Exenatide improves β-cell function up to 3 years of treatment in patients with type 2 diabetes: a randomised controlled trial.

• Glucagon-like peptide (GLP)-1 receptor agonist treatment improves β-cell function. In this study, we investigated whether the improvements are sustained during a 3-year treatment period.Sixty-nine metformin-treated type 2 diabetes patients were randomised to the GLP1 receptor agonist, exenatide (EXE) twice daily (BID) or to insulin glargine (GLAR). β-cell function parameters were derived using the Mari model from standardised breakfast and lunch meals that were administered before treatment, and after 1 and 3years of treatment. EXE was administered before breakfast.Fifty-nine (EXE: n=30; GLAR: n=29) and thirty-six (EXE: n=16; GLAR: n=20) patients completed the meal at 1- and 3-year treatment respectively. After 3years, groups had comparable glycaemic control (HbA1c: EXE 6.6±0.2% and GLAR 6.9±0.2%; P=0.216). Compared with GLAR, at 1 and 3years, EXE induced a stronger reduction in post-breakfast glucose concentrations (P<0.001), with lower C-peptide levels (P<0.001). Compared with GLAR, EXE increased insulin secretion at 8mmol/L glucose throughout the study period (P<0.01). Both treatments improved β-cell glucose sensitivity after 1-year treatment. However, only EXE treatment sustained this improvement for 3years. No consistent changes in other β-cell parameters including rate sensitivity and potentiation were observed.Compared with GLAR, EXE improved the parameters of β-cell function, especially insulin secretion at 8mmol/L glucose and β-cell glucose sensitivity, which was sustained during the 3-year treatment period.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Nyckelord

Blood Glucose

Diabetes Mellitus

Type 2

drug therapy

physiopathology

Female

Humans

Hypoglycemic Agents

pharmacology

therapeutic use

Insulin-Secreting Cells

drug effects

physiology

Male

Middle Aged

Peptides

pharmacology

therapeutic use

Postprandial Period

Treatment Outcome

Venoms

pharmacology

therapeutic use

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