Initial Observation Of Exenatide For Treatment Of Type 2 Diabetes

Objective: To investigate effects of exenatide on glycemic control,the change of weight and adverse effects in patients with type 2 diabetes mellitus.Method: According to the standard of diabetes diagnosis that WHO suggested in 1999,we selected 66 patients with type 2 diabetes and inadequate glycemic control (defined as hemoglobin A1c level ranging from 7.0% to 10.0%) despite combination metformin therapy,Which were out-patients and hospitalized patients in endocrine section of the affiliated hospital of Qing Hai University and other parts of country hospitals from October, 2009 to December, 2010. The 66 patients were randomized into The exnatide group(n=32) (twice-daily Exnatide plus metformin) and The insulin glargine group(n=34)(once-daily insulin glargine plus metformin), Therapy goals: FBG≤5.6 mmol, HbAlc≤7%.The therapy went on 26 weeks. According to FBG, hypoglycemia, and the incidence of serious side effects to regulate the therapy plans. If the patients who meets the withdraw standards or gives up the therapy on himself, he should immediately exit the clinical study. At the end of the study on the 26th week, the two groups were undertook the examination, such as FBG, HbAlc, Weight, monitored 7 times of the blood glucose in one day, and recorded related adverse effects of medicine.Result: At the end of the study on the 26th week, HbA1c were all decreased in two groups, but no Statistical difference between the two groups (P> 0.05); FPG were all significantly decreased in two groups, but the insulin glargine groups decreased greater than the exenatide groups (P<0.05); weight was significantly decreased in Tthe exenatide group (P<0.05),however, weight was raised the insulin glargine groups (P<0.05), the two groups had statistical difference (P <0.05);SMBG of the two groups had characteristics respectively, glucose concentrations decreased greater in the exenatide groups than in the insulin glargine groups: at post-morning meal (P<0.05) and post-evening meal (P<0.05), but patients received insulin glargine had lower glucose levels at fasting (P<0.05), prelunch (P<0.05), predinner (P<0.05), and at 3:00 a,m. (P<0.05); Rates of symptomatic hypoglycemia had no statistical significance between the two groups (P> 0.05); Rates of gastrointestinal symptoms were more common in the exenatide group than in the insulin glargine group, the two groups had statistical significance (P <0.05). In the exenatide group, the HbAlc of pre-therapy was higher than the post-therapy (P <0.05), FBG was lower than the pre- therapy (P<0.05), the percentage of ideal blood glucose on 7 times of the blood glucose in one day was lower than the pre- therapy (P <0.05), the body weight was lower than the pre- therapy (P <0.05).Conclusions: The study suggests that exenatide and insulin glargine achieved similar improvements of overall glycemic control in patients with type 2 diabetes that was suboptimally controlled with Singly oral combination therapy. However, exenatide was associated with Outstanding and perdurable blood sugar control, the risk of hypoglycemia is low,weight reduction, fix-dose, conveniencely cure and a higher incidence of gastrointestinal adverse effects.