Comparison of Exenatide and Metformin Monotherapy in Overweight/Obese Patients with Newly Diagnosed Type 2 Diabetes

Abstract

Aims The present study assessed the therapeutic effect of exenatide and metformin as the initial therapy on overweight/obese patients with newly diagnosed type 2 diabetes (T2D). Methods The prospective, nonrandomized, interventional study enrolled a total of 230 overweight or obese patients with newly diagnosed T2D who were administrated exenatide or metformin hydrochloride for 12 weeks. Results 224/230 patients, including 106 in the exenatide group and 118 in the metformin group, completed the 12-week treatment. Both exenatide and metformin significantly decreased the HbA1c levels in overweight/obese patients with newly diagnosed T2D (all P < 0.05). The reduction in HbA1c and the proportion of patients with HbA1c < 7.0% (53 mmol/mol) were higher in the exenatide group than in the metformin group (all P < 0.05). The exenatide treatment caused a greater decline in the body weight and BMI as compared to the metformin treatment (all P < 0.01). The exenatide treatment (β = 0.41, P < 0.01) and baseline HbA1c level (β = −0.84, P < 0.01) were independent influencing factors for the decrease in HbA1c level. Conclusions For an initial therapy in overweight/obese patients with newly diagnosed T2D, exenatide causes a better glycemic control than metformin. This trial is registered with NCT03297879.

A second‐generation glucagon‐like peptide‐1 receptor agonist mitigates vomiting and anorexia while retaining glucoregulatory potency in lean diabetic and emetic mammalian models

“…Importantly, these alternative strategies also lead to modest but significant body weight reductions. 36,37 Preventing access to CNS GLP-1Rs is the probable explanation for the lack of B12-Ex4-induced emesis in the shrew. Our immunohistological evidence supports this notion as we observed sparse c-Fos activation following systemic B12-Ex4 administration in the AP and NTS, two hindbrain nuclei known to mediate feeding behaviour and emesis, 13,[38][39][40][41] while native Ex4 produced robust activation of these nuclei.…”

“…dipeptidyl peptidase‐4 inhibitors, metformin and sodium‐glucose co‐transporter‐2 inhibitors) do not achieve the same overall positive outcome on glucose handling compared with GLP‐1R agonists. Importantly, these alternative strategies also lead to modest but significant body weight reductions 36,37 …”

The Changes of Lipidomic Profiles Reveal Therapeutic Effects of Exenatide in Patients With Type 2 Diabetes

“…Blood samples were collected after overnight fasting and stored at −80°C until lipidomics analysis. The general methodology for clinical measurements is described in our previous study ( 16 , 20 ). Eligible T2DM subjects received a continual subcutaneous injection of exenatide for a total of 12 weeks (5 µg twice a day for 4 weeks, followed by 10 µg twice a day for 8 weeks).…”

6,8-(1,3-Diaminoguanidine) luteolin and its Cr complex show hypoglycemic activities and alter intestinal microbiota composition in type 2 diabetes mice

“…22,23 As MH increases glucose utilization in muscle and adipose tissue while inhibiting glucose absorption in the intestinal tract, its application in the treatment of diabetes usually leads to an increase in body weight loss. 24 In contrast, after a 4-week treatment, both DAGL and DAGL·Cr significantly increased the body weight of T2DM mice, possibly because DAGL and DAGL·Cr promote glucose absorption and reduce energy loss. 25 Notably, the results revealed that DAGL·Cr had a better effect on the restoration of body weight than DAGL, suggesting that the complexation of Cr( iii ) improved the weight loss of T2DM mice; similar results were also reported by Yanni et al .…”

“…tinal tract, its application in the treatment of diabetes usually leads to an increase in body weight loss. 24 In contrast, after a 4-week treatment, both DAGL and DAGL•Cr significantly increased the body weight of T2DM mice, possibly because DAGL and DAGL•Cr promote glucose absorption and reduce energy loss. 25 Notably, the results revealed that DAGL•Cr had a…”