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This article originally posted 16 May, 2014 and appeared in  MedicationType 2 DiabetesGLP-1Issue 729GLP-1 Special Editions May 2014GLP-1 Special Editions June 2014

Chronic Twice-daily Exenatide Treatment on Beta Cell Function in New-onset T2DM

Improvements seen in peripheral insulin sensitivity and hepatic insulin extraction….

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Researchers conducted a 24-week, randomized, double-blinded, placebo-controlled, multicenter study with 79 participants given an oral glucose tolerance test at baseline before starting treatment and after 24 weeks of treatment. Participants were asked to report to their clinical testing site in the morning after an overnight fast of 10-12 hours.

The results of the trial showed that all groups lost significant amounts of weight around 2-5 kilograms, but when compared to the placebo, 24-weeks of daily high or low doses reduced HbA1c and additionally, improved fasting and postprandial hyperglycemia as well. Exenatide was associated with an improved peripheral insulin sensitivity and hepatic insulin resistance index free of changes in weight. Plasma insulin levels and insulin secretion rates, however, during the oral glucose tolerance test did not differ before or after treatment with exenatide or placebo. Exenatide when given in the higher dose was associated with a significant improvement in beta cell sensitivity to glucose, and reduced hepatic insulin extraction. The P value was less than 0.05, labeling this study as statistically significant.

According to the results of this study, a patient with new onset type 2 diabetes given exenatide chronically will experience enhanced insulin secretion rates, and increased beta cell sensitivity to glucose. Although these improvements are seen in the beta cell function, the plasma insulin and C-peptide levels do not necessarily reflect so.

Practice Pearls:
  • When given exenatide chronically it enhances insulin secretion rates, and increases beta cell sensitivity to glucose
  • Improvements when giving exenatide chronically is seen in the beta cell function but does not reflect in the plasma insulin and C-peptide levels
  • Patients taking exenatide in this study also showed significant weight loss, around 2-5 kilograms.

Gastaldelli, Amalia, Robert G. Brodows, and David D'Alessio. "The Effect of Chronic Twice Daily Exenatide Treatment on β-cell Function in New Onset Type 2 Diabetes." Clin Endocrinol. 2014;80(4):545-553.  

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This article originally posted 16 May, 2014 and appeared in  MedicationType 2 DiabetesGLP-1Issue 729GLP-1 Special Editions May 2014GLP-1 Special Editions June 2014

Past five issues: Issue 744 | Diabetes Clinical Mastery Series Issue 203 | Issue 743 | Diabetes Clinical Mastery Series Issue 202 | SGLT-2 Inhibitors Special Edition August 2014 |

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