Diabetes, Metabolic Syndrome and Obesity (Sep 2022)

Expert Opinion on Diabetes Management Challenges and Role of Basal Insulin/GLP-1 RA Fixed-Ratio Combination in People with Type 2 Diabetes from Indonesia

  • Suastika K,
  • Eliana F,
  • Kshanti IAM,
  • Mardianto M,
  • Mudjarnako SW,
  • Natalia N,
  • HS HN,
  • Sibarani RP,
  • Soewondo P,
  • Soelistijo SA,
  • Tarigan TJE,
  • Zufry H

Journal volume & issue
Vol. Volume 15
pp. 2977 – 2990

Abstract

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Ketut Suastika,1 Fatimah Eliana,2 Ida Ayu Made Kshanti,3 Mardianto Mardianto,4 Sony Wibisono Mudjarnako,5 Nanny Natalia,6 Heri Nugrohom HS,7 Roy Panusunan Sibarani,8 Pradana Soewondo,9 Soebagijo Adi Soelistijo,5 Tri Juli Edi Tarigan,9 Hendra Zufry10 1Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University, Sanglah Hospital Denpasar, Bali, Indonesia; 2Faculty of Medicine, Yarsi University, Jakarta, Indonesia; 3Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia; 4Faculty of Medicine, University of Sumatra Utara/Adam Malik Central Hospital, Internal Medicine, Medan, Indonesia; 5Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; 6Faculty of Medicine, Padjadjaran University, Hasan Sadikin Hospital, Bandung, Indonesia; 7Faculty of Medicine, Diponegoro University, Central General Hospital Dr. Kariadi, Semarang, Indonesia; 8Endocrinology and Diabetes Center EMC Hospital Sentul City, Bogor, Indonesia; 9Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; 10Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, School of Medicine Universitas Syiah Kuala/Dr. Zainoel Abidin General Teaching Hospital, Banda Aceh, IndonesiaCorrespondence: Ketut Suastika, Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Udayana University-Sanglah Hospital, Kamboja Street, Dangin Puri Kangin, No. 8, 80233, Denpasar, Bali, Indonesia, Tel +62 81 138 0916, Email [email protected]: Indonesia is struggling with a rapidly growing burden of diabetes due to rapid socioeconomic transition. People with type 2 diabetes mellitus (T2DM) need appropriate treatment strategies to maintain glycemic control. New modalities with simplicity, such as fixed-ratio combination of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA), further referred to as FRC, have proven to be an effective and practical therapeutic approach that may address this issue. In January 2021, a scientific expert meeting was held with the participation of endocrinologists from Indonesia to provide expert opinions regarding the optimal practical use of the FRC basal insulin/GLP1-RA. Topics discussed in the meeting included the challenges in diabetes management, clinical inertia with insulin therapy, local and international guideline positioning, initiation, titration, and switching of basal insulin and GLP-1 RA, including FRC, and the management of T2DM.Keywords: fixed-ratio combination, basal insulin, GLP1 RA, type 2 diabetes mellitus

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