Clinical application of Exenatide for type 2 diabetes

Abstract

Exenatide is the first in a new class of compounds, which possess similar activity to the naturally-occurring hormone glucagon-like peptide-1 (GLP-1. In three phase Ⅲ trials in patients with type 2 diabetes mellitus (T2DM). who have Inadequate glycaemic control despite receiving treatment with metformin and/ or sulfonylurea, the addition of exenatide twice daily significantly reduced glycated haemoglobin ( ≤ 1 %), and fasting and postprandial plasma glucose and was associated with progressive and significant bodyweight reduction from baseline for up to 2 years, Nausea (about 40%) was the most commonly reported adverse event in the combined exenatide groups. The addition of exenatide also improved glycemic control in a small population with T2DM receiving thiazolidinedione. The glycaemic control with exenatide was similar to that achieved with insulin glargine or biphasic insulin aspart. However， the insulin doses were well below doses used in recent studies. In a head-to-head clinical trial， exenatide once-weekly caused greater improvements in glycemic control and was better tolerated than exenatide twice daily. On the basis of the data, adjunctive therapy with exenatide is a valuable therapeutic option in obese patients with T2DM requiring moderate improvements in glycaemic control despite treatment with metformin and/or a sulfonylurea, In addition, exenatide once-weekly is a promising development candidate for the treatment of T2DM.