GLP1 RAs are Recommended To Be First Injectable for Diabetes

Amy Butts | GAPA 2020 CME Conference

Written by: Amy Butts, PA-C, MPAS, CDE, BC-ADM

ADA releases its Standards of Care yearly in January. Guidelines from 2019 and 2020 both recommend that when going to an injectable for type 2 diabetes that we should be reaching for a GLP1 RA. This is recommended due to the efficacy and safety that this class provides.  GLP1 RAs provide a robust A1C reduction often greater than 1%, weight loss due to benefits of satiety, and no hypoglycemia due to its glucose-dependent insulin-releasing properties.  More recently, several of the GLP1 RA has been shown to reduce cardiovascular risk in patients with established cardiovascular disease. Insulin is still a necessary tool in our kit.  In fact, if after GLP1 RA and or three or more oral agents the A1C is not at a goal then introducing basal insulin is recommended. Basal insulin provides fasting glucose control and GLP1 RA provides fasting and postprandial control, so it is an excellent combination choice with fewer injections than basal/bolus therapy. Remember individualization of care is a priority. So this may not be an option for some, which is why it is wonderful that we have so many options to choose from.

 

For more information on managing diabetes, see Amy Butts, PA-C, MPAS, CDE, BC-ADM speak at the GAPA 2020 Summer Conference in Sandestin, Florida.

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