PMC:3724972 / 13724-14315 JSONTXT

{"project":"2_test","denotations":[{"id":"23673515-23228667-63233627","span":{"begin":587,"end":589},"obj":"23228667"}],"text":"Patients with CD, however, are often insulin-resistant. A recently published proposal for management of hyperglycemia in patients with CD treated with pasireotide recommends metformin as first-line medical treatment for CD patients who develop new or worsening hyperglycemia with pasireotide, with an adjunctive DPP-4 inhibitor, sulfonylurea/glinide, and/or GLP-1 analog as required to achieve glycemic control. Metformin plus insulin is recommended if such combination therapy is not tolerated or insufficient and early intervention with insulin is recommended on a case-by-case basis [45]."}