Addition of exenatide to obese insulin-treated patients can improve glycemia and weight but is less well tolerated
A nationwide audit of the extent, safety, efficacy and tolerability of reported off-license exenatide use has found that the addition of exenatide to obese insulin-treated patients can improve glycemia and weight. The anonymous online audit was carried out by the Association of British Clinical Diabetologists and assessed real clinical practice by 315 contributors from 126 U.K. centers. HbA1c and weight changes, exenatide discontinuation, adverse events and treatment satisfaction were compared among 4,857 patients with mean baseline HbA1c of 9.45% and BMI of 40 kg/m2, 39.6% of whom used exenatide with insulin. A comparison of patients using exenatide with insulin versus non-insulin-treated patients revealed mean latest HbA1c of 0.51% vs. 0.94%, respectively, and mean weight reduction of 5.8 vs. 5.5 kg, respectively. Overall, exenatide was less effective in lowering HbA1c, but 34.2% of patients still achieved HbA1c reduction ≥ 1%. Combination treatment was less well tolerated and insulin-treated patients had higher rates of exenatide discontinuation , hypoglycemia , gastrointestinal side effects and treatment dissatisfaction . Further research could help to identify obese, insulin-treated patients who might benefit from exenatide treatment : 703).
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