A research team involving Emory (Medicine and Rollins), Temple, Vanderbilt Clinical studies are evidencing that the use of short-acting exenatide with and without basal insulin in noncritically ill hospitalized patients helps improve glycemic control and was tolerated well. Exenatide, made by Amylin is a GLP Receptor Agonist and the Lead Investigator noted there are several to choose from.

The Study

The study involved a multicenter, open-label pilot study comparing the efficacy and safety of exenatide by itself or paired with basal insulin in 150 noncritically ill hospitalized patients with type 2 diabetes.

The four participating academic hospitals recruited the patients from within their patient population. They were from 18 to 80 in age and the inclusion criteria included known history of type 2 diabetes under treatment by either diet, oral agents and/or low-dose insulin at a total daily dose of fewer than 0.5 units/kg as well as a blood glucose level between 140 mg/dL and 400 mg/dL. The authors report that the patients were randomized to exenatide 5 μg twice daily (n=48), exenatide 5 μg twice daily plus basal insulin (n=52), or a basal-bolus insulin regimen (n=52).

The Results

It was reported that the patients with exenatide plus basal insulin had the lowest overall mean hospital blood glucose level (154.1 mg/dL), thereafter the basal-bolus insulin treatment (166.1 mg/dL) and exenatide alone (177.1 mg/dL). Moreover, analysis of the results evidences a material difference in mean blood glucose levels (-23 mg/dL) between treatment with exenatide plus basal insulin and exenatide alone.

Principal Investigator Comments

Guillermo Umpierrez, MD, study author from the Department of Medicine at Emory University reported that “increasing data from several randomized controlled studies indicate that incretin agents such as DPP-4 (dipeptidyl peptidase-4) inhibitors with basal insulin are as effective as basal-bolus (multi-dose) insulin regimens for the management of patients with type 2 diabetes.” Dr. Umpierrez also noted “Although the short-acting exenatide was used in this study, we have several dailies and once-weekly GLP-1 receptor agonists we can choose from. Our study indicates that these agents are safe for hospital use.”

GLP-1 Receptor Agonists List

TrialSite News includes a list of GLP-1 receptor agonists for type 2 diabetes in the United States.

Source: Diabetes Journals

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