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Exenatide Therapy in Obese Patients With Type 2 Diabetes Mellitus Treated with Insulin

2007; Elsevier BV; Volume: 13; Issue: 5 Linguagem: Inglês

10.4158/ep.13.5.444

1934-2403

Prabhakar Viswanathan, Ajay Chaudhuri, Ruchi Bhatia, Fida Al-Atrash, Priya Mohanty, Paresh Dandona,

Pancreatic function and diabetes

Objective To evaluate the effect of exenatide on clinical parameters in obese patients with type 2 diabetes mellitus whose hyperglycemia is not adequately controlled despite treatment with oral hypoglycemic agents and insulin. Methods In this retrospective analysis, clinical progress of 52 obese patients with type 2 diabetes treated with exenatide, 5 mcg twice daily, in an outpatient setting was reviewed. Treatment initiation was between September and December 2005. Mean follow-up period was 26 weeks. Thirty-eight patients took exenatide regularly (Group A); 14 patients discontinued exenatide because of insurance, personal, or economic reasons (Group B). Measurements at baseline and at follow-up included body weight; blood pressure; and levels of hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein (CRP), and plasma lipids. Insulin dosage requirements were assessed. Results Mean body weight (± standard error of the mean) decreased by 6.46 ± 0.8 kg (P<.001) in Group A and increased by 2.4 ± 0.6 kg in Group B (P<.001). In Group A, mean HbA1c decreased by 0.6 ± 0.21% (P = .007), and the insulin dosage requirement decreased for rapid-acting and mixed insulins (P<.02). In Group A, means of the following parameters decreased: serum total cholesterol by 8.5 ± 3.3% (P = .03), triglycerides by 26 ± 7.6% (P = .01), systolic blood pressure by 9.2 ± 3.3 mm Hg (P = .02), and high-sensitivity CRP by 34 ± 14.3% (P = .05). These indices did not change in Group B. Conclusion Exenatide effectively treats obese patients with type 2 diabetes on insulin, leading to weight loss and reduction in levels of HbAlc, systolic blood pressure, triglycerides, and high-sensitivity CRP. (Endocr Pract 2007;13:444-450)