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Chaudhuri et al. (1) raised the question of why exenatide increased insulin sensitivity in our patients with long-standing type 1 diabetes without simultaneously improving HbA1c (2). The authors expressed concern about the possibility that GLP-1 analogs might be dismissed as ineffective, which would counter their own positive experience with liraglutide in type 1 diabetes.They speculated that we had attempted to safely introduce exenatide without increasing the frequency of hypoglycemia and thus had cautiously decreased insulin doses. This is correct; we initially lowered prandial insulin doses by 50% and thereafter increased insulin doses as needed (3). Thus, we were not surprised to observe an unchanged HbA1c. In our trial, the …

diabetes care

Response to Comment on Sarkar et al. Exenatide Treatment for 6 Months Improves Insulin Sensitivity in Adults With Type 1 Diabetes. Diabetes Care 2014;37:666–670