A crossover study of the combination therapy of metformin and exenatide or biphasic insulin aspart 30 in overweight or obese patients newly diagnosed with type 2 diabetes mellitus

Abstract

Abstract. The aim of the present study was to explore the effects of various combinations of exenatide, metformin (MET) and biphasic insulin aspart 30 (BIA30) on type 2 diabetes mellitus (T2DM). Two hundred overweight or obese patients newly diagnosed with T2DM were evenly randomized into two groups: A (twice daily for all: Phase I, 5 µg exenatide + 0.5 g MET for 4 weeks, then 10 µg exenatide + 0.5 g MET for 8 weeks; Phase II, 0.5 g MET for 12 weeks; Phase III, 0.3-0.4 U/kg/day BIA30 + 0.5 g MET for 12 weeks) and B (Phases I, II, III matched the phases III, II and I in group A). In groups A and B a significant decrease and increase, respectively, in glycated hemoglobin (HbAlc) and body mass index (BMI) was noted during Phase I. A 3.2±0.4-kg decrease in body weight in group A and a 2.6±0.3-kg increase in group B was observed. In Phase II, HbAlc was significantly increased in both groups (P<0.05). In Phase III, the BMI was increased in group A and reduced in group B (P<0.05). There was a 3.8±0.4-kg weight decrease in group B and 4.2±0.5-kg increase in group A (P<0.05). The combination of exenatide and MET promoted weight loss, glycemic control, β-cell function index, C peptide and adiponectin levels. These results suggested that the combination of exenatide and MET is better than the combination of BIA and MET for the therapy of overweight or obese patients newly diagnosed with T2DM.

Glucagon‐like peptide‐1 receptor agonists improve biomarkers of inflammation and oxidative stress: A systematic review and meta‐analysis of randomised controlled trials

“…They comprised 6749 patients (inflammation evaluated in 6560, oxidative stress in 701 patients), included a median (IQR) study population of 60 (33‐122) participants, and had a median (IQR) follow‐up of 6 months (84‐182 days). Trials recruited from 11 individual countries and were multinational in four cases (14 from China, 30–33,37–39,41,44,47,48,56,58,65 seven from the United States, 36,52,53,59,61,63,68 three international studies, 46,64,66 three from Italy, 49,62,67 three from Japan, 45,55,57 two from Denmark, 50,69 two from Greece, 42,54 two Sweden, 34,35 one from France, 51 one from Germany, 60 one from India, 40 and one from Spain 43 ). Participants had a mean age of 53.1 years, 56.3% were women, the mean HbA1c was 55.6 (±8.89) mmol/mol, the mean BMI was 28.8 (±3.52) kg/m 2 .…”

“…Participants had T2DM (39 trials) or prediabetes (three trials), and had a mean diabetes duration of 7.46 (±4.22) years (Table 1). In 16 studies (20.8% of total participants), both the active and control arms were also receiving concomitant metformin, 33,35,40,43,45,48,50–54,61–63,65,67 whereas the presence of concomitant medications was not clear in 11 studies (25.2% of total participants) 30,32,36,38,39,44,47,56–58,64 . In three studies (5.8% of total participants) >50% of participants received concomitant metformin and other diabetes medications 45,51,61 .…”

Impact of Incretin-Based Therapies on Adipokines and Adiponectin

“…Jin and coworkers in 2020 demonstrated that liraglutide reversed HFD induced hyper-resistinemia in rats [ 73 ]. Quan et al in 2017 found that exenatide therapy significantly decreased resistin level in obese newly diagnosed diabetic patients [ 89 ]. Li et al in 2015 reported that liraglutide downregulated resistin peptide in patients with T2DM [ 90 ].…”

Impact of glucagon‐like peptide‐1 receptor agonists on adiponectin concentrations: A meta‐analysis of randomized controlled trials

“…Included studies were published between 2008 and 2020. 8,9,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The range of treatment duration was from 12 to 52 weeks. Only 1 study was cross-over, 19 and 19 out of the 20 included trials had a parallel design.…”

“…8,9,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The range of treatment duration was from 12 to 52 weeks. Only 1 study was cross-over, 19 and 19 out of the 20 included trials had a parallel design. Trials enrolled subjects with type 2 diabetes, 8,9,16-26,28,29,31 type 1 diabetes, 33 nonalcoholic steatohepatitis, 27 nonalcoholic fatty liver disease, 24,31 polycystic ovary syndrome 30,32 and hypertension.…”