| Effects of Exenatide on Measures of {beta}-Cell Function After 3 Years in Metformin-Treated Patients With Type 2 Diabetes. | |
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MedLine Citation:
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PMID: 21868779 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE We previously showed that exenatide (EXE) enhanced insulin secretion after 1 year of treatment, relative to insulin glargine (GLAR), with a similar glucose-lowering action. These effects were not sustained after a 4-week off-drug period. This article reports the results after additional 2 years of exposure. RESEARCH DESIGN AND METHODS Sixty-nine metformin-treated patients with type 2 diabetes were randomized to EXE or GLAR. Forty-six patients entered the 2-year extension study in which they continued their allocated therapy. Thirty-six completed (EXE: n = 16; GLAR: n = 20) the 3-year exposure period. Insulin sensitivity (M value) and β-cell function were measured by euglycemic hyperinsulinemic clamp followed by hyperglycemic clamp with arginine stimulation at pretreatment (week 52) and 4 weeks after discontinuation of study medication (week 56 and week 172). First-phase glucose stimulated C-peptide secretion was adjusted for M value and calculated as the disposition index (DI). RESULTS At 3 years, EXE and GLAR resulted in similar levels of glycemic control: 6.6 ± 0.2% and 6.9 ± 0.2%, respectively (P = 0.186). EXE compared with GLAR significantly reduced body weight (-7.9 ± 1.8 kg; P < 0.001). After the 4-week off-drug period, EXE increased the M value by 39% (P = 0.006) while GLAR had no effect (P = 0.647). Following the 4-week off-drug period, the DI, compared with pretreatment, increased with EXE, but decreased with GLAR (1.43 ± 0.78 and -0.99 ± 0.65, respectively; P = 0.028). CONCLUSIONS EXE and GLAR sustained HbA(1c) over the 3-year treatment period, while EXE reduced body weight and GLAR increased body weight. Following the 3-year treatment with EXE, the DI was sustained after a 4-week off-drug period. These findings suggest a beneficial effect on β-cell health. |
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Authors:
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Mathijs C Bunck; Anja Cornér; Bjorn Eliasson; Robert J Heine; Rimma M Shaginian; Marja-Riitta Taskinen; Ulf Smith; Hannele Yki-Järvinen; Michaela Diamant |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetes care Volume: 34 ISSN: 1935-5548 ISO Abbreviation: Diabetes Care Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-08-26 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: United States |
Other Details:
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Languages: eng Pagination: 2041-7 Citation Subset: IM |
Affiliation:
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Corresponding author: Mathijs C. Bunck, mcmbunck@vumc.nl. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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