Table 4.

A review of potential adjuvant pharmacological therapies to insulin in obese patients with type 1 diabetes.

Name of the drug	Mechanism of action	The benefits for obese patients with T1DM	Side effects
Metformin	• Reducing gluconeogenesis in the liver, promoting glucose uptake in peripheral tissues	• Reducing cardiovascular risk, improving insulin sensitivity, reducing weight, BMI and adiposity	• Increased prevalence of minor gastrointestinal side effects
GLP-1 receptor agonists	• Increasing the secretion of insulin and decreasing the release of glucagon in a glucose-dependent manner	• Reducing HbA1c, BMI, fasting and postprandial blood glucose levels and insulin dose	• Increased prevalence of gastrointestinal side effects
DPP-4 inhibitors	• Inhibition of GLP-1 degradation	• No significant effect on the reduction of HbA1c, body weight, BMI or insulin dose	• Unknown
Pramlintide	• Decreasing postprandial glucagon output, delaying gastric emptying, promoting satiety	• Improving glycaemic control, reducing insulin dose and body weight	• Transient hypoglycemia, gastrointestinal side effects
SGLT-2 inhibitors	• Inhibiting glucose reabsorption in proximal tubule of nephron	• Reduction in HbA1c level, body weight and total daily insulin dose	• Euglycemic diabetic ketoacidosis, urinary tract and genital infections