Exenatide Twice Daily Plus Glargine Versus Aspart 70/30 Twice Daily in Patients With Type 2 Diabetes With Inadequate Glycemic Control on Premixed Human Insulin and Metformin
Copyright © 2021 AACE. Published by Elsevier Inc. All rights reserved..
OBJECTIVE: Many patients with type 2 diabetes treated with premixed insulin gradually have inadequate glycemic control and switch to a basal-bolus regimen, which raises some concerns for weight gain and increased hypoglycemic risk. Switching to combination use of glp-1 agonist and basal insulin may be an alternative option.
METHODS: After a 12-week premixed human insulin 70/30 dosage optimization period, 200 patients with HbA1c of 7.0% to 10.0% were randomized into 24-week treatment groups with exenatide twice a day plus glargine or with aspart 70/30 twice a day.
RESULTS: After 24 weeks, the patients receiving exenatide plus glargine (n = 90) had improved HbA1c control compared with those receiving aspart 70/30 (n = 90) (least squares mean change: ‒0.59 vs ‒0.13%; difference [95% CI]: ‒0.45 [‒0.74 to ‒0.17]) in the full analysis set population. Weight decreased 3.5 kg with exenatide and decreased 0.4 kg with aspart 70/30 (P < .001). The insulin dose was reduced 10.7 units/day (95% CI, ‒12.2 to ‒9.2 units; P < .001) with exenatide, and increased 9.7 units/day (95% CI, 8.2 to 11.2 units; P < .001) with aspart 70/30. The most common adverse events were gastrointestinal adverse effects in the exenatide group (nausea [21%], vomiting [16%], diarrhea [13%]). The incidence of hypoglycemia was similar in 2 groups (27% for exenatide and 38% for aspart 70/30; P = .1).
CONCLUSION: In premixed human insulin‒treated patients with type 2 diabetes with inadequate glycemic control, switching to exenatide twice a day plus glargine was superior to aspart 70/30 twice a day for glycemic and weight control.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists - 27(2021), 8 vom: 15. Aug., Seite 790-797 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Chen, Xi [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 10.08.2021 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.eprac.2021.03.015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM323867170 |
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| 100 | 1 | |a Chen, Xi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Exenatide Twice Daily Plus Glargine Versus Aspart 70/30 Twice Daily in Patients With Type 2 Diabetes With Inadequate Glycemic Control on Premixed Human Insulin and Metformin |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 10.08.2021 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 AACE. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: Many patients with type 2 diabetes treated with premixed insulin gradually have inadequate glycemic control and switch to a basal-bolus regimen, which raises some concerns for weight gain and increased hypoglycemic risk. Switching to combination use of glp-1 agonist and basal insulin may be an alternative option | ||
| 520 | |a METHODS: After a 12-week premixed human insulin 70/30 dosage optimization period, 200 patients with HbA1c of 7.0% to 10.0% were randomized into 24-week treatment groups with exenatide twice a day plus glargine or with aspart 70/30 twice a day | ||
| 520 | |a RESULTS: After 24 weeks, the patients receiving exenatide plus glargine (n = 90) had improved HbA1c control compared with those receiving aspart 70/30 (n = 90) (least squares mean change: ‒0.59 vs ‒0.13%; difference [95% CI]: ‒0.45 [‒0.74 to ‒0.17]) in the full analysis set population. Weight decreased 3.5 kg with exenatide and decreased 0.4 kg with aspart 70/30 (P < .001). The insulin dose was reduced 10.7 units/day (95% CI, ‒12.2 to ‒9.2 units; P < .001) with exenatide, and increased 9.7 units/day (95% CI, 8.2 to 11.2 units; P < .001) with aspart 70/30. The most common adverse events were gastrointestinal adverse effects in the exenatide group (nausea [21%], vomiting [16%], diarrhea [13%]). The incidence of hypoglycemia was similar in 2 groups (27% for exenatide and 38% for aspart 70/30; P = .1) | ||
| 520 | |a CONCLUSION: In premixed human insulin‒treated patients with type 2 diabetes with inadequate glycemic control, switching to exenatide twice a day plus glargine was superior to aspart 70/30 twice a day for glycemic and weight control | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Xu, Yongping |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Shao, Shiyin |e verfasserin |4 aut | |
| 700 | 1 | |a Duan, Yanran |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Peiwen |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Liya |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Jing |e verfasserin |4 aut | |
| 700 | 1 | |a Zeng, Jiaoe |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Mei |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Shi |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Jianhua |e verfasserin |4 aut | |
| 700 | 1 | |a Zhao, Tao |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Juping |e verfasserin |4 aut | |
| 700 | 1 | |a Liao, Yong |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Xiaowen |e verfasserin |4 aut | |
| 700 | 1 | |a Hu, Shufang |e verfasserin |4 aut | |
| 700 | 1 | |a Xue, Yaoming |e verfasserin |4 aut | |
| 700 | 1 | |a Zeng, Zhaoyang |e verfasserin |4 aut | |
| 700 | 1 | |a He, Wentao |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Zhelong |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Wenjun |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Liegang |e verfasserin |4 aut | |
| 700 | 1 | |a Yin, Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Xuefeng |e verfasserin |4 aut | |
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