Effect of Adding Exenatide (Synthetic
Exendin-4) to Metformin and/or Sulfonylurea Treatment
in Patients With Type 2
Exendin-4 is a promising therapeutic for patients
with type 2 diabetes.
AC2993 (synthetic exendin-4; exenatide) is a peptide
that enhances glucose-dependent insulin secretion,
suppresses inappropriately elevated glucagon secretion,
and slows gastric emptying. AC2993 also promotes
ß-cell proliferation and neogenesis in vitro
and in animal models. This study examines the
activity and safety of subcutaneously injected
AC2993 in patients with type 2 diabetes currently
treated with diet and/or oral antidiabetic agents
(OAAs).
A total of 109 patients treated with diet and
a sulfonylurea and/or metformin were enrolled
in a blinded study. Patients were randomly assigned
to one of three subcutaneously (SC) injected regimens
of AC2993 (0.08 µg/kg) or placebo for 28
days.
The results showed that all three AC2993 regimens
led to significant reductions in serum fructosamine
relative to placebo (P 0.004). Mean reductions
ranged from 39 to 46 µmol/l. All AC2993
groups had reductions in HbA1c ranging from 0.7
to 1.1% (P 0.006). An end-of-study HbA1c <7%
was achieved by 15% of AC2993 patients versus
4% of placebo patients, confirming AC2993 effects
on fasting and postprandial glycemia. On days
14 and 28, the ß-cell index (homeostasis
model assessment) for patients treated with AC2993
was 50–100% higher than baseline, contrasting
with unchanged levels for placebo. The most common
adverse event was transient mild-to-moderate nausea.
From the results it was concluded that, AC2993
is a promising therapeutic for patients with type
2 diabetes. In this study, it had significant
effects on HbA1c levels in patients not currently
achieving optimal glucose control with diet and/or
OAAs. Diabetes Care 26:2370-2377, 2003
===========================
Diagnostic
Tests for Home or Office: Total
Cholesterol, Cholesterol Panel, TSH (Thyroid Test),
PSA, and A1c. More
Info:
