Initiating therapy with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) often necessitates a decrease in the dosage of long-acting insulin. This adjustment is crucial to mitigate the risk of hypoglycemia. The rationale stems from the complementary mechanisms of action; GLP-1 RAs enhance glucose-dependent insulin secretion, while basal insulin provides a steady background level of the hormone. Combining these without adjustment can lead to excessive insulin levels.
This practice is important for patient safety and glycemic control. Utilizing a combination therapy improves blood sugar management while minimizing the potential for adverse events. Historically, insulin was the primary therapy for type 2 diabetes management. The introduction of GLP-1 RAs represents a significant advancement, allowing for a more nuanced and individualized approach to glucose regulation. By reducing the reliance on exogenous insulin, clinicians can often achieve better outcomes with fewer side effects.
