The influence of 6-months treatment with exenatide on type 2 diabetes mellitus compensation, anthropometric and biochemical parameters
Authors:
T. Roubíček 1; M. Mráz 1; M. Bártlová 1; P. Kaválková 1; D. Haluzíková 1,2; P. Trachta 1; J. Housová 1; M. Matoulek 1; Š. Svačina 1; M. Haluzík 1
Authors‘ workplace:
III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
1; Ústav tělovýchovného lékařství 1. lékařské fakulty UK a VFN Praha, přednosta doc. MUDr. Zdeněk Vilikus, CSc.
2
Published in:
Vnitř Lék 2010; 56(1): 15-20
Category:
Original Contributions
Overview
Objectives:
Exenatide, a synthetic GLP‑1 analogue, is a new antidiabetic agent from the group of incretine mimetics coming into the daily clinical practice. In our study we evaluated the effect of 6-months treatment with exenatide on diabetes compensation, anthropometric and biochemical parameters in the patients with poorly controlled type 2 diabetes mellitus and obesity.
Method:
We included 18 patients with poorly controlled diabetes (mean HbA1c 8.5 ± 0.3%) treated with diet and peroral antidiabetic agents (4 patients were treated with insulin in the past). Exenatide was administered via subcutaneous injection twice daily for 6 months. Patients were examined after 1 month, when the dose of exenatide was increased from 5 μg twice daily to 10 μg twice daily and after 3 and 6 months. We evaluated the diabetes compensation, biochemical parameters, body weight changes and side effects of exenatide.
Results:
6-months exenatide treatment significant decreased body weight (baseline vs 6 month treatment 107.3 ± 4.4 kg vs 103.7 ± 4.6 kg, p = 0.02), BMI (36.7 ± 1.2 kg/m2 vs 35.3 ± 1.3 kg/m2, p = 0.01) a HbA1c (8.5 ± 0.3 % vs 7.4 ± 0.4%, p = 0.04) and increased HDL‑cholesterol (0.92 ± 0.1 mmol/l vs 0.98 ± 0.1 mmol/l, p = 0.02). Fasting glycemia tended to decline at the end of the study, but the difference did not reach the statistical significance. The area under the curve of glycemia levels after the standardized breakfast in the subgroup of 8 patients after the 6-months exenatide treatment was significantly lower when compared to baseline values (2,908 ± 148 vs 2,093 ± 194, p = 0.03). Concentrations of total and LDL‑cholesterol and triglycerides did not change significantly. The most frequent side effects of exenatide treatments were transient anorexia and nausea (38.5%), dyspepsia and functional gastrointestinal discomfort (38.5%) and various neuropsychical symptoms (nervosity and insomnia – 30.8%). Most of the side effects disappeared during the treatment, none of these side effects was a reason for discontinuation of a treatment. 3 minor hypoglycemic episodes occured in patients simultaneously treated with derivates of sulfonylurea, but no serious hypoglycemia occured during the entire study.
Conclusion:
Exenatide treatment in obese patients with poor diabetes control was accompanied by statistically significant decrease of body weight, improvement of diabetes control and increase in HDL‑cholesterol.
Key words:
exenatide – GLP‑1 – type 2 diabetes mellitus – body weight – obesity
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