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Exenatide Improves Hyperglycemia by Reducing Postprandial Glucose and Fasting Glucose: Presented at AACE

By Mike Fillon

CHICAGO, I.L. -- May 2, 2006 -- Exenatide improved hyperglycemia in a new study by reducing both postprandial glucose (PPG) excursions and fasting glucose (FG), while insulin glargine improved hyperglycemia primarily by reducing FG with no significant effect on PPG excursions.

Results of the study were presented here on April 27^th at the annual meeting of the American Association of Clinical Endocrinologists (AACE).

Insulin glargine is a human insulin analog produced by recombinant DNA technology. Since it is absorbed slowly it has a 24-hour duration of action that does not peak after subcutaneous administration.

Exenatide, also known as synthetic exendin-4, is a new agent for the treatment of type 2 diabetes. Clinical trials suggest that exenatide treatment decreases blood glucose while also inducing weight loss.

Previously, researchers at Eli Lilly and Company reported that treatment of type 2 diabetes with either exenatide or insulin glargine resulted in similar improvements in glycemic control when added to metformin and a sulfonylurea.

"We conducted a post-hoc analysis to determine the relative contribution of PPG excursions to hyperglycemia in exenatide and glargine treated patients," said researcher John H. Holcombe, MD, medical fellow in diabetes, Eli Lilly.

In their new study, the researchers found that although both agents reduced fasting glucose, insulin glargine did so to a greater extent than exenatide. The researchers also found that exenatide reduced postprandial glucose excursions, while insulin glargine did not.

In the study, a total of 414 patients with a mean age of 58.4 years and a mean body mass index of 31.5 kg/m² who had baseline and 26-week self-monitored blood glucose (SMBG) data. At baseline and at 26 weeks, SMBG profiles were collected before and 2 hours after breakfast, lunch and dinner. PPG area under the curve excursions and percentage of hyperglycemia due to PPG excursions were calculated and compared between treatments.

Results show that at baseline, PPG excursions were similar between the exenatide and glargine-treated patients. At 26 weeks, however, a significant reduction from baseline in PPG excursions was noted only in the exenatide arm.


[Presentation title: Exenatide and Insulin Glargine Differentially Affect Postprandial Glucose Excursions in Patients with Type 2 Diabetes. Abstract 278]

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