Table 2.

Benefits, potential uses, cautions, and side effects of adjunctive therapies for type 1 diabetes.

Adjunctive Therapy	Benefits	Potential Use	Cautions	Side Effects
Pramlintide [35–41]	Lower A1c, weight loss in overweight/obese	Reduction of postprandial hyperglycemia, use in overweight/obese patients with T1D	May worsen gastroparesis, may require decreases in prandial insulin doses to avoid hypoglycemia, use with caution in those with hypoglycemia unawareness	Nausea, vomiting, anorexia, headache, slow dose titration and administration with food recommended to avoid side effects
Metformin [42–45]	Marginally lowers A1c, modest reduction in body weight for adolescents	Obese/overweight patients with T1D	Lactic acidosis in renal dysfunction, B12 deficiency with long-term use, hypoglycemia in adolescents, may require decreases in insulin doses to avoid hypoglycemia	Diarrhea, nausea/vomiting, flatulence, asthenia, indigestion, abdominal discomfort, headache
Liraglutide [49–50,64]	Weight reduction, lower TDD insulin	Obese/overweight patients with T1D	Use with caution in patients with thyroid cancer, may cause hemorrhagic or necrotizing pancreatitis, may need to decrease insulin doses to avoid hypoglycemia	Nausea, diarrhea, vomiting, decreased appetite, dyspepsia, constipation.
Sodium/Glucose cotransporter Type 2 inhibitor [54–61,65]	Lower A1c, weight loss, decreased systolic blood pressure, lower TDD insulin, less glucose variability	Patients with T1D knowledgeable on signs/symptoms of ketosis, willing to check ketone levels regularly, and are aware of risk of DKA	Euglycemic DKA, need for urine/blood ketone monitoring in patients with T1D, may need to decrease insulin doses to avoid hypoglycemia	Polyuria, UTI, yeast infections