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Glucose Variability and β- Cell Response by GLP-1 Analogue added-on CSII for Patients with Poorly Controlled Type 2 Diabetes.

Lin CH, Hsieh SH, Sun JH, Tsai JS, Huang YY - Sci Rep (2015)

Bottom Line: There was no difference in mean glucose but a significant higher standard deviation of plasma glucose (SDPG) was found in the exenatide group (50.51 ± 2.43 vs. 41.49 ± 3.00 mg/dl, p = 0.027).The adiponectin level was significantly increased with exenatide added on (0.39 ± 0.32 vs. -1.62 ± 0.97 μg/mL, in exenatide and placebo groups, respectively, p = 0.045).In conclusion, the add-on of GLP-1 analogue to CSII increased glucose variability and the β - cell response in patients with poorly controlled T2DM.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.

ABSTRACT
The effects of twice-daily GLP-1 analogue injections added on continuous subcutaneous insulin infusion (CSII) in patients with poorly controlled type 2 diabetes (T2DM) were unknown. After optimization of blood glucose in the first 3 days by CSII during hospitalization, patients with poorly controlled T2DM were randomized to receive CSII combined with injections of exenatide or placebo for another 3 days. A total of 51 patients (30 in exenatide and 21 in placebo groups) with mean A1C 11% were studied. There was no difference in mean glucose but a significant higher standard deviation of plasma glucose (SDPG) was found in the exenatide group (50.51 ± 2.43 vs. 41.49 ± 3.00 mg/dl, p = 0.027). The improvement of incremental area under the curve (AUC) of glucose and insulinogenic index (Insulin 0-peak/ Glucose 0-peak) in 75 g oral glucose tolerance test was prominent in the exenatide group (p < 0.01). The adiponectin level was significantly increased with exenatide added on (0.39 ± 0.32 vs. -1.62 ± 0.97 μg/mL, in exenatide and placebo groups, respectively, p = 0.045). In conclusion, the add-on of GLP-1 analogue to CSII increased glucose variability and the β - cell response in patients with poorly controlled T2DM.

No MeSH data available.


Related in: MedlinePlus

Baseline and end-of-study eight-point blood glucose profiles (mean ± SEM).*p < 0.05 between GLP-1 analogue and placebo at endpoint by ANCOVA test after adjustment of adjustment of sex, mean age, BMI, duration of diabetes mellitus, C-peptide and A1C levels.
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f1: Baseline and end-of-study eight-point blood glucose profiles (mean ± SEM).*p < 0.05 between GLP-1 analogue and placebo at endpoint by ANCOVA test after adjustment of adjustment of sex, mean age, BMI, duration of diabetes mellitus, C-peptide and A1C levels.

Mentions: The 8-point blood glucose profiles were shown in Fig. 1. The glucose value at 2-hour after dinner was significantly lower in the GLP-1 analogue group than in the placebo group (p < 0.05) at the end of study by ANCOVA test after the adjustments of sex, mean age, BMI, duration of diabetes mellitus, C-peptide and A1C levels. Supplement Table 2 showed all adverse events that occurred in at least 3% of GLP-1 analogue recipients. More GLP-1 analogue recipients than placebo recipients had abdominal fullness (11 [36.7%] vs. 0 [0%], respectively; p = 0.001). No treatment-emergent pancreatitis or acute renal failure occurred. The frequency of hypoglycemia was not different between two groups among overall, nocturnal and severe categories.


Glucose Variability and β- Cell Response by GLP-1 Analogue added-on CSII for Patients with Poorly Controlled Type 2 Diabetes.

Lin CH, Hsieh SH, Sun JH, Tsai JS, Huang YY - Sci Rep (2015)

Baseline and end-of-study eight-point blood glucose profiles (mean ± SEM).*p < 0.05 between GLP-1 analogue and placebo at endpoint by ANCOVA test after adjustment of adjustment of sex, mean age, BMI, duration of diabetes mellitus, C-peptide and A1C levels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660278&req=5

f1: Baseline and end-of-study eight-point blood glucose profiles (mean ± SEM).*p < 0.05 between GLP-1 analogue and placebo at endpoint by ANCOVA test after adjustment of adjustment of sex, mean age, BMI, duration of diabetes mellitus, C-peptide and A1C levels.
Mentions: The 8-point blood glucose profiles were shown in Fig. 1. The glucose value at 2-hour after dinner was significantly lower in the GLP-1 analogue group than in the placebo group (p < 0.05) at the end of study by ANCOVA test after the adjustments of sex, mean age, BMI, duration of diabetes mellitus, C-peptide and A1C levels. Supplement Table 2 showed all adverse events that occurred in at least 3% of GLP-1 analogue recipients. More GLP-1 analogue recipients than placebo recipients had abdominal fullness (11 [36.7%] vs. 0 [0%], respectively; p = 0.001). No treatment-emergent pancreatitis or acute renal failure occurred. The frequency of hypoglycemia was not different between two groups among overall, nocturnal and severe categories.

Bottom Line: There was no difference in mean glucose but a significant higher standard deviation of plasma glucose (SDPG) was found in the exenatide group (50.51 ± 2.43 vs. 41.49 ± 3.00 mg/dl, p = 0.027).The adiponectin level was significantly increased with exenatide added on (0.39 ± 0.32 vs. -1.62 ± 0.97 μg/mL, in exenatide and placebo groups, respectively, p = 0.045).In conclusion, the add-on of GLP-1 analogue to CSII increased glucose variability and the β - cell response in patients with poorly controlled T2DM.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.

ABSTRACT
The effects of twice-daily GLP-1 analogue injections added on continuous subcutaneous insulin infusion (CSII) in patients with poorly controlled type 2 diabetes (T2DM) were unknown. After optimization of blood glucose in the first 3 days by CSII during hospitalization, patients with poorly controlled T2DM were randomized to receive CSII combined with injections of exenatide or placebo for another 3 days. A total of 51 patients (30 in exenatide and 21 in placebo groups) with mean A1C 11% were studied. There was no difference in mean glucose but a significant higher standard deviation of plasma glucose (SDPG) was found in the exenatide group (50.51 ± 2.43 vs. 41.49 ± 3.00 mg/dl, p = 0.027). The improvement of incremental area under the curve (AUC) of glucose and insulinogenic index (Insulin 0-peak/ Glucose 0-peak) in 75 g oral glucose tolerance test was prominent in the exenatide group (p < 0.01). The adiponectin level was significantly increased with exenatide added on (0.39 ± 0.32 vs. -1.62 ± 0.97 μg/mL, in exenatide and placebo groups, respectively, p = 0.045). In conclusion, the add-on of GLP-1 analogue to CSII increased glucose variability and the β - cell response in patients with poorly controlled T2DM.

No MeSH data available.


Related in: MedlinePlus