Premium
Long‐term tolerance and efficacy of adjunctive exenatide therapy on glycaemic control and bodyweight in type 2 diabetes: a retrospective study from a specialist diabetes outpatient clinic
Author(s) -
Carrington M. J.,
Chan Y.K.,
Stewart S.,
Sjouke B.,
Brazilek R.,
Cohen N.
Publication year - 2014
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12377
Subject(s) - medicine , exenatide , type 2 diabetes , diabetes mellitus , weight loss , odds ratio , sulfonylurea , insulin , adverse effect , confidence interval , endocrinology , obesity
Background Weight gain and hypoglycaemia are common adverse effects associated with anti‐diabetic treatments.Aim Our aim was to evaluate the long‐term effects of adjunctive exenatide therapy on weight loss and glycaemic control in patients with type 2 diabetes. Methods A review of medical records in a specialist diabetes clinic over 5 years identified 446 patients who were prescribed exenatide therapy. We examined change in glycosylated haemoglobin ( HbA 1c ), weight, albumin‐creatinine ratio and hypoglycaemic medication during 24 months follow up. Results Subjects were aged 59 ± 10 years (49% women) and received exenatide in combination with oral agents and insulin (47%). During an average of 17 ± 14 months follow up, 51% (more women than men; odds ratio 1.69, 95% confidence interval 1.14–2.49) remained on treatment. Lack of efficacy (33%) and/or gastrointestinal (27%) side‐effects were the main reasons for treatment cessation. At 24 months, there was a reduction in HbA 1c of 0.7 ± 1.2% and weight loss of 4.3 ± 5.2 kg. Change in HbA 1c was similar regardless of concurrent insulin therapy, yet insulin was associated with greater weight reduction (4.8 ± 5.3 vs 3.8 ± 5.1 kg, P = 0.016). Independent predictors of HbA 1c response were higher baseline HbA 1c , longer duration of diabetes and use of insulin or sulfonylureas at study end. Predictors of weight response were baseline use of insulin or thiazolidinediones, increased age, female sex and sulfonylurea or thiazolidinediones at study end. Longer exenatide treatment duration was favourable for reducing HbA 1c and weight. Conclusions Exenatide is effective in reducing HbA 1c and weight, regardless of concurrent insulin, and in a specialist diabetes outpatient clinic, is recommended for use in clinical practice.