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Metabolic outcomes of matched patient populations initiating exenatide BID vs. insulin glargine in an ambulatory care setting
Author(s) -
Pawaskar M.,
Li Q.,
Hoogwerf B. J.,
Reynolds M. W.,
Faries D.,
Engelman W.,
Bruhn D.,
Bergenstal R. M.
Publication year - 2012
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/j.1463-1326.2012.01581.x
Subject(s) - exenatide , medicine , body mass index , insulin glargine , blood pressure , ambulatory , diabetes mellitus , type 2 diabetes , propensity score matching , retrospective cohort study , endocrinology
Aim: This observational study evaluated the clinical effectiveness of exenatide BID (exenatide) vs. insulin glargine (glargine) in patients with type 2 diabetes mellitus in ambulatory clinical practice. Methods: Retrospective analyses were conducted using an electronic medical record (EMR) database among adult patients with type 2 diabetes mellitus initiating exenatide or glargine between 1 November 2006 and 30 April 2009. The cohorts were propensity‐score matched to control baseline demographics, clinical measures, health status and medication use. The changes from baseline to a 12‐month follow‐up period for A1C (primary outcome), weight, body mass index (BMI), blood pressure and lipid levels were compared between the matched cohorts using paired tests. Results: Propensity‐score matching between the exenatide (n = 4494) and glargine (n = 5424) cohorts led to 2683 matched pairs with comparable characteristics, including age, gender and baseline clinical values. The exenatide cohort achieved a greater mean reduction in A1C (−0.6% vs. −0.4%, p < 0.01), weight (−2.6 kg vs. −0.2 kg, p < 0.01), BMI (−0.8 kg/m 2 vs. −0.04 kg/m 2 , p < 0.01) and systolic blood pressure (SBP) (−1.8 mmHg vs. −0.1 mmHg, p < 0.01) in the follow‐up period. The changes in diastolic blood pressure and lipid levels were not significantly different between cohorts. Conclusions: Compared to glargine, exenatide‐treated patients experienced significant reductions in A1C, weight, BMI and SBP. Acknowledging the limitations of observational research, exenatide showed greater clinical effectiveness than glargine from a large EMR database in the ambulatory care setting.