Combining Incretin-Based Therapies With Insulin Realizing the potential in type 2 diabetes

In conclusion, combining incretin-based therapies with basal insulin provides complementary actions, lowering both PPG and FPG, to improve glycemic control in type 2 diabetes. Theoretically, incretin-based therapies are an alternative to bolus insulin for certain groups of patients, such as the elderly, where meeting A1C targets must be balanced against the risk of hypoglycemia; however, studies evaluating any potential benefit in the elderly have not been conducted. Additionally, the weight-sparing effect of GLP-1RAs makes them well suited for use in patients with concerns about insulininduced weight gain. The improvements in glycemic control may reduce the incidence of diabetes-related complications, and taken together with the reduced risk of hypoglycemia, an incretin plus basal insulin regimen could provide significant health-economic advantages. Further research is needed to establish the longterm benefits of insulin plus incretin therapy. © 2013 by the American Diabetes Association.