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Changes in weight and diabetes compensation (HbA1c) in patients with diabetes mellitus type 2 after adding exenatide (Byetta) to the current treatment in 28 diabetology departments in the Czech Republic – BIBY-I study (observations lasting 3 to 12 months)


Authors: J. Perušičová 1;  I. Haladová 2;  P. Piťhová 1;  Pracovní Skupina Diabetologů: D. Ácsová;  J. Bělobrádková;  A. Belzová;  K. Berková;  B. Doležalová;  H. Dvořáková;  K. Hejnicová;  M. Hudcová;  D. Kallmünzerová;  Z. Krejsová;  G. Markofová;  H. Müllerová;  K. Owen;  M. Pelikánová;  L. Raclavská;  E. Račická;  O. Škarpová;  A. Váchová;  A. Veselá;  J. Vyoralos;  J. Brož;  T. Edelsberger;  MUDr. Marek Honka;  T. Hrdina;  P. Chmura;  J. Tošovský
Authors‘ workplace: Interní klinika 2. lékařské fakulty UK a FN Motol Praha, přednosta prof. MUDr. Milan Kvapil, CSc., MBA 1;  I. interní klinika Lékařské fakulty UK a FN Plzeň, přednosta prof. MUDr. Martin Matějovič, Ph. D. 2
Published in: Vnitř Lék 2013; 59(3): 165-171
Category: Original Contributions

Overview

BIBY study objective:
To obtain experience with exenatide treatment (Byetta) in patients with diabetes mellitus type 2 in a common clinical practice of diabetology departments.

Type of observation:
Observational study conducted by a randomly selected group of outpatient medical practitioners from 28 diabetology departments in the Czech Republic.

Observed and assessed population:
465 patients underwent at least three months of Byetta treatment; 347 persons (74.6% of the research population) stayed for the extended observation of 6–12 months. Apart from the basic identification data (year of birth, sex, age when diabetes mellitus manifested, height, maximum patient weight before diabetes and when diabetes mellitus manifested), the following information was recorded in three-month intervals: weight, waistline, glycated haemoglobin (HbA1c), and diabetes mellitus treatment The population included 50.3% women and 49.7% men, and the average age at the time of diabetes manifestation was 48 (20–73 years). The period between the diabetes manifestation and the start of exenatide treatment was 8.3 years on average.

Results:
The average maximum BMI value before the detection of diabetes was 39.05 (± 6.73); at the time of the diabetes manifestation 37.88 (± 6.40); and at the start of Byetta treatment 39.01 (± 6.22). The BMI after three, six, and 12 months of treatment was as follows: 37.86 (± 6.12), 37.18 (± 6.0), and 36.60 (± 6.21); it decreased by ≥ 0.5 in 83.3% patients who were under observation for 12 months. HbA1c value decreased in the first three months from 7.39% (± 1.57) to 6.41% (± 1.34), p < 0.0001. In the period of three-six months, the value decreased to 6.22% (± 1.34), and after 12 months, HbA1c was at 6.04 (± 1.20). An improvement in HbA1c value of 0.5–2.0% occurred after the first year in 49% of our research population. The waistline was measured on a regular basis in only 267 patients (58.9%). The average initial value of 120.7cm was reduced within three months of the treatment to 118.3cm, and within six and 12 months to 117.3 and 112.6cm respectively.

Conclusion:
Adding Byetta to the currently applied treatment of obese patients with diabetes mellitus type 2 led, in 66.8% of the population, to a statistically significant reduction in HbA1c levels in the first three-six months of the treatment; after 12 months of treatment, 25% of the population was still showing an improvement in HbA1c of >2.0%. Of observed patients, 74.4% significantly reduced their BMI (by >0.5) during the first three months; 39.6% of patients reduced their BMI in the period of three-six months.

Key words:
diabetes mellitus type 2 – change in weight of a diabetic – exenatide – Byetta – BMI – HbA1c


Sources

1. Brixner DI, AcAdam-Marx C, Ye X et al. Six--month outcomes on A1C and cardiovascular risk factors in patients with type 2 diabetes treated with exenatide in a ambulatory care setting. Diabetes, Obesity and Metabolism 2009; 11: 1122–1130.

2. Hurren KM, Pinelli NR. Drug-drug interac­tions with glucagon-like peptide-1 receptor agonists. Ann Pharmacother 2012; 46: 710–717.

3. Macconell L, Brown C, Gurney K et al. Safety and tolerability of exenatide twice daily in pa­tients with type 2 diabetes: integrated analysis of 5594 patients from 19 placebo-controlled and comparator-controlled clinical trials. Diabetes Metab Syndr Obes 2012; 5: 29–41.

4. Nikfar S, Abdollahi M, Salari P. The efficacy and tolerability of exenatide in comparison to placebo; a systematic review and meta-analysis of randomized clinical trials. J Pharm Pharm Sci 2012; 15: 1–30.

5. Paul S, Best J, Klein K et al. Effects of HbA(1c) and weight reduction on blood pressure in patients with type 2 diabetes mellitus treated with exenatide. Diabetes Obes Metab 2012, Apr 17 [Epub ahead of print].

6. Pawaskar M, Zagar A, Sugihara T et al. Health­care resource utilization and costs assessment of type 2 diabetes patients initiating exenatide BID or glargine: a retrospective database analysis. J Med Econ 2011; 14: 16–27.

7. Pencek R, Brunell SC, Li Y et al. Use of concomitant glucose-lowering therapies and associated treatment results observed in clinical trials of twice-daily exenatide. Endocr Pract 2012; 18: 227–237.

8. Preumont V, Hermans MP, Brichard S et al. Six-month exenatide improves HOMA hyperbolic product in type 2 diabetic patients mostly by enhancing beta-cell function rather than insulin sensitivity. Diabetes Metab 2010; 36: 293–298.

9. Roubíček T, Mráz M., Bártlová M et al. Vliv 6měsíčního podávání exenatidu na kopmpenzaci diabetes mellitus 2.typu, antropometrické a biochemické parametry. Vnitř Lék 2010; 56: 15–20.

10. Segal JB, Dy SM, Millman EA et al. Diffusion into use of exenatide for glucose control in dia­betes mellitus: a retrospective cohort study of a new therapy. Clin Ther 2007; 29: 1784–1794.

11. Varanasi A, Chjaudhuri A, Dhindsa S et al. Durability of effects of exenatide treatment on glycemic control, body weight, systolic blood presure, CRP and triglyceride concentrations. Endocr Pract 2010; 14: 1–20.

12. Yong W, Shibo W, Jingang L Remission of Insulin Resistance in Type 2 Diabetic Patients After Gastric Bypass Surgery or Exenatide Therapy. Obes Surg. 2012 Mar 23 [Epub ahead of print]

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 3

2013 Issue 3

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