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- Title
Comparison of Glycemic Variability in Chinese T2DM Patients Treated with Exenatide or Insulin Glargine: A Randomized Controlled Trial.
- Authors
Yin, Ting-Ting; Bi, Yan; Li, Ping; Shen, Shan-Mei; Xiong, Xiao-Lu; Gao, Li-Jun; Jiang, Can; Wang, Yan; Feng, Wen-Huan; Zhu, Da-Long
- Abstract
Introduction: Increasing the frequency of blood glucose monitoring aids the evaluation of glycemic variability and blood glucose control by antidiabetic drugs. It remains unclear, however, whether GLP-1 receptor agonists or basal insulin has a better effect on glycemic variability in type 2 diabetes mellitus (T2DM) patients who are inadequately controlled by metformin. We used a continuous glucose monitoring system (CGMS) to compare patients on a GLP-1 receptor agonist with patients on basal insulin in terms of glycemic variability.Methods: This prospective randomized study assigned T2DM patients treated with metformin (N = 39) to either exenatide treatment or insulin glargine treatment for 16 weeks. Glycemic variability was assessed using a CGMS; hemoglobin A1c (HbA1c), β-cell function, weight, body mass index (BMI), and waist circumference were also evaluated.Results: Mean blood glucose level, continuous overlapping net glycemic action, mean amplitude of glycemic excursions, percentage of the time that the blood glucose value was > 10.0 mmol/L, and highest blood glucose level (P < 0.01-0.05) significantly decreased in both groups. Standard deviation of the mean glucose value, largest amplitude of glycemic excursions, and waist circumference significantly decreased for those treated with exenatide (P < 0.05), while no changes were observed with insulin glargine treatment. Percentage of the time that the blood glucose value was > 7.8 mmol/L decreased after insulin glargine use (P < 0.05) but not with the exenatide intervention. Similar decreases in fasting blood glucose and HbA1c and increases in the 1/homeostasis model assessment of insulin resistance, disposition index 30, and disposition index 120 were observed in both groups (P < 0.01-0.05). Reductions in weight and BMI were greater with exenatide than with insulin glargine treatment (P < 0.05).Conclusions: In overweight and obese patients with T2DM inadequately controlled by metformin, exenatide and insulin glargine have similar efficacies in terms of glycemic variability, HbA1c alleviation, and β-cell function, but exenatide has a greater effect on body weight and BMI.
- Subjects
GLYCEMIC control; GLUCOSE in the body; TREATMENT of diabetes; PEOPLE with diabetes; MEDICAL care
- Publication
Diabetes Therapy, 2018, Vol 9, Issue 3, p1253
- ISSN
1869-6953
- Publication type
Article
- DOI
10.1007/s13300-018-0412-6