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Choosing injectable therapy: The metabolic fulcrum.
J Pak Med Assoc · 2016
Last updated 2026-05-28This study suggests people with type 2 diabetes can be grouped into three categories based on their metabolism: predominantly catabolic, eubolic (balanced), or maladaptive anabolic. Those in the catabolic group may respond best to intensive insulin therapy, while those with maladaptive anabolism may benefit from a GLP-1 receptor agonist (GLP1RA), or a combination of GLP1RA and basal insulin if needed.
AI summary of the abstract below.
| Journal | J Pak Med Assoc, 2016 |
|---|---|
| Citations | 1 |
| Relative citation ratio | 0.03 |
| NIH percentile | 4 |
| Molecules | — |
| Conditions studied | Type 2 Diabetes, Obesity, Cardiovascular Risk Reduction, Mash |
Abstract
This clinical decision making hypothesis utilizes the metabolic fulcrum based approach to classify persons with diabetes into three categories: predominantly catabolic, eubolic, and predominantly [maladaptive] anabolic. This systematic arrangement helps define choice of injectable therapy in type 2 diabetes mellitus. Patients with predominant catabolism, may respond better to intensive insulin therapy. Dual action insulin, including premixed insulin and I Deg Asp (insulin degludec aspart), may be an acceptable alternative. Uncomplicated, eumetabolic patients with type 2 diabetes may use any of the various drugs available. Patients classified as having maladaptive anabolism may benefit from a GLP1RA. If this does not suffice, a GLP1RA + basal insulin combination may be effective.
Verbatim abstract via PubMed 27427149 ↗