The Effect of Adding Exenatide to a Thiazolidinedione in Suboptimally Controlled Type 2 Diabetes

Zinman, Bernard; Hoogwerf, Byron J.; Quesada-García, Santiago; Milton, Denái R.; Giaconia, Joseph M.; Kim, Dennis Dong Hwan; Trautmann, Michael E.; Brodows, Robert G.

doi:10.7326/0003-4819-146-7-200704030-00003

Cited by 400 publications

(339 citation statements)

References 31 publications

Supporting

Mentioning

311

Contrasting

Unclassified

Order By: Relevance

“…Tedavinin süresiyle ve doz titrasyonu ile azalabilmektedir. 8 Hastalarımızda tedaviyi bırakacak derecede bulantı olmamıştır. Bulantıyı azaltmak için literatürde önerildiği şekilde düşük dozla başlanıp zaman içinde doz artırılmıştır.…”

Section: Discussionunclassified

6th Month Metabolic and Laboratory Findings of Our Patients Taking Exenatide

Özışık¹,

Kutbay²,

Yürekli³

et al. 2016

Turkiye Klinikleri J Endocrin

View full text Add to dashboard Cite

Ö ÖZ ZE ET T A Am ma aç ç: : Eksenatid, GLP-1 reseptörlerine yüksek afinite de bağlanmakta, endojen GLP-1 etkisi ile glukoz bağımlı insülin sekresyonu, gastrik boşalmanın geciktirilmesi, glukagon süpresyonu, iştah baskılanması ve β-hücre kitlesini artırıcı etkilerini göstermektedir. Bu çalışmada eksenatid tedavisi verdiğimiz hastalarda, kısa dönemde laboratuvar ve metabolik parametrelerde iyileşme sağlanıp sağlanmadığının değerlendirilmesi amaçlanmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Ocak 2013-Aralık 2015 tarihleri arasında eksenatid başlanan hastalar retrospektif olarak çalışmaya dâhil edildi. Eksenatid ön-cesi ve tedaviden 6 ay sonraki kilo, beden kitle indeksi, açlık plazma glukozu, hemoglobin A1c, lipit profili değerleri kaydedilerek analize alındı. Hastaların 26'sı tedavi öncesi metformin ya da kombine oral antidiyabetik tedavi altında iken, 7 hasta bu tedavilere ek olarak bazal bolus insülin, 2 hasta ise bazal insülin almakta idi. B Bu ul lg gu ul la ar r: : Hastaların 31'i kadın, 5'i erkek idi. Çalışmaya alınan hastaların yaş ortalaması 51,5±10,4 yıl olarak bulundu. Hemoglobin A1c eksenatid tedavisi öncesi %7,9±1,6, sonrası %7,0±1,3, kilo; tedavi öncesi 114,6±16,4 kg, tedavi sonrası 105,8±16,0 kg olarak saptandı. Beden kitle indeksi (BKİ); eksenatid tedavisi öncesi 45,4±6,2, sonrası 41,8±6,9 kg/m 2 hesaplandı. S So on nu uç ç: : Obez hastalarda tedaviye eksenatid eklenmesi ile hastalarda kilo kaybı (p=0,000), BKİ (p=0,000) ve hemoglobin A1c (p=0,002) düzeylerinde istatistiksel olarak anlamlı düşme saptanmıştır. İnsülin kullanan hastalarda eksenatidinin tedaviye eklenmesi ile insülin dozunda %44,1'lik azalma görülmüştür. Hastalarımızın açlık plazma glukozu, düşük yoğunluklu lipoprotein, yüksek yoğunluklu lipoprotein ve trigliserid düzeylerinde başlangıç değerlerine göre azalma olmasına rağmen, bu azalma istatistiksel olarak anlamlı değildir.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Eksenatid; glukagon benzeri peptit 1; obezite A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Exenatide binds to glucagon-Like peptide-1 (GLP-1) receptors with high affinity, with the effect of GLP-1 endogenous, indicating effects of glucose dependent insulin secretion, delaying gastric emptying, glucagon suppression, suppressing appetite and increasing the mass of β-cell. Our aim was to figure out whether exenatide treatment provided good metabolic and laboratory control in our diabetic patients in short term. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The patients were recruited retrospectively in dates between January 2013-December 2015. Demographic parameters of the patients were recorded. Weight, body mass index (BMI), fasting plasma glucose (FPG), hemoglobin A1c, lipid profile of patients (high density lipoprotein-HDL, low density lipoprotein-LDL, triglyceride-TG) were analyzed before and the 6 month after the exenatide treatment. While 26 of the patients before treatment were in cure of metformin or combined oral antidiabetic, 7 patients in addition to these...

show abstract

Section: Discussionunclassified

6th Month Metabolic and Laboratory Findings of Our Patients Taking Exenatide

Özışık¹,

Kutbay²,

Yürekli³

et al. 2016

Turkiye Klinikleri J Endocrin

View full text Add to dashboard Cite

show abstract

“…Severe nausea was uncommon and data from open label extension trials (51) have not shown a significant correlation between nausea and the progressive weight loss observed in patients receiving exenatide therapy. In the oral anti-diabetic agent trials (44)(45)(46)48), the overall incidence of hypoglycemia for exenatide and the control groups ranged from 5-36% and 3-13%, respectively. In the insulin comparator trials (49,50); the overall rates were similar across the treatment groups (exenatide, range 4.7 -7.3 events/patient-year; insulin, range 5.6 -6.3 events/patient-year).…”

Section: Exenatide Clinical Trials In Patients With T2dmmentioning

confidence: 99%

Incretin mimetics and dipeptidyl peptidase-4 inhibitors: innovative treatment therapies for type 2 diabetes

Davidson

Parente²,

Gross

2008

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

the prevalence of diabetes and impaired glucose tolerance is predicted to dramatically increase over the next two decades. clinical therapies for type 2 diabetes mellitus (t2dM) have traditionally included lifestyle modification, oral anti-diabetic agents, and ultimately insulin initiation. In this report, we review the clinical trial results of two innovative t2dM treatment therapies that are based on the glucoregulatory effects of incretin hormones. Incretin mimetics are peptide drugs that mimic several of the actions of glucagon-like peptide-1 (gLP-1) and have been shown to lower glycated hemoglobin (A1c) levels in patients with t2dM. Additionally, incretin mimetics lower postprandial and fasting glucose, suppress elevated glucagon release, and are associated with progressive weight reduction. dipeptidyl peptidase-4 (dPP-4) inhibitors increase endogenous gLP-1 levels by inhibiting the enzymatic degradation of gLP-1. clinical studies in patients with t2dM have shown that dPP-4 inhibitors reduce elevated A1c, lower postprandial and fasting glucose, suppress glucagon release, and are weight neutral. collectively, these new drugs, given in combination with other antidiabetic agents, such as metformin, sulfonylureas, and/or thiazolidinediones, can help restore glucose homeostasis in poorly controlled patients with t2dM. É previsto que a prevalência de diabetes e a intolerância à glicose aumente dramaticamente ao longo das próximas duas décadas. As terapias clínicas para diabetes melito tipo 2 (dM2) têm tradicionalmente incluído modificação do estilo de vida, agentes antidiabéticos orais e, por último, o início da insulina. neste artigo, revisamos os resultados dos estudos clínicos de duas terapias inovadoras no tratamento do dM2 baseadas nos efeitos glicorregulatórios dos hormônios incretina. Os incretinomiméticos são medicamentos peptídeos que mimetizam várias das ações do peptídeo semelhante ao glucagon-1 (gLP-1) e têm demonstrado reduzir níveis de hemoglobina glicada (A1c) em pacientes com dM2. Adicionalmente, incretinomiméticos reduzem as glicemias pós-prandial e de jejum, suprimem a liberação elevada do glucagon, e são associados com redução de peso. Os inibidores da dipeptidil peptidase-4 (dPP-4) aumentam os níveis de gLP-1 endógeno pela inibição da degradação enzimática do gLP-1. Estudos clínicos em pacientes com dM2 têm demonstrado que inibidores da dPP-4 reduzem A1c elevada, reduzem as glicemias pós-prandial e de jejum, suprimem a liberação elevada do glucagon e são neutros quanto ao peso. coletivamente, estas novas medicações, administradas em combinação com outros agentes antidiabéticos, como metformina, sulfoniluréias e/ou tiazolidinedionas (tZds), podem ajudar a recuperar a homeostase glicêmica de pacientes com dM2 não-controlados. (Arq Bras Endocrinol Metab

show abstract

“…It is a functional, partly DPP-IVresistant analogue of human GLP-1. 13 Studies have examined the efficacy of adding exenatide to concurrent oral therapy (metformin, 14 sulphonylureas, 15 a combination of both 16 or thiazolidinediones 17 ) in patients with suboptimal glycaemic control. The starting dose of exenatide is 5 g twice daily for four weeks followed by 10 g twice daily thereafter.…”

Section: Exenatidementioning

confidence: 99%

“…As shown in Table 1, HbA 1c reduction is typical and weight loss was observed in all the studies except LEAD-1. 17,[24][25][26][27][28] It is of interest that a recent placebocontrolled study in obese individuals without T2DM demonstrated a significant weight reduction associated with liraglutide at 20 weeks. 29 The mean weight loss observed with liraglutide doses of 1.2 mg, 1.8 mg, 2.4 mg and 3.0 mg were Ϫ4.8 kg, Ϫ5.5 kg, Ϫ6.3 kg and Ϫ7.2 kg, respectively, compared with Ϫ2.8 kg with placebo.…”

Section: Liraglutidementioning

confidence: 99%

The incretin system in the management of type 2 diabetes mellitus

Stephens

2010

Clinical Medicine

View full text Add to dashboard Cite

The Effect of Adding Exenatide to a Thiazolidinedione in Suboptimally Controlled Type 2 Diabetes

Cited by 400 publications

References 31 publications

6th Month Metabolic and Laboratory Findings of Our Patients Taking Exenatide

6th Month Metabolic and Laboratory Findings of Our Patients Taking Exenatide

Incretin mimetics and dipeptidyl peptidase-4 inhibitors: innovative treatment therapies for type 2 diabetes

The incretin system in the management of type 2 diabetes mellitus

Contact Info

Product

Resources

About