Abstract

Advances in treatment offerings are moving beyond classical considerations around glucose control to focus on other aspects of the disease. Such advances include the development of treatments that address the high cardiovascular (CV) risk in patients with diabetes, or have novel mechanisms of action, and new technologies that will facilitate the future integration of care. The proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors represent a new therapeutic approach for managing CV risk in patients with diabetes. New clinical data recently generated from dedicated diabetes studies have established PCSK9 inhibitors as an efficacious and well-tolerated treatment option for patients with diabetes and persistently elevated low-density lipoprotein-cholesterol levels, despite optimised lipid-lowering therapy. Treatments with novel mechanisms of action are also being investigated. Sotagliflozin, a dual inhibitor of the sodium-glucose cotransporter 1 (SGLT1) and sodium-glucose cotransporter 2 (SGLT2), may offer additional clinical benefits beyond those of existing selective SGLT2 inhibitors in patients with Type 1 diabetes mellitus. The sotagliflozin inTandem Phase III programme will provide valuable insights regarding the potential role of dual SGLT1 and SGLT2 inhibitors as an adjunct to insulin therapy in patients with Type 1 diabetes mellitus. Furthermore, advances in diabetes devices, such as implantable drug delivery systems, non-invasive glucose monitoring, and closed-loop artificial pancreas systems, are fuelling the development of new models of patient care. While there will inevitably be other innovations, three major advances will dramatically change diabetes care over the next 10–20 years: 1) digital diabetes health technologies, 2) artificial intelligence and machine learning, and 3) virtual reality.

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