ECE2013 Poster Presentations Cardiovascular Endocrinology & Lipid Metabolism (41 abstracts)
Combination therapy in diabetic patients with insulin glargine and exenatide in the internal medicine service two of hospitals in Valencia
Belen Roig-Espert 1 , Juan Jose Tamarit-Garcia 2 , Patricia Sacie-Reyes 2 , Belen Vizcaino-Castillo 2 , Ana Ruiz-Garcia 2 , Amparo Lozano-Cebrian 2 , Marta Balaguer-Catalan 2 & Arturo Artero-Mora 2
1Manises Hospital, Manises – Valencia, Spain; 2Dr Peset University Hospital, Valencia, Spain.
Background and objective: Combination therapy in diabetic patients is seeking better clinical outcomes by acting on different targets in the pathophysiology of the disease.
Insulin glargine provides excellent glycemic control, especially in the fasting glucose control, in spite of a increasing in weight, compared with exenatide which is more effective in controlling postprandial glycemic and in reducing insulin resistance, plus a reducing effect on the weight.
Design and methods: – Men/Women: 12/18, age 67.36±4.4 years, duration of diabetes 19.6±4.7 years.
– Baseline data: weight 106.51±7.24 kg, BMI 41.25±3.1258 kg/m2, glicated hemoglobin (HbA1c) 8.8±0.61, 64.97± insulin dose 18.64 UI.
– Changes in insulin requirements UI/kg: baseline 0.61±0.18, at 3–6 months 0.39±0.06 and 0.23±0.36 at 9-12 months. Significant reduction in insulin dose: 35.65% at 3–6 months and 48.65% at 9–12 months. Insulin was removed in five patients.
– Changes in weight: all patients lost weight: 4.6±2.73 kg at 3–6 months and 8.4±6.23 kg at 9–12 months.
– HbA1c evolution: reduced by 83.2% at 3–6 months and 85.3% at 9–12 months. The mean reduction in HbA1c was 0.9±1.03 at 3–6 months and 1.3±1.22% at 9–12 months.
– Tolerance: withdrawal for Exenatide in four patients (13.3%): 2 gastrointestinals intolerance and another 2 by insufficient metabolic control.
Conclusions: The combined use of insulin glargine and exenatide improves glycemic control and in many cases allows the reduction of insulin dose, obtaining further reduction in weight, which makes this partnership a first-choice treatment in of patients with type 2 diabetes and BMI over 30 kg/m2.
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