Effects of Exenatide on Measures of β-Cell Function After 3 Years in Metformin-Treated Patients With Type 2 Diabetes

• DOI: 10.2337/dc11-0291
• Publication Date: 2011-08-25T21:52:35Z
• Authors: Mathijs C. Bunck; Anja Cornér; Bjorn Eliasson; Robert J. Heine; Rimma M. Shaginian; Marja-Riitta Task...; Ulf Smith; Hannele Yki-Järvinen; Michaela Diamant
• Keywords: Adult; Blood Glucose; Glycated Hemoglobin; Male; C-Peptide; Venoms; Body Weight; Insulin Glargine; Middle Aged; Metformin; 3. Good health; 12. Responsible consumption; Insulin, Long-Acting; Diabetes Mellitus, Type 2; Insulin-Secreting Cells; Exenatide; Humans; Hypoglycemic Agents; Female; Peptides; Original Research; Aged

OBJECTIVE We previously showed that exenatide (EXE) enhanced insulin secretion after 1 year of treatment, relative to glargine (GLAR), with a similar glucose-lowering action. These effects were not sustained 4-week off-drug period. This article reports the results additional 2 years exposure. RESEARCH DESIGN AND METHODS Sixty-nine metformin-treated patients type diabetes randomized EXE or GLAR. Forty-six entered 2-year extension study in which they continued their allocated therapy. Thirty-six completed (EXE: n = 16; GLAR: 20) 3-year exposure Insulin sensitivity (M value) and β-cell function measured by euglycemic hyperinsulinemic clamp followed hyperglycemic arginine stimulation at pretreatment (week 52) 4 weeks discontinuation medication 56 week 172). First-phase glucose stimulated C-peptide was adjusted for M value calculated as disposition index (DI). RESULTS At 3 years, GLAR resulted levels glycemic control: 6.6 ± 0.2% 6.9 0.2%, respectively (P 0.186). compared significantly reduced body weight (−7.9 1.8 kg; P < 0.001). After period, increased 39% 0.006) while had no effect 0.647). Following DI, pretreatment, EXE, but decreased (1.43 0.78 −0.99 0.65, respectively; 0.028). CONCLUSIONS HbA1c over treatment weight. DI findings suggest beneficial on health.