Clinical characteristics and outcomes in patients with type 2 diabetes adding insulin glargine to exenatide or exenatide to insulin glargine in a US managed care setting

Abstract

INTRODUCTION • Insulin glargine is a once-daily long-acting basal insulin analog that provides effective glycemic control when administered with either oral antidiabetic drugs (OADs) or a rapidacting insulin in patients with type 2 diabetes mellitus (T2DM).1 • Exenatide is a glucagon-like peptide 1 receptor agonist that improves glycemic control in patients with T2DM when added to metformin and/or sulfonylureas.2 • Several randomized studies have compared the efficacy and safety of these drugs. For example, an open-label crossover study in 138 patients with T2DM showed that 16 weeks of treatment with either insulin glargine or exenatide was associated with similar significant improvements from baseline in glycated hemoglobin A1C (A1C). • A recently published randomized controlled trial suggested that adding exenatide to existing insulin glargine therapy improved glycemic control without increasing hypoglycemia or weight gain in patients with T2DM.4 • However, few studies have assessed the effectiveness and treatment persistence of combination insulin glargine and exenatide in a real-world setting.