Exenatide, Basal Insulin Combination Effective for Inpatient Treatment of Diabetes

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Patients in the exenatide group after discharge experienced significantly higher amounts of nausea and vomiting compared with the basal insulin group.
Patients in the exenatide group after discharge experienced significantly higher amounts of nausea and vomiting compared with the basal insulin group.
The following article is part of conference coverage from the American Diabetes Association's 78th Scientific Sessions (ADA 2018) in Orlando,Florida. Endocrinology Advisor's staff will report on medical research and technological advances in diabetes and diabetes education, conducted by experts in the field. Check back for the latest news from ADA 2018.

ORLANDO — Surgical patients with type 2 diabetes benefit from inpatient and post-discharge treatment involving exenatide therapy in combination with basal insulin to safely and effectively manage blood glucose. This research was presented at the American Diabetes Association's 78th Scientific Sessions held in Orlando, Florida, June 22 - 26, 2018.

This multi-center, open-label study sought to determine the safety and efficacy of exenatide alone or in combination with basal insulin as used to treat hospitalized patients with type 2 diabetes. The study included 150 patients with type 2 diabetes and blood glucose levels between 140-400 mg/dL who were treated with exenatide therapy (n=47), exenatide and basal therapy (n=51), or basal-bolus regimen (n=52). 

Hospitalized patients were started with exenatide 5 mcg twice daily, 0.25 U/kg/day of basal insulin, and 0.5 U/kg/day basal-bolus therapy given half as glargine and half as lispro prior to meals. At discharge, patients continued with pre-admission therapy and were randomly assigned to receive exenatide or basal insulin for up to 3 months.

Study results showed that, while hospitalized, a higher proportion of patients using the combination of exenatide and basal insulin achieved target blood glucose levels (70-180 mg/dL), resulting in a lower mean daily blood glucose measurement compared with exenatide alone or basal-bolus therapy (P<.01). No differences in hypoglycemia or gastrointestinal adverse events between the study groups. Following discharge, all groups maintained similar blood glucose control; however, the exenatide group experienced more gastrointestinal adverse events than the basal insulin group (P<.001).  The mean HbA1c 3 months after discharge was 8.2±1.9% in the exenatide group and 7.3±1% in the basal insulin group.

Researchers indicated that exenatide in combination with basal insulin is safe and effective for both inpatient and post-discharge for the management of individuals with type 2 diabetes.

Disclosures

Disclosure M. Fayfman: None. D.L. Mize: None. D.J. Rubin: Research Support; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc.. I. Anzola: None. M.A. Urrutia: None. C. Ramos: None. F.J. Pasquel: Consultant; Self; Merck Sharp & Dohme Corp., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc.. J. Haw: None. P. Vellanki: Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc., AstraZeneca. H. Wang: None. K.E. Joyce: None. A. Karunakaran: None. B.S. Albury: None. R. Weaver: None. L. Viswanathan: None. S. Jaggi: None. R.J. Galindo: None. G.E. Umpierrez: Research Support; Self; Sanofi US, Merck & Co., Inc., Novo Nordisk Inc., AstraZeneca. Advisory Panel; Self; Sanofi, Intarcia Therapeutics, Inc..

For more coverage of ADA 2018, click here. 

Reference

Fayfman M, Mize DL, Rubin DJ, et al. Safety and efficacy of exenatide therapy for the management of hospitalized patients with type 2 diabetes—Exenatide Hospital Trial. Poster presented at: ADA 2018 78th Scientific Sessions; June 22-26, 2018; Orlando, FL. Poster 1078.

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