Alternativas para el manejo farmacológico de la diabetes mellitus tipo II, en pacientes adultos con inadecuada respuesta a la monoterapia. Revisión sistemática

Abstract

Background: Diabetes Mellitus control involves pharmacological measures, mainly based on monotherapy, that often do not meet the proposed objectives; therefore, multiple therapies are often necessary after monotherapy failure. General objective: To analyze the evidence of pharmacological management alternatives for Diabetes Mellitus Type II in adult patients with inadequate response to monotherapy to establish an informed criterion on using alternative therapies versus monotherapy. Methods: A systematic and qualitative review study was conducted through the PRISMA method. Results: It was evidenced that GLP-1 analog usage as an adjunct to metformin was associated with a significant reduction in fasting plasma glucose and HbA1c. The study by Handelsman et al. (2019) in patients who had consumed metformin, revealed a decrease in HbA1c when applying the triple therapy of Dapagliflozin plus Saxagliptin and Metformin compared to the one based on Sitagliptin plus Metformin, with a reduction of -1.41 ± 0.007 % versus -1.07 ± 0.07 % respectively. Conclusions: Multiple therapies are necessary for controlling Diabetes Mellitus, and using GLP-1 analogs as part of this therapy was associated with greater therapeutic safety and better glycemic results.