Endocrine Abstracts

Introduction: The aim of this study was to evaluate effects on glycemic control, body weight and cardiovascular risk factors (BP, lipids and Epworth sleepiness scale) in diabetic patients with morbid obesity treated with exenatide.

Material and methods: We studied consecutively 21 T2DM patients, all of them treated with metformin full dosage and insufficient metabolic control referred to our clinic for preoperative control of bariatric surgery. Twelve of these patients (treatment group) were treated in addition with conventional regimen exenatide (5 μg s.c./12 h, 30 days and 10 μg s.c./12 h later) for 6–12 months or until surgery. Not altered any other therapeutic regimen. All of them were attached to a specific program of diet and exercise and reviewed monthly by a specialist nurse practitioner. Mann–Whitney and Wilcoxon test were performed.

Results: The mean patient age was 38.8±10.8 years in treatment group and 44.9±12 years in control group, with a ratio female:male 2:1. The average time of diabetes mellitus in treatment group was 3.1±1.1 years an 3.05±1.5 years in control group. Two thirds of patients had a diagnosis of obstructive sleep apnea (OSA) and ambulatory CPAP used during nocturnal rest, without statistically significant differences between groups. At the end of the study, better results were obtained in the treatment group, with statistically significant differences in clinical parameters of control of OSA (Epworth sleepiness scale): 6.7±3.2 vs 12.1±1.5 P<0.01, and in glycemic control (HbA1c: 7.1±0.9 vs 8.6±0.9, P<0.01), but not in weight loss (BMI: 42.1±4.5 vs 44,8±6.6, P=0.7). The most frequent adverse event in treatment group was nausea mild to moderate. There were no losses to follow up due to this cause during the study period.

Conclusions: Adjunctive therapy with exenatide in morbidly obese T2DM-patients achieved a sustained improvement in glycemic control and OSA and persists after body weight stabilization.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.