TABLE 2.

Best practices when combining insulin with non‐insulin anti‐hyperglycaemic treatments

Drug class/name	Best practice
Sulfonylureas	Stop sulfonylureas when initiating basal insulin due to hypoglycaemia risk 67
Thiazolidinediones	Stop thiazolidinediones or reduce dose when initiating basal insulin 2
Metformin	Continue treatment with metformin when initiating basal insulin 2 , 65
GLP‐1RAs	Combining GLP‐1 RAs with basal insulin has high efficacy and limits weight gain and hypoglycaemia; consider GLP‐1 RAs if a patient has established cardiovascular disease or chronic kidney disease 2
DPP‐4 inhibitors	Do not combine insulin with DPP‐4 inhibitors if a patient is also using a GLP‐1 RA 2
SGLT‐2 inhibitor	Consider a SGLT‐2 inhibitor if patient has established cardiovascular disease, chronic kidney disease, or heart failure; insulin dose may need to be reduced to prevent hypoglycaemia 2

Abbreviations: DPP‐4, dipeptidyl peptidase 4; GLP‐1RAs, glucagon‐like peptide‐1 receptor agonists; SGLT‐2, sodium–glucose cotransporter‐2.