Endocrine Abstracts

Introduction: The recent ADA and EASD algorithm for the treatment of type 2 DM suggests addition of basal insulin or GLP-1 agonist to pre-existing treatment when glycemic control is not achieved.

Aim: Compare efficacy and safety of exenatide (E) versus insulin Glargine (G) added after metformin monotherapy.

Patients and method

Our study was open labeled, non- randomized, retrospective and included 48 patients, 17 men/ 31 women, mean age 61.98±8.8 years, mean duration of DM 11.8±7.25 years, and mean HbA1c 8.34±1.63 at baseline. All patients were on metformin (1700 mg/day) for at least 3 months when E or G was added. Body mass index (BMI), systolic (SBP) and diastolic (DBP) pressure, frequency and severity of hypoglycemic episodes, gastrointestinal side effects, HbA1c and lipid profile were determined at baseline and after 24 weeks.

Results: HbA1c reduction was similar in both groups (E: P=0.006 vs G: P=0.010). G group had more hypoglycemias (P=0.039). E group had greater BMI reduction than G (−2.5±1.8 vs 0.1±1.4; P=0.002). GI side effects and changes in SBP/DBP were insignificant in both groups. Total cholesterol was reduced (E: P=0.010 vs G: P=0.014). E group had higher HDL P=0.021, lower LDL (P=0.012) and triglycerides (P=0.016) at the end of the study.

Conclusion: Exenatide equals Glargine in glycemic control with fewer hypoglycemias and better metabolic parameters. In order to form selection criteria between the two strategies further testing is needed with randomized studies, longer observation period and greater numbers of patients.

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.