Comment on: Nauck MA, Duran S, Kim D et al (2007) A comparison of twice-daily exenatide and biphasic insulin aspart in patients with type 2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study. Diabetologia 50:259–267

Response to comment on: Nauck MA, Duran S, Kim D et al (2007) A comparison of twice-daily exenatide and biphasic insulin aspart in patients with type 2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study. Diabetologia 50:259–267

“…The mean baseline HbA 1c in our exenatide-insulin comparator trials [4,7] was lower than the mean baseline HbA 1c observed in many treat-to-target trials, explaining less pronounced reductions in HbA 1c while achieving a similar endpoint level. In the second exenatide trial mentioned by Home [7], exenatide and insulin glargine achieved similar glucose control, with an endpoint HbA 1c of approximately 7.1% attained in both treatment arms, which is nearly identical to the best published trial results in the studies mentioned by Home [1].…”

Exenatide is Non-inferior to Insulin in Reducing HbA1c: An Integrated Analysis of 1423 Patients with Type 2 Diabetes

“…A limitation of this analysis is that insulin titration was not forced in 3 of the protocols. Previously, the insulin titration schedule for several of these trials had been criticized as not being intensive because the mean insulin dose was 25 U/d, 38 although the dose was titrated to maintain an FPG Ͻ 5.6 mmol/L. Despite a less-intense approach to insulin titration, the improvements to HbA 1c observed in the crossover study were similar across insulin dosing tertiles with exenatide and insulin treatment.…”

One-Year Treatment With Exenatide Improves β-Cell Function, Compared With Insulin Glargine, in Metformin-Treated Type 2 Diabetic Patients

“…These previous insulin comparator trials have been criticized for not achieving optimal insulin doses in the comparator arm of the study (19) despite mean reductions in A1C levels that were within the range of reductions observed in comparable insulin trials. In the current study, insulin titration resulted in a mean daily insulin dose of 34 ± 19 units.…”