PMID- 20530705
OWN - NLM
STAT- MEDLINE
DCOM- 20101008
LR  - 20221207
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 44
IP  - 7-8
DP  - 2010 Jul-Aug
TI  - Glucagon-like peptide-1 analog and insulin combination therapy in the management 
      of adults with type 2 diabetes mellitus.
PG  - 1294-300
LID - 10.1345/aph.1P047 [doi]
AB  - OBJECTIVE: To evaluate the efficacy and tolerability of combination glucagon-like 
      peptide-1 (GLP-1) analogs and insulin in the management of type 2 diabetes 
      mellitus (T2DM) in adults. DATA SOURCE: A MEDLINE search (1966-April 2010) was 
      conducted using the key terms glucagon-like peptide-1 analog, exenatide, incretin 
      mimetic, liraglutide, diabetes mellitus, and insulin. STUDY SELECTION AND DATA 
      EXTRACTION: All English-language articles identified from the data source were 
      evaluated and reviewed for inclusion. Original research and retrospective cohorts 
      were included in this review. The references of articles that we identified were 
      examined for any additional studies appropriate for review. DATA SYNTHESIS: 
      Exenatide is a subcutaneously administered GLP-1 receptor agonist that is used 
      for the improvement of glycemic control in adults with T2DM. Through actions 
      similar to those of endogenous GLP-1, exenatide contributes to improved 
      postprandial glycemic control and weight loss. The concomitant use of exenatide 
      and insulin is currently not Food and Drug Administration-approved due to lack of 
      clinical trial data. However, combination insulin and exenatide may be 
      advantageous, especially for reducing weight gain, particularly for obese 
      patients with T2DM. Several small prospective and retrospective studies 
      evaluating combination therapy found statistically significant reductions in 
      hemoglobin A(1c) (A1C), weight, and total daily insulin dose requirements. The 
      most common adverse effects reported included gastrointestinal effects, such as 
      nausea and vomiting, and hypoglycemia. CONCLUSIONS: Although there is a limited 
      amount of data and not all studies demonstrated A1C reduction, the combination of 
      exenatide with insulin therapy appears to be a safe option in the management of 
      T2DM. It may be a promising therapeutic strategy for some patients, as reductions 
      in weight and insulin doses were observed. Further well-designed prospective 
      trials are warranted to fully determine the long-term effectiveness and safety of 
      this combination as well as its place in therapy.
FAU - Tzefos, Maria
AU  - Tzefos M
AD  - School of Pharmacy, Wingate University, NC 28174, USA. m.tzefos@wingate.edu
FAU - Olin, Jacqueline L
AU  - Olin JL
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20100608
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Blood Glucose)
RN  - 0 (GLP1R protein, human)
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Peptides)
RN  - 0 (Receptors, Glucagon)
RN  - 0 (Venoms)
RN  - 9P1872D4OL (Exenatide)
SB  - IM
MH  - Blood Glucose/drug effects
MH  - Diabetes Mellitus, Type 2/*drug therapy/physiopathology
MH  - Drug Therapy, Combination
MH  - Exenatide
MH  - Glucagon-Like Peptide-1 Receptor
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/pharmacology/*therapeutic use
MH  - Insulin/adverse effects/pharmacology/therapeutic use
MH  - Peptides/adverse effects/pharmacology/therapeutic use
MH  - Receptors, Glucagon/agonists
MH  - Venoms/adverse effects/pharmacology/therapeutic use
RF  - 25
EDAT- 2010/06/10 06:00
MHDA- 2010/10/12 06:00
CRDT- 2010/06/10 06:00
PHST- 2010/06/10 06:00 [entrez]
PHST- 2010/06/10 06:00 [pubmed]
PHST- 2010/10/12 06:00 [medline]
AID - aph.1P047 [pii]
AID - 10.1345/aph.1P047 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2010 Jul-Aug;44(7-8):1294-300. doi: 10.1345/aph.1P047. Epub 
      2010 Jun 8.