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Comparison of adverse effects among different GLP-1 receptor agonists added to basal insulin and between GLP-1 receptor agonists and basal Insulin versus basal-plus or basal-bolus insulin in type 2 diabetes

Andrey Emanuilov Manov*, Ashan Thomas Hatharasinghe and Katrina Equinox Lopez

Diabetes mellitus type 2/ DM2/ - is increasing in incidence in United States and throughout the world mostly due to increasing Obesity epidemy- around 40 % of adult people in USA. Two are the major defects of the disease- insulin resistance which sets up the stage 4-7 years before DM type 2 is diagnosed and relative to the increased resistance insulin deficiency. After the diagnosis of DM type 2 the Insulin resistance stays usually constant while the Insulin deficiency progresses necessitating the intensification of the therapy and eventually the need of Insulin. Initially the insulin is started usually as a basal and eventually as the DM type 2- progresses we add bolus rapid acting insulin to major meal- basal plus regimen/BP/ and eventually to every meal- basal- bolus /BB/ insulin. This intensification of the therapy is frequently able to control DM type 2, but leads to significant 3-4 kg weight gain with risk of hypoglycemia.