Therapy with exenatide in obese and morbidly obese type 2 diabetic patients: comparative analysis
M Diéguez Felechosa1, C Tusón Rovira1, C Sánchez Ragnarsson2, F Casal Alvarez1, N Valdés Gallego1, L Manjón Miguélez1 & J Prieto Santiago1
Aim: To compare the effectiveness and tolerability of Exenatide twice daily treatment of obese and morbidly obese type 2 diabetic (T2D) patients.
Material and methods: To analyze data of obese and severe obese T2D patients initiated on Exenatide in our Endocrine clinics who complete one year of treatment. We separate patients in two groups: group A (BMI<40 kg/m2) and group B (BMI≥40 kg/m2). We did not include any modifications in previous lifestyle plans.
Results: We included 42 patients, 18 in group A (10 women and 8 men, mean±S.D. age 57±10 years, 9±4 years of diabetes evolution) and 24 in group B (20 women and 4 men, mean±S.D. age 61±9 years, 5±4 years of diabetes evolution).
At baseline, HbA1c was 7.2±1.3 vs 7.8±1.6 and weight 92.8±12.8 kg (BMI 36.5±2 kg/m2) vs 111±14 kg (BMI 44.4±3 kg/m2) in group A and B respectively.
After 12 months of treatment, mean HbA1c reduction was 0.9±2% in group A and 0.6±1.4% in group B, mean weight loss 5.9±6 kg (BMI reduction 2.3±2.8 kg/m2) in group A and 10±7.8 (BMI 3.6±3 kg/m2) in group B, being all of them statistical significant (P<0.01 Wilcoxon test). Comparing HbA1c, weight and BMI mean reductions of two groups we have not assessed significant differences (P>0.05 MannWhitney U test).
Adverse events were registered in 9 patients (50%) in group A and in 4 patients (16.7%) in group B (P<0.01 χ2 test), with similar withdrawal rates (22.2 vs 21.7%).
Conclusions: Exenatide treatment significantly reduces HbA1c and weight in our population of obese T2D patients. We have not observed any significant difference in Exenatide efficacy between obese and severe obese T2D patients. Morbidly obese patients showed better Exenatide tolerance profile.