Combination of Glucagon-like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter Inhibitors in Type 1 Diabetes: Why, when and How? An Exploration of the Rationale and Clinical Scenarios for Combining These 2 Adjunctive Agents.

Even with the most advanced insulin preparations and delivery systems currently available, it is challenging for many people with type 1 diabetes (T1D) to achieve target levels of glycemic management. Adjunct therapy in T1D consists of adding glucose-lowering agents besides insulin with the aim of lowering hemoglobin A1c (HbA1c) and improving other health outcomes, including weight. It is an attractive potential strategy for achieving glycemic targets and other benefits in this T1D subpopulation. While not yet Food and Drug Adminstration (FDA)-approved for this use, incretin-based therapies (glucagon-like peptide-1 receptor agonist-based therapy) and sodium-glucose cotransporter-1/2 (SGLT-1/2) inhibitors are being prescribed off-label for T1D.