| Glucagon-like peptide-1 analog and insulin combination therapy in the management of adults with type 2 diabetes mellitus. | |
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MedLine Citation:
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PMID: 20530705 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the efficacy and tolerability of combination glucagon-like peptide-1 (GLP-1) analogs and insulin in the management of type 2 diabetes mellitus (T2DM) in adults. DATA SOURCE: A MEDLINE search (1966-April 2010) was conducted using the key terms glucagon-like peptide-1 analog, exenatide, incretin mimetic, liraglutide, diabetes mellitus, and insulin. STUDY SELECTION AND DATA EXTRACTION: All English-language articles identified from the data source were evaluated and reviewed for inclusion. Original research and retrospective cohorts were included in this review. The references of articles that we identified were examined for any additional studies appropriate for review. DATA SYNTHESIS: Exenatide is a subcutaneously administered GLP-1 receptor agonist that is used for the improvement of glycemic control in adults with T2DM. Through actions similar to those of endogenous GLP-1, exenatide contributes to improved postprandial glycemic control and weight loss. The concomitant use of exenatide and insulin is currently not Food and Drug Administration-approved due to lack of clinical trial data. However, combination insulin and exenatide may be advantageous, especially for reducing weight gain, particularly for obese patients with T2DM. Several small prospective and retrospective studies evaluating combination therapy found statistically significant reductions in hemoglobin A(1c) (A1C), weight, and total daily insulin dose requirements. The most common adverse effects reported included gastrointestinal effects, such as nausea and vomiting, and hypoglycemia. CONCLUSIONS: Although there is a limited amount of data and not all studies demonstrated A1C reduction, the combination of exenatide with insulin therapy appears to be a safe option in the management of T2DM. It may be a promising therapeutic strategy for some patients, as reductions in weight and insulin doses were observed. Further well-designed prospective trials are warranted to fully determine the long-term effectiveness and safety of this combination as well as its place in therapy. |
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Authors:
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Maria Tzefos; Jacqueline L Olin |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-06-08 |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 44 ISSN: 1542-6270 ISO Abbreviation: Ann Pharmacother Publication Date: 2010 Jul-Aug |
Date Detail:
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Created Date: 2010-07-01 Completed Date: 2010-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1294-300 Citation Subset: IM |
Affiliation:
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School of Pharmacy, Wingate University, NC 28174, USA. m.tzefos@wingate.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Glucose
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drug effects Diabetes Mellitus, Type 2 / drug therapy*, physiopathology Drug Therapy, Combination Hemoglobin A, Glycosylated / metabolism Humans Hypoglycemic Agents / adverse effects, pharmacology, therapeutic use* Insulin / adverse effects, pharmacology, therapeutic use Peptides / adverse effects, pharmacology, therapeutic use Receptors, Glucagon / agonists Venoms / adverse effects, pharmacology, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Peptides; 0/Receptors, Glucagon; 0/Venoms; 0/glucagon-like peptide receptor; 11061-68-0/Insulin; 141732-76-5/exenatide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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