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学科主题: 临床医学
题名:
Comparison of the effects on glycaemic control and beta-cell function in newly diagnosed type 2 diabetes patients of treatment with exenatide, insulin or pioglitazone: a multicentre randomized parallel-group trial (the CONFIDENCE study)
作者: Xu, W.1; Bi, Y.2; Sun, Z.3; Li, J.1; Guo, L.4; Yang, T.5; Wu, G.6; Shi, L.7; Feng, Z.8; Qiu, L.9; Li, Q.10; Guo, X.11; Luo, Z.12; Lu, J.13; Shan, Z.14; Yang, W.15; Ji, Q.16; Yan, L.17; Li, H.18; Yu, X.19; Li, S.20; Zhou, Z.21,22; Lv, X.23; Liang, Z.24; Lin, S.25; Zeng, L.1; Yan, J.1; Ji, L.26; Weng, J.1
关键词: -cell function ; exenatide ; glucose ; insulin ; pioglitazone
刊名: JOURNAL OF INTERNAL MEDICINE
发表日期: 2015
DOI: 10.1111/joim.12293
卷: 277, 期:1, 页:137-150
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: FASTING PLASMA-GLUCOSE ; METFORMIN ; EFFICACY ; MELLITUS ; GLARGINE ; SAFETY ; TWICE ; PRESERVATION ; METAANALYSIS ; SITAGLIPTIN
英文摘要:

ObjectiveProgressive -cell dysfunction hinders the maintenance of glycaemic control in type 2 diabetes, but comparative data on -cell-protective therapies are lacking in the early stage of type 2 diabetes. Here we evaluated the comparative glycaemic efficacy and impact on -cell function of three antihyperglycaemic agents that have a -cell-protective effect, exenatide, insulin and pioglitazone, in newly diagnosed patients with type 2 diabetes.

Design and methodsIn this 48-week, multicentre, parallel-group study, 416 patients newly diagnosed with type 2 diabetes were randomly assigned 1:1:1 to receive exenatide, insulin or pioglitazone. The primary end-point was the change in glycosylated haemoglobin (HbA1c) from baseline. Secondary end-points included effects on weight, blood pressure, lipid profiles and -cell function assessed by homeostasis model assessment, fasting proinsulin:insulin (PI/I), disposition index (DI) and acute insulin response (AIR).

ResultsAt week 48, mean [95% confidence interval (CI)] HbA(1c) changes from baseline were -1.8% (-1.55% to -2.05%) with exenatide, -1.7% (-1.52% to -1.96%) with insulin and -1.5% (-1.23% to -1.71%) with pioglitazone. Treatment differences were -0.20% (95% CI -0.46% to 0.06%) for exenatide versus insulin (P=0.185), and -0.37% (95% CI -0.63% to -0.12%) for exenatide versus pioglitazone (P=0.002). Significant improvements from baseline in AIR, PI/I and DI were observed with all treatments, with the greatest improvements in DI, as well as weight, blood pressure and lipid profile, observed with exenatide.

ConclusionsAll three agents showed efficacy regarding glycaemic control and metabolic benefits; however, exenatide showed the greatest efficacy. -cell function improved in all treatment groups; hence, early initiation of -cell-protective therapy may halt the decline in -cell function in type 2 diabetes.

语种: 英语
所属项目编号: 81025005
项目资助者: Key Projects of Clinical Disciplines of Hospitals Affiliated ; National Science Fund for Distinguished Young Scholars ; Eli Lilly and Co. ; Amylin Pharmaceuticals, Inc. ; Sun Yat-sen University ; Bristol-Myers Squibb ; Astra Zeneca
WOS记录号: WOS:000346652000010
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53504
Appears in Collections:北京大学第一临床医学院_内分泌内科_期刊论文

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作者单位: 1.Sun Yat Sen Univ, Affiliated Hosp 3, Guangdong Prov Key Lab Diabetol, Dept Endocrinol & Metab, Guangzhou 510630, Guangdong, Peoples R China
2.Nanjing Univ, Med Sch, Drum Tower Hosp, Dept Endocrinol, Nanjing 210008, Jiangsu, Peoples R China
3.Southeast Univ, Sch Med, Inst Diabet, Dept Endocrinol,Zhongda Hosp, Nanjing, Jiangsu, Peoples R China
4.Minist Publ Hlth, Beijing Hosp, Dept Endocrinol, Beijing, Peoples R China
5.Nanjing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Nanjing, Jiangsu, Peoples R China
6.Guangdong Med Coll, Affiliated Hosp, Dept Endocrinol, Zhanjiang, Peoples R China
7.Guiyang Med Coll, Affiliated Hosp, Dept Endocrinol, Guiyang, Guizhou, Peoples R China
8.Chongqing Med Univ, Affiliated Hosp 1, Dept Endocrinol, Chongqing, Peoples R China
9.Inner Mongolia Med Univ, Affiliated Hosp, Dept Endocrinol, Hohhot, Peoples R China
10.Harbin Med Univ, Affiliated Hosp 2, Dept Endocrinol, Harbin, Peoples R China
11.Peking Univ, Hosp 1, Dept Endocrinol, Beijing 100871, Peoples R China
12.Guangxi Med Univ, Affiliated Hosp 1, Dept Endocrinol, Nanning, Peoples R China
13.Chinese Peoples Liberat Army Gen Hosp, Dept Endocrinol, Beijing, Peoples R China
14.China Med Univ, Affiliated Hosp 1, Dept Endocrinol, Shenyang, Peoples R China
15.China Japan Friendship Hosp, Dept Endocrinol, Beijing, Peoples R China
16.Fourth Mil Med Univ, Xijing Hosp, Dept Endocrinol & Metab, Xian 710032, Peoples R China
17.Qingyuan Peoples Hosp, Dept Endocrinol, Qingyuan, Peoples R China
18.Gen Hosp Beijing Mil Reg, Dept Endocrinol, Beijing, Peoples R China
19.Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Endocrinol, Guangzhou 510275, Guangdong, Peoples R China
20.Kunming Med Univ, Affiliated Hosp 1, Dept Endocrinol, Kunming, Peoples R China
21.Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Dept Endocrinol, Wuhan 430074, Peoples R China
22.Cent S Univ, Xiangya Hosp 2, Inst Metab & Endocrinol, Ctr Diabet, Changsha, Hunan, Peoples R China
23.Cent S Univ, Minist Educ, Key Lab Diabet Immunol, Changsha, Hunan, Peoples R China
24.Shenzhen Univ, Affiliated Hosp 1, Dept Endocrinol, Shenzhen, Peoples R China
25.Shantou Univ, Coll Med, Affiliated Hosp 1, Dept Endocrinol, Shantou, Peoples R China
26.Peking Univ, Peoples Hosp, Dept Endocrinol, Beijing 100871, Peoples R China

Recommended Citation:
Xu, W.,Bi, Y.,Sun, Z.,et al. Comparison of the effects on glycaemic control and beta-cell function in newly diagnosed type 2 diabetes patients of treatment with exenatide, insulin or pioglitazone: a multicentre randomized parallel-group trial (the CONFIDENCE study)[J]. JOURNAL OF INTERNAL MEDICINE,2015,277(1):137-150.
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