Exenatide versus glibenclamide in patients with diabetes

G. Derosa, P. Maffioli, S. A T Salvadeo, I. Ferrari, P. D. Ragonesi, F. Querci, I. G. Franzetti, G. Gadaleta, L. Ciccarelli, M. N. Piccinni, A. D'Angelo, A. F G Cicero

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Abstract

Background: Incretin-based therapies have provided additional options for the treatment of type 2 diabetes mellitus. The aim of our study was to evaluate the effects of exenatide compared to glibenclamide on body weight, glycemic control, β-cell function, insulin resistance, and inflammatory state in patients with diabetes. Methods: One hundred twenty-eight patients with uncontrolled type 2 diabetes mellitus receiving therapy with metformin were randomized to take exenatide 5μg twice a day or glibenclamide 2.5mg three times a day and titrated to exenatide 10μg twice a day or glibenclamide 5mg three times a day. We evaluated body weight, body mass index (BMI), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance (HOMA-IR) index, homeostasis model assessment β-cell function (HOMA-β) index, plasma proinsulin (PPr), PPr/FPI ratio, resistin, retinol binding protein-4 (RBP-4), and high-sensitivity C-reactive protein (Hs-CRP) at baseline and after 3, 6, 9, and 12 months. Results: Body weight and BMI decreased with exenatide and increased with glibenclamide. A similar improvement of HbA1c, FPG, and PPG was obtained in both groups, whereas FPI decreased with exenatide and increased with glibenclamide. The HOMA-IR index decreased and the HOMA-β index increased with exenatide but not with glibenclamide. A decrease of PPr was reported in both groups, but only glibenclamide decreased the PPr/FPI ratio. Resistin and RBP-4 decreased with exenatide and increased with glibenclamide. A decrease of Hs-CRP was obtained with exenatide, whereas no variations were observed with glibenclamide. Conclusions: Both exenatide and glibenclamide gave a similar improvement of glycemic control, but only exenatide gave improvements of insulin resistance and β-cell function, giving also a decrease of body weight and of inflammatory state.

Original languageEnglish
Pages (from-to)233-240
Number of pages8
JournalDiabetes Technology and Therapeutics
Volume12
Issue number3
DOIs
Publication statusPublished - Mar 1 2010

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Glyburide
Proinsulin
Fasting
Insulin Resistance
Body Weight
Insulin
Resistin
Glucose
Retinol-Binding Proteins
Homeostasis
C-Reactive Protein
Type 2 Diabetes Mellitus
exenatide
Body Mass Index
Incretins
Metformin
Glycosylated Hemoglobin A
Therapeutics

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medical Laboratory Technology

Cite this

Exenatide versus glibenclamide in patients with diabetes. / Derosa, G.; Maffioli, P.; Salvadeo, S. A T; Ferrari, I.; Ragonesi, P. D.; Querci, F.; Franzetti, I. G.; Gadaleta, G.; Ciccarelli, L.; Piccinni, M. N.; D'Angelo, A.; Cicero, A. F G.

In: Diabetes Technology and Therapeutics, Vol. 12, No. 3, 01.03.2010, p. 233-240.

Research output: Contribution to journalArticle

Derosa, G, Maffioli, P, Salvadeo, SAT, Ferrari, I, Ragonesi, PD, Querci, F, Franzetti, IG, Gadaleta, G, Ciccarelli, L, Piccinni, MN, D'Angelo, A & Cicero, AFG 2010, 'Exenatide versus glibenclamide in patients with diabetes', Diabetes Technology and Therapeutics, vol. 12, no. 3, pp. 233-240. https://doi.org/10.1089/dia.2009.0141
Derosa, G. ; Maffioli, P. ; Salvadeo, S. A T ; Ferrari, I. ; Ragonesi, P. D. ; Querci, F. ; Franzetti, I. G. ; Gadaleta, G. ; Ciccarelli, L. ; Piccinni, M. N. ; D'Angelo, A. ; Cicero, A. F G. / Exenatide versus glibenclamide in patients with diabetes. In: Diabetes Technology and Therapeutics. 2010 ; Vol. 12, No. 3. pp. 233-240.
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AU - Salvadeo, S. A T

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AU - Franzetti, I. G.

AU - Gadaleta, G.

AU - Ciccarelli, L.

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N2 - Background: Incretin-based therapies have provided additional options for the treatment of type 2 diabetes mellitus. The aim of our study was to evaluate the effects of exenatide compared to glibenclamide on body weight, glycemic control, β-cell function, insulin resistance, and inflammatory state in patients with diabetes. Methods: One hundred twenty-eight patients with uncontrolled type 2 diabetes mellitus receiving therapy with metformin were randomized to take exenatide 5μg twice a day or glibenclamide 2.5mg three times a day and titrated to exenatide 10μg twice a day or glibenclamide 5mg three times a day. We evaluated body weight, body mass index (BMI), glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance (HOMA-IR) index, homeostasis model assessment β-cell function (HOMA-β) index, plasma proinsulin (PPr), PPr/FPI ratio, resistin, retinol binding protein-4 (RBP-4), and high-sensitivity C-reactive protein (Hs-CRP) at baseline and after 3, 6, 9, and 12 months. Results: Body weight and BMI decreased with exenatide and increased with glibenclamide. A similar improvement of HbA1c, FPG, and PPG was obtained in both groups, whereas FPI decreased with exenatide and increased with glibenclamide. The HOMA-IR index decreased and the HOMA-β index increased with exenatide but not with glibenclamide. A decrease of PPr was reported in both groups, but only glibenclamide decreased the PPr/FPI ratio. Resistin and RBP-4 decreased with exenatide and increased with glibenclamide. A decrease of Hs-CRP was obtained with exenatide, whereas no variations were observed with glibenclamide. Conclusions: Both exenatide and glibenclamide gave a similar improvement of glycemic control, but only exenatide gave improvements of insulin resistance and β-cell function, giving also a decrease of body weight and of inflammatory state.

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