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A direct comparison of long‐ and short‐acting GLP ‐1 receptor agonists (taspoglutide once weekly and exenatide twice daily) on postprandial metabolism after 24 weeks of treatment
Author(s) -
Gastaldelli A.,
Balas B.,
Ratner R.,
Rosenstock J.,
Charbonnel B.,
Bolli G. B.,
Boldrin M.,
Balena R.
Publication year - 2014
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12192
Subject(s) - postprandial , exenatide , medicine , endocrinology , insulin , metformin , meal , glucagon , glucagon like peptide 1 receptor , dulaglutide , glucagon like peptide 1 , diabetes mellitus , type 2 diabetes , receptor , agonist
Aims T‐emerge 2 was a randomized, open‐label, 24‐week trial comparing subcutaneous taspoglutide 10 mg weekly (Taspo10), taspoglutide 20 mg weekly (Taspo20; titrated after 4 weeks of Taspo10), with exenatide 10 mcg BID (Exe; after 4 weeks of Exe 5 mcg) in patients inadequately controlled on metformin, a thiazolidinedione, or both. T‐emerge 2 showed that once‐weekly Taspo provided better glycaemic control than Exe. This report focuses on a subset of T‐emerge 2 participants undergoing a standardized liquid meal comparing Taspo to Exe, which has been previously shown to lower postprandial glucose. Methods Meal tolerance tests ( MTT ) were performed at baseline and at week 24 in a subset of Taspo10, Taspo20 and Exe patients (n = 42, 39 and 67, respectively). Blood samples for glucose, insulin, glucagon and C‐peptide were obtained before and after (30, 60, 90, 120 and 180 min) ingestion of a standardized liquid meal. Results The 2‐h postprandial, mean 0–3 h and iAUC0 ‐3 h glucose during the MTT was reduced to a similar extent in all groups and the time profile of the postprandial glucose showed a similar pattern. Taspo10 and Taspo20, but not Exe, significantly increased insulin from baseline (both mean and iAUC0 ‐3 h). Although changes from baseline in C‐peptide were not significant within any treatment group, the mean change from baseline (both mean 0–3 h and iAUC0 ‐3 h) was significantly increased in Taspo10 vs. Exe. Mean glucagon showed significant decreases in all groups. Conclusion Taspoglutide and Exe improved postprandial glucose tolerance to a similar extent but possibly with different intimate mechanisms.