Diabetes Metab J.  2017 Feb;41(1):69-74. 10.4093/dmj.2017.41.1.69.

Exenatide versus Insulin Lispro Added to Basal Insulin in a Subgroup of Korean Patients with Type 2 Diabetes Mellitus

• Yoon KH
• Hardy E
• Han J

• KMID: 2368531
• DOI: http://doi.org/10.4093/dmj.2017.41.1.69

Abstract

BACKGROUND
The prevalence of type 2 diabetes mellitus (T2DM) and obesity is increasing in Korea. Clinical studies in patients with T2DM have shown that combining the glucagon-like peptide-1 receptor agonist exenatide twice daily with basal insulin is an effective glucose-lowering strategy. However, these studies were predominantly conducted in non-Asian populations.
METHODS
We conducted a subgroup analysis of data from a multinational, 30-week, randomized, open-label trial to compare the effects of exenatide twice daily (n=10) or three times daily mealtime insulin lispro (n=13) among Korean patients with T2DM inadequately controlled (glycosylated hemoglobin [HbA1c] >7.0%) on metformin plus optimized insulin glargine.
RESULTS
Exenatide twice daily and insulin lispro both reduced HbA1c (mean −1.5% and −1.0%, respectively; P<0.01 vs. baseline). Fasting glucose and weight numerically decreased with exenatide twice daily (−0.7 mmol/L and −0.7 kg, respectively) and numerically increased with insulin lispro (0.9 mmol/L and 1.0 kg, respectively). Minor hypoglycemia occurred in four patients receiving exenatide twice daily and three patients receiving insulin lispro. Gastrointestinal adverse events were the most common with exenatide twice daily treatment.
CONCLUSION
This analysis found treatment with exenatide twice daily improved glycemic control without weight gain in Korean patients with T2DM unable to achieve glycemic control on metformin plus basal insulin.

Keyword

Diabetes mellitus, type 2; Exenatide; Insulin lispro

MeSH Terms

Diabetes Mellitus, Type 2*
Fasting
Glucagon-Like Peptide-1 Receptor
Glucose
Humans
Hypoglycemia
Insulin Glargine
Insulin Lispro*
Insulin*
Korea
Meals
Metformin
Obesity
Prevalence
Weight Gain
Glucagon-Like Peptide-1 Receptor
Glucose
Insulin
Insulin Glargine
Insulin Lispro
Metformin

Figure

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  Fig. 1 Primary and secondary outcomes over 30 weeks for the per-protocol population: (A) change in glycosylated hemoglobin (HbA1c) values (primary outcome measure); (B) insulin glargine dose in the exenatide twice daily (BID) treatment group (open squares) and the insulin lispro treatment group (closed triangles), and total insulin dose in the insulin lispro group (closed circles); (C) change in fasting glucose; (D) self-monitored blood glucose values at randomization (gray lines) and 30 weeks (black lines); and (E) change in weight. Values are presented as mean±standard error. aP<0.05, bP≤0.01, cP<0.001.

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