been the subject of research in type 1 diabetes, and both are in use today by adults with type 1 diabetes, though this use is off-label.
If you are struggling to achieve your target HbA1c, you might want to discuss these new medications with your diabetes team.
- The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus. Free full text available in PDF format.
- Empagliflozin, a sodium glucose co-transporter 2 inhibitor, in the treatment of type 1 diabetes.
- Renal glucose handling in diabetes and sodium glucose cotransporter 2 inhibition. Free full text available in HTML format.
- AACE: Off Label Use for Liraglutide in Type 1's.
- Four weeks of treatment with liraglutide reduces insulin dose without loss of glycemic control in type 1 diabetic patients with and without residual beta-cell function. Free full text available in HTML and PDF formats.
- Liraglutide as additional treatment for type 1 diabetes. Free full text available in HTML and PDF formats.