PMID- 18463034
OWN - NLM
STAT- MEDLINE
DCOM- 20080811
LR  - 20221207
IS  - 1934-2403 (Electronic)
IS  - 1530-891X (Linking)
VI  - 14
IP  - 3
DP  - 2008 Apr
TI  - Safety and efficacy of exenatide in combination with insulin in patients with 
      type 2 diabetes mellitus.
PG  - 285-92
AB  - OBJECTIVE: To evaluate the 1-year efficacy and safety of treatment with exenatide 
      in combination with insulin (a use not approved by the US Food and Drug 
      Administration). METHODS: Electronic medical records of 3 private-practice 
      endocrinologists were reviewed to identify patients with type 2 diabetes mellitus 
      (T2DM) receiving insulin who subsequently began exenatide therapy. Patients' 
      baseline hemoglobin A1c (A1C) levels, weights, lipid profiles, blood pressures, 
      and medication utilization were compared with corresponding data obtained after a 
      minimal duration of 12 months. RESULTS: We identified 134 patients with T2DM 
      initiating exenatide therapy in combination with insulin between April 2005 and 
      April 2006. One-year follow-up information was available for 124 patients. 
      Exenatide use resulted in a significant 0.87% reduction in A1C (P<.001), despite 
      a 45% discontinuation of premeal insulin use (P<.001), a 9-U reduction in mean 
      premeal insulin doses (P = .0066), a reduction in the median number of daily 
      insulin injections from 2 to 1 (P = .0053), and a 59% discontinuation rate of 
      sulfonylurea use (P = .0088). Exenatide use was associated with a mean weight 
      loss of 5.2 kg (P<.001), with 72% of evaluable patients losing weight. 
      Forty-eight patients (36%) discontinued exenatide therapy during the first year, 
      primarily attributable to gastrointestinal intolerance. Fourteen patients (10%) 
      experienced hypoglycemia, most of which was mild. CONCLUSION: Exenatide in 
      combination with insulin in patients with T2DM was associated with significant 
      reductions in A1C and weight after 1 year of therapy. This was offset, however, 
      by an exenatide discontinuation rate of 36%, primarily due to adverse 
      gastrointestinal effects.
FAU - Sheffield, Catherine A
AU  - Sheffield CA
AD  - Department of Pharmacy Practice, Albany College of Pharmacy The Endocrine Group, 
      Albany, New York 12208, USA.
FAU - Kane, Michael P
AU  - Kane MP
FAU - Busch, Robert S
AU  - Busch RS
FAU - Bakst, Gary
AU  - Bakst G
FAU - Abelseth, Jill M
AU  - Abelseth JM
FAU - Hamilton, Robert A
AU  - Hamilton RA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Peptides)
RN  - 0 (Venoms)
RN  - 9P1872D4OL (Exenatide)
SB  - IM
MH  - Abdominal Pain/chemically induced
MH  - Aged
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Exenatide
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/*therapeutic use
MH  - Insulin/adverse effects/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Nausea/chemically induced
MH  - Peptides/adverse effects/*therapeutic use
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Venoms/adverse effects/*therapeutic use
MH  - Vomiting/chemically induced
EDAT- 2008/05/09 09:00
MHDA- 2008/08/12 09:00
CRDT- 2008/05/09 09:00
PHST- 2008/05/09 09:00 [pubmed]
PHST- 2008/08/12 09:00 [medline]
PHST- 2008/05/09 09:00 [entrez]
AID - S1530-891X(20)43576-1 [pii]
AID - 10.4158/EP.14.3.285 [doi]
PST - ppublish
SO  - Endocr Pract. 2008 Apr;14(3):285-92. doi: 10.4158/EP.14.3.285.