有研究評估使用胰島素治療的第一型DM病患, 輔助使用注射型及口服的降血糖藥物的效果
使用胰島素治療再加上pramlintide 普蘭林肽, 隨機研究顯示能降低A1C 0% -0.3%, 降低體重 1-2 公斤
Injectable and oral glucose-lowering drugs have been studied for their efficacy as adjuncts to insulin treatment of type 1 diabetes. Pramlintide is based on the naturally occurring β-cell peptide amylin and is approved for use in adults with type 1 diabetes. Results from randomized controlled studies show variable reductions of A1C (0–0.3%) and body weight (1–2 kg) with addition of pramlintide to insulin (25,26). Similarly, results have been reported for several agents currently approved only for the treatment of type 2 diabetes.
第一型DM患者, 注射胰島素的同時使用 metformin, 可稍微降低體重及血脂肪, 但無法降低 A1C
The addition of metformin to adults with type 1 diabetes caused small reductions in body weight and lipid levels but did not improve A1C (27,28).
第一型DM患者使用胰島素治療加上 GLP-1RA liraglutide 及 exenatide, 可降低 0.2% A1C (很微量), 降低體重 3 公斤,
The addition of the glucagon-like peptide 1 (GLP-1) receptor agonists (RAs) liraglutide and exenatide to insulin therapy caused small (0.2%) reductions in A1C compared with insulin alone in people with type 1 diabetes and also reduced body weight by ∼3 kg (29).
胰島素治療加上 SGLT2i, 相較於單純只用胰島素, 可以改善A1C 及體重. 但第一型DM患者使用 SGLT2i 會增加 2-4 倍酮酸中毒機率, 輔助藥物的危險及利益仍需進一步評估
目前只有 pramlintide 證實對第一型DM有益處.
Similarly, the addition of a sodium–glucose cotransporter 2 (SGLT2) inhibitor to insulin therapy has been associated with improvements in A1C and body weight when compared with insulin alone (30,31); however, SGLT2 inhibitor use in type 1 diabetes is associated with a two- to fourfold increase in ketoacidosis. The risks and benefits of adjunctive agents continue to be evaluated, but only pramlintide is approved for treatment of type 1 diabetes.
Pramlintide 普蘭林肽是由Amylin Pharmaceuticals 開發的可注射的胰島澱粉樣多肽類似物藥物
pramlintide，是 amylin的類似物，amylin與胰島素都是由胰臟的 β細胞分泌，血中 amylin增加時，會抑制升糖素、減緩胃排空、刺激飽食中樞，因而能降低血糖，也能降低體重，必須皮下注射使用。
在臨床試驗的表現：一篇收納 656位糖尿病病患的 RCT，追蹤 52週，發現使用 pramlintide (120 μg SC BID)的組別體重平均降低 1.4 kg，比起使用 placebo組增加 0.7 kg，達到統計學上顯著差異 (P<0.05)。
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