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empagliflozin + dulaglutide + basal insulin + metformin
- Development stage
- Unknown
- Lead developer
- University of California, San Francisco
- Modality
- Peptides, Small Molecules, Recombinant Proteins and Enzymes
- Administration
- Oral, Subcutaneous
01
Overview
The 'stepping-down approach' is a therapeutic regimen developed and studied by researchers at the University of California, San Francisco (UCSF) for the treatment of obese patients with poorly controlled type 2 diabetes mellitus. This strategy involves de-escalating from multiple daily insulin injections (MDI) to a combination therapy consisting of a sodium-glucose cotransporter-2 (SGLT2) inhibitor (specifically empagliflozin), a glucagon-like peptide-1 (GLP-1) receptor agonist (such as dulaglutide or albiglutide), basal insulin, and metformin. The regimen aims to improve glycemic control and facilitate weight loss by replacing prandial insulin injections with non-insulin agents that have weight-lowering properties, thereby addressing common barriers to compliance such as weight gain and injection burden.
- Other names
- Stepping-down ApproachSGLT2i + GLP-1 RA + basal insulin + metforminempagliflozin + albiglutide + basal insulin + metformin
02
Targets
INSR (Insulin receptor)AMPK (Adenosine monophosphate–activated protein kinase)SGLT2 (Sodium-glucose cotransporter protein subunit 2)GLP1R (GLP-1R)
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