Response to comment on: Nauck MA, Duran S, Kim D et al (2007) A comparison of twice-daily exenatide and biphasic insulin aspart in patients with type 2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study. Diabetologia 50:259–267

Abstract

Response to comment on: Nauck MA, Duran S, A comparison of twice-daily exenatide and biphasic insulin aspart in patients with type 2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study.

Incretin Mimetics and Dipeptidyl Peptidase-4 Inhibitors in the Treatment of Type 2 Diabetes

“…Study participants in the exenatide studies were mainly patients with a longer diabetes duration (4.9 to 9.9 years). [12][13][14]16,17 In contrast, the DPP-4 inhibitor study patients [22][23][24][25][26][27][28][29][30] had shorter diabetes duration (1.9-6.5 years). Baseline HbA 1c levels in all studies were similar and in general HbA 1c reduction was greater in patients with higher baseline HbA 1c levels.…”

“…16,17 In these studies, exenatide was non-inferior to insulin aspart and glargine in terms of HbA 1c reduction and led to reduced bodyweight, while insulin therapy was associated with significant weight gain. 16,17 Another difference in the results of the cited exenatide and DPP-4 studies is that DPP-4 inhibitors were not associated with weight loss, [7][8][9][22][23][24][25][26][27][28][29][30] while exenatide demonstrated the additional benefit of significant weight reduction. 6,[12][13][14][16][17][18] Exenatide and DDP-4 inhibitors have a low potential to cause hypoglycaemia.…”

“…5,6,[12][13][14]16,17 Sitagliptin and vildagliptin are generally well tolerated, with no characteristic pattern of adverse events associated with the use of these medications. 2,4,[22][23][24][25][26][27][28][29][30] For sitagliptin, adverse events (regardless of causal relationship) reported in at least 5% of patients and more frequently than in the control group included upper respiratory tract infections and nasopharyngitis. [26][27][28][29][30] For vildagliptin, adverse events reported in at least 5% of patients included upper respiratory tract infections, nasopharyngitis, dizziness, influenza and headache.…”

“…Mimetics and Dipeptidyl Peptidase-4 Inhibitors in the Treatment of Type 2 Diabetes glipizide. Study participants had had prior single-agent metformin therapy without satisfactory metabolic control 30. Reduction in HbA 1c levels in the two groups (sitagliptin versus glipizide) was similar at 52 weeks, at -0.51 and -0.56% from mean baseline values of 7.7 and 7.6%, respectively.…”