Document Detail


Combination Therapy with Insulin Glargine and Exenatide: Real-world Outcomes in Patients with Type 2 Diabetes.
MedLine Citation:
PMID:  22216894     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective: To investigate the real-world use of combination insulin glargine/exenatide therapy for type 2 diabetes mellitus (T2DM) and associated treatment persistence and glycemic control. Methods: In this retrospective study, data were extracted from a national US insurance claims database for patients with T2DM for whom insulin glargine and exenatide were co-prescribed in differing order: insulin glargine added after exenatide (EXE+); exenatide added after insulin glargine (GLA+); glargine and exenatide initiated together (GLA+EXE). Patients had continuous health plan coverage for 6 months pre- (baseline) and 1-year post-index (follow-up). Results: A total of 453 patients were eligible for analysis: 141 patients were included in the EXE+ cohort, 281 in the GLA+ cohort, and 31 in the GLA+EXE cohort. There were significant differences between the groups at baseline, including a significantly lower A1C in the GLA+ versus the EXE+ cohort (p=0.0023). Around one third of patients stayed on both drugs up until the end of the follow-up period (GLA+: 30.2%; EXE+: 29.0%; GLA+EXE: 29.0%). However, more patients stayed on insulin glargine than on exenatide in each cohort. Significant A1C reductions were observed in each of the cohorts at follow-up: GLA+: -0.4%; EXE+: -0.9%; GLA+EXE: -1.2%; p<0.01, and were significantly higher in the GLA+EXE and EXE+ cohorts than in the GLA+ cohort (p=0.03, and p=0.002, respectively). The mean number of hypoglycemic events increased slightly from baseline but remained low in each of the cohorts (GLA+: 0.12 to 1.42; EXE+: 0.09 to 1.04; GLA+EXE: 0.23 to 1.87 per patient, all p>0.1). Conclusions: Combined therapy with insulin glargine and exenatide resulted in A1C reductions in T2DM patients with poor glycemic control without a significantly increased risk of hypoglycemia irrespective of treatment order. Limitations of this study are the between-cohort differences at baseline, lack of a comparator group, and small n number, particularly in the GLA+EXE cohort.
Authors:
Philip Levin; Wenhui Wei; Li Wang; Chunshen Pan; Damon Douglas; Onur Baser
Related Documents :
21409314 - Effects of insulin versus sulphonylurea on beta-cell secretion in recently diagnosed ty...
15644104 - Therapy of ocular and visceral leishmaniasis in a cat.
1227684 - Thermographical investigation of decubitus ulcers.
15336614 - The effect of atorvastatin on markers of bone turnover in patients with type 2 diabetes.
16011384 - Daily fluctuations in self-control demands and alcohol intake.
12768554 - Behavior of septum primum mobility in third-trimester fetuses with myocardial hypertrophy.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-4
Journal Detail:
Title:  Current medical research and opinion     Volume:  -     ISSN:  1473-4877     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0351014     Medline TA:  Curr Med Res Opin     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The bivalent ligand approach leads to highly potent and selective acylguanidine-type histamine H<sub...
Next Document:  Graphene Quantum Dots Derived from Carbon Fibers.