Expert Opinion on Diabetes Management Challenges and Role of Basal Insulin/GLP-1 RA Fixed-Ratio Combination in People with Type 2 Diabetes from Indonesia

Abstract

Indonesia is struggling with a rapidly growing burden of diabetes due to rapid socioeconomic transition. People with type 2 diabetes mellitus (T2DM) need appropriate treatment strategies to maintain glycemic control. New modalities with simplicity, such as fixed-ratio combination of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA), further referred to as FRC, have proven to be an effective and practical therapeutic approach that may address this issue. In January 2021, a scientific expert meeting was held with the participation of endocrinologists from Indonesia to provide expert opinions regarding the optimal practical use of the FRC basal insulin/GLP1-RA. Topics discussed in the meeting included the challenges in diabetes management, clinical inertia with insulin therapy, local and international guideline positioning, initiation, titration, and switching of basal insulin and GLP-1 RA, including FRC, and the management of T2DM.

Keywords:

• fixed-ratio combination
• basal insulin
• GLP1 RA
• type 2 diabetes mellitus

Compliance with Ethics Guidelines

This article is based on previously conducted studies, published guidelines, and opinions of leading experts and does not contain any studies with human participants or animals performed by any of the authors.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, execution, acquisition of data, giving insight/feedback and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Ketut Suastika, Ida Ayu Made Kshanti, Mardianto, M, Sony Wibisono Mudjarnako, Nanny Natalia, Heri Nugroho HS, Roy Panusunan Sibarani, Pradana Soewondo, Soebagijo Adi Sulistijo, Tri Juli Edi Tarigan, and Hendra Zufry have no conflict of interest of this work.

Additional information

Funding

The Indonesian Society of Endocrinology provided financial support to the experts from the region across Indonesia who participated in the expert meeting and published the manuscript.