TY - JOUR
T1 - Exenatide improves β-cell function up to 3 years of treatment in patients with type 2 diabetes
T2 - a randomised controlled trial
AU - van Raalte, Daniël H
AU - Bunck, Mathijs C
AU - Smits, Mark M
AU - Hoekstra, T
AU - Cornér, Anja
AU - Diamant, Michaela
AU - Eliasson, Bjorn
AU - Marja-RiittaTaskinen, [Unknown]
AU - Heine, Robert J
AU - Smith, Ulf
AU - HanneleYki-Järvinen, null
AU - Mari, Andrea
PY - 2016/10
Y1 - 2016/10
N2 - OBJECTIVE: 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.RESEARCH DESIGN AND METHODS: 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 3 years of treatment. EXE was administered before breakfast.RESULTS: 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 3 years, 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 3 years, 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 8 mmol/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 3 years. No consistent changes in other β-cell parameters including rate sensitivity and potentiation were observed.CONCLUSIONS: Compared with GLAR, EXE improved the parameters of β-cell function, especially insulin secretion at 8 mmol/L glucose and β-cell glucose sensitivity, which was sustained during the 3-year treatment period.
AB - OBJECTIVE: 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.RESEARCH DESIGN AND METHODS: 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 3 years of treatment. EXE was administered before breakfast.RESULTS: 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 3 years, 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 3 years, 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 8 mmol/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 3 years. No consistent changes in other β-cell parameters including rate sensitivity and potentiation were observed.CONCLUSIONS: Compared with GLAR, EXE improved the parameters of β-cell function, especially insulin secretion at 8 mmol/L glucose and β-cell glucose sensitivity, which was sustained during the 3-year treatment period.
KW - Blood Glucose
KW - Diabetes Mellitus, Type 2
KW - Female
KW - Humans
KW - Hypoglycemic Agents
KW - Insulin-Secreting Cells
KW - Journal Article
KW - Male
KW - Middle Aged
KW - Peptides
KW - Postprandial Period
KW - Randomized Controlled Trial
KW - Treatment Outcome
KW - Venoms
U2 - https://doi.org/10.1530/EJE-16-0286
DO - https://doi.org/10.1530/EJE-16-0286
M3 - Article
C2 - 27466218
SN - 0804-4643
VL - 175
SP - 345
EP - 352
JO - European journal of endocrinology
JF - European journal of endocrinology
IS - 4
ER -