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学科主题: 临床医学
题名:
Efficacy and tolerability of exenatide monotherapy in obese patients with newly diagnosed type 2 diabetes: a randomized, 26 weeks metformin-controlled, parallel-group study
作者: Yuan Ge-heng1; Song Wei-li2; Huang You-yuan1; Guo Xiao-hui1; Gao Yan1
关键词: exenatide ; metformin ; obesity ; type 2 diabetes
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2012-08-05
DOI: 10.3760/cma.j.issn.0366-6999.2012.15.006
卷: 125, 期:15, 页:2677-2681
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]: GLUCAGON-LIKE PEPTIDE-1 ; GLYCEMIC CONTROL ; BETA-CELL ; MANAGEMENT ; HYPERGLYCEMIA ; SULFONYLUREA ; THERAPIES ; MELLITUS ; INSULIN
英文摘要:

Background Incretin-based therapies provide additional options for treating type 2 diabetes. We aimed to evaluate the efficacy and tolerability of exenatide monotherapy in obese patients with type 2 diabetes.

Methods A 26-week, metformin controlled, parallel-group study was conducted among antidiabetic drug-naive obese patients aged >18 years, and with type 2 diabetes. Participating patients were randomly assigned to receive exenatide or metformin treatments.

Results Fifty-nine patients (age (50.5 +/- 8.6) years, body mass index (BMI) (30.2 +/- 1.6) kg/m(2), and hemoglobin A1C (HbA(1C) (8.2 +/- 1.2)%) were enrolled in the study. Glucose control and weight reduction improved in both groups receiving treatment. HbA(1C) and oral glucose tolerance test (OGTT) 2 hour glycemia reduction with exenatide was superior to that obtained with metformin ((-2.10 +/- 1.79)% vs. (-1.66 +/- 1.38)%, (-5.11 +/- 2.68) mmol/L vs. (-2.80 +/- 2.70) mmol/L, P <0.05). Fast plasma glucose (FPG) reduction was not significantly different between the two groups ((-1.8 +/- 2.0) mmol/L vs. (-1.6 +/- 1.7) mmol/L, P >0.05). Patients treated with exenatide achieved HbA(1C) of <7% (97% of patients) and <6.5% (79%) at end-point, vs. 93% and 73% with metformin (P >0.05). Greater weight reduction was also achieved with exenatide ((-5.80 +/- 3.66) kg) than with metformin ((-3.81 +/- 1.38) kg, P <0.01). Homeostasis model assessment of beta-cell function (HOMA-B) was not significantly increased, but the insulinogenic index and HOMA for insulin sensitivity (HOMA-S) were greatly improved in the exenatide group (P <0.05). Nausea was the most common adverse effect in exenatide treatment (30% vs. 8%; P <0.05), but most cases were of mild to moderate intensity. One case in the exenatide group was withdrawn early because of severe nausea. Hypoglycemia events were often observed during the first 4 weeks, with 12% of patients in the exenatide and 3.2% in metformin groups, respectively (P <0.05). No incidents of severe hypoglycemia were reported.

Conclusions Exenatide demonstrated more beneficial effects on HbA(1C), weight reduction and insulin resistance during 26 weeks of treatment, but there were more hypoglycemic events and mild-to-moderate nausea compared with metformin. These results suggested that exenatide monotherapy may provide a viable treatment option in newly developed type 2 diabetes. Chin Med J 2012;125(15):2677-2681

语种: 英语
WOS记录号: WOS:000307677700006
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64410
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.Peking Univ, Hosp 1, Dept Endocrinol, Beijing 100034, Peoples R China
2.Beijing Univ Chinese Med & Pharmacol, Huguosi Hosp Tradit Chinese Med, Beijing 100035, Peoples R China

Recommended Citation:
Yuan Ge-heng,Song Wei-li,Huang You-yuan,et al. Efficacy and tolerability of exenatide monotherapy in obese patients with newly diagnosed type 2 diabetes: a randomized, 26 weeks metformin-controlled, parallel-group study[J]. CHINESE MEDICAL JOURNAL,2012,125(15):2677-2681.
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