Endocrine Abstracts

Objectives: Evaluate the impact of the therapy with GLP-1 analogues (exenatide) toguether with basal insulin in glycemic control and weight of patients with type 2 diabetes mellitus poorly controlled.

Materials and methods: We analyzed 37 patients with type 2 diabetes with poor glycemic control and obesity, treatment with exenatide and basal insulin. As pre-treatment 56.7% of our patients were with basal insulin, 10.8% with insulin mixtures and 32.4% with basal-bolus regimen. The patients with basal insulin exenatide were added exenatide. The patients with insulin mixtures were passed to basal insuline more exenatide. Finally to the patients with basal bolus insulin we replaced rapid insulin by exenatide, always maintaining the metformin unless contraidicated. At the start we reinforce the diabetes education and we analyze the variables: HbA1c, weight and the insulin requeriment in 3 months. We did statistical analysis with SPSSv18 throught t-student for paired data.

Results: Our series had a mean age of 51.8±11.5 years, 26 men (70.3%) and 11 women (29.7%).They had about 8.0±7.5 years of disease progression and poor metabolic control expressed as HbA1c of 8.27±1.71% and BMI of 40.3±6.0 kg/m2. In our series 22 patients (59.5%) were on glargine and 15 patients (40.5%) with detemir.

We observed a decrease clinically relevant and statistically significant in the average HbA1c at 3 months of 8.27% to 6.95% (1.33%) (P<0.001). At the same time there is a average weight loss of 5.3 kg at 3 months (P<0.001). We also analyzed the insulin needs to appreciate an average reduction in dose of 0.38 IU/kg to 0.31 IU / kg (−0.07 IU / kg) at 3 months (P<0.05). As Adverse effects of interest were reported gastrointestinal disturbances (nausea, vomiting) in 6 patients causing 2 retired. We did not observed episodes of hypoglycemia.

Conclusions: The association of GLP-1 analogues with basal insulin in patients with type 2 diabetes, who need insulin therapy for their poor control, is an interesting therapeutic option and to consider for the improvement in glycemic control and weight loss. This also contributes to the decrease of the insulin requirements in their treatment.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.