{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:15:17Z","timestamp":1774631717667,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T00:00:00Z","timestamp":1703808000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Many people living with type 1 diabetes (type 1 diabetes mellitus (T1DM)) do not meet glycaemic targets. Adjunctive therapies have both risks and metabolic benefits and may have a role in selected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review the prescribing patterns of adjunctive therapy for the treatment of T1DM diabetes in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted an online survey of Australian endocrinologists and endocrinology registrars. We surveyed the frequency of, motivations and concerns regarding the prescription of metformin, dipeptidyl peptidase\u20104 (DPP\u2010IV) inhibitors, sodium\u2010glucose transport protein 2 (SGLT\u20102) inhibitors and glucagon\u2010like peptide 1 receptor agonist (GLP1RA) in T1DM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010two practitioners participated. Most respondents (94%) had prescribed adjuncts for the treatment of T1DM in some form. Weight (89%), large insulin doses (73%), glycaemic variability (52%), high HbA1c (48%) and the presence of cardiovascular disease (48%) were the most common factors determining the use of adjuncts. The most commonly prescribed adjuncts were metformin (94%) and SGLT\u20102 inhibitors (65%). Respondents who had never prescribed an SGLT\u20102 inhibitor (<jats:italic>n<\/jats:italic> =\u200918) reported risk of diabetic ketoacidosis (DKA) (100%), off\u2010label status (39%), lack of evidence (39%), withdrawal of support from the European Medicines Agency (17%) and cost (17%) as factors contributing to their decision. Thirty\u2010one respondents (60%) had prescribed a GLP1RA. Among those who had never prescribed a GLP1RA (<jats:italic>n<\/jats:italic> =\u200921), off\u2010label status (57%), lack of evidence (48%), cost (38%) and expected lack of efficacy (14%) were factors affecting their decision. Only five respondents (10%) had prescribed a DPP\u2010IV inhibitor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Australian endocrinologists commonly prescribe adjuncts to address cardiometabolic concerns in T1DM. DKA risk and off\u2010label status are significant factors contributing to reluctance to prescribe.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.16312","type":"journal-article","created":{"date-parts":[[2023,12,30]],"date-time":"2023-12-30T07:38:30Z","timestamp":1703921910000},"page":"779-785","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prescribing patterns of adjunctive therapy for the treatment of type 1 diabetes mellitus among Australian endocrinologists"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-4561","authenticated-orcid":false,"given":"Patrice","family":"Forner","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology St Vincent's Hospital  Sydney New South Wales Australia"},{"name":"St Vincent's Healthcare Campus, Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Snaith","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology St Vincent's Hospital  Sydney New South Wales Australia"},{"name":"St Vincent's Healthcare Campus, Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Clinical Diabetes, Appetite and Metabolism Garvan Institute of Medical Research  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry R.","family":"Greenfield","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology St Vincent's Hospital  Sydney New South Wales Australia"},{"name":"St Vincent's Healthcare Campus, Faculty of Medicine University of New South Wales  Sydney New South Wales Australia"},{"name":"Clinical Diabetes, Appetite and Metabolism Garvan Institute of Medical Research  Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408214"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2014.29"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/db10-0328"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-304237"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2020.0171"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-021-01430-3"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2019.11.007"},{"key":"e_1_2_7_10_1","unstructured":"European Medicines Agency.First Oral Add\u2010on Treatment to Insulin for Certain Patients with Type 1 Diabetes (Media Release); 1 Feb 2019Available from URL:https:\/\/www.ema.europa.eu\/en\/news\/first-oral-add-treatment-insulin-treatment-certain-patients-type-1-diabetes"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1087"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264-020-01010-6"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14620"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-1749"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-0403"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac618"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.26.10.2871"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.07.036"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1636-9"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.o373"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0343"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0342"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S194688"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51637"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000170"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-5448.2009.00519.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.2015.1084502"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-017-0282-3"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01686-x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2016.08.022"},{"key":"e_1_2_7_31_1","unstructured":"Medical Board of Australia.Australian Health Practitioners Regulation Agency. 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