Effects of medium-long term regular treatment with exenatide in type 2 diabetic patients: A lombard multicenter initiative [Effetti del trattamento persistente con exenatide a medio-lungo termine in soggetti con diabete mellito di tipo 2: Esperienza multicentrica lombarda]

Le résumé fourni par la source

Exenatide (Exe) is a GLP-1 receptor agonist that boosts β-cell insulin secretion, in order to correct hyperglycemia. Exe also suppresses glucagon release without inhibiting the response to hypoglycemia. This retrospective study examined the efficacy of regular treatment with Exe in type 2 diabetic patients, whose blood glucose was not adequately managed despite lifestyle modifications and oral antidiabetic drugs (OAD). We collected data from 238 outpatients (114 M, 124 F; aged 58.3 ± 9.5 years; diabetes duration 10.1 ± 6.7 years) from seven diabetes centers in Lombardy (Italy). In order to detect any differences in the effects of Exe in relation to baseline levels of the main metabolic and anthropometric parameters, we divided this population post-hoc on the basis of the medians for the following variables: HbA1c (up to and including 8.5%, or more), fasting plasma glucose (FPG, up to 175 mg/dl, or more), body mass index (BMI, up to 37.5 kg/m2, or more), and diabetes duration (up to 9 years, or more). This gave a good picture of metabolic and anthropometric patterns over time. We also divided patients on the basis of the OAD they were taking at study entry. Metformin was the most widely used non-secretagogue (Group Non-S: 96 patients); sulphonilureas and repaglinide were the main secretagogues (Group S: 142 patients). Group S patients were older than Group Non-S cases (p < 0.01), with a longer diabetes duration, and higher HbA1c and FPG (p < 0.0001). Non-S patients had heavier body weight at baseline (p = 0.001), and higher BMI (p = 0.01). Clinical and anthropometric parameters progressively and uniformly declined, most markedly HbA1c, which was higher at baseline in Group S. Exe reduced body weight more in the Non-S group, reaching statistical significance after 24 months (p = 0.01). These findings confirm the therapeutic efficacy of Exe for better glycemic control and body weight reduction after a medium-long period of treatment. Previous use of oral secretagogues did not invalidate the fa-vorable effect of Exe on some of the main cardiovascular risk factors.

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