Application of adjunctive therapies for treatment of type 1 diabetes (T1D) has been an area of intense exploration. However, prior to the recent approval of the dual SGLT1/2 inhibitor in Europe, the sole therapy approved for those with T1D had been pramlintide. Garnering approval from the FDA in 2005, pramlintide has had limited penetrance into clinical practice, potentially due to the need for multiple daily subcutaneous injections to administer it. To overcome this issue, some have explored co-formulation of pramlintide with insulin analogues. This presentation will review the mechanism of action of pramlintide, studies describing its use in those with T1D, and examine how co-formulation has altered the potential to integrate this therapy, even in automated insulin delivery systems.
Additionally, the role of metformin in treatment of T1D will also be reviewed focusing on the mechanism of action, studies of the agent in those with T1D, with particular focus on its effects on long-term risk of cardiovascular disease.