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18-04-2010 | Cardiology | Article

Exenatide treatment adds extra benefit to lifestyle modification

Abstract

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MedWire News: Treatment with exenatide plus lifestyle modification significantly improves glycemic control, reduces weight, and decreases blood pressure in overweight Type 2 diabetics taking metformin or a sulfonylurea compared with lifestyle modification alone, report US researchers.

“Lifestyle modification is an effective and important treatment component for hyperglycemia and associated risk factors in patients with, or at risk of developing, Type 2 diabetes,” say Caroline Apovian (Boston University, Massachusetts) and team.

“However, successfully starting and maintaining lifestyle modification in clinical practice is challenging,” they add.

The researchers recruited 194 patients with Type 2 diabetes, aged 54.8 years on average, to take part in this study. At baseline the participants had a mean weight of 95.5 kg and had a glycated hemoglobin level (HbA1c) of 7.6%.

The patients had been treated for at least 6 weeks prior to the start of the study with either metformin and/or a sulfonylurea, which they continued to take.

At baseline the participants were randomly assigned to receive either 5 μg exenatide injected twice daily plus participation in a lifestyle modification program (n=96) or placebo plus participation in a lifestyle modification program (n=98) for a period of 24 weeks, with a dose doubling of exenatide or placebo at 4 weeks.

The lifestyle modification program was run by a dietitian and involved the creation of individualized, calorie controlled diets and activity plans to increase physical activity.

At 24 weeks, both groups had achieved similar decreases in calorie intake and increases in physical activity.

However, the exenatide group had significantly greater reductions in weight (6.16 vs 3.97 kg), HbA1c (1.21% vs 0.73%), systolic (9.44 vs 1.97 mmHg) and diastolic blood pressure (2.22 vs +0.47 mmHg) than the placebo group at 24 weeks.

Significantly more patients who took exenatide had nausea than those who took placebo at 44.8% versus 19.4%, but this did not significantly influence withdrawal rates from the study, which were similar at 4.2% and 5.1%, respectively.

“These results reinforce the importance of caloric restriction and exercise in the treatment of this disease and show that when combined with exenatide, treatment with lifestyle modification leads to even greater weight loss, improved glycemic control, and decreased blood pressure compared with treatment with lifestyle modification alone,” conclude the authors in the American Journal of Medicine.

“Therefore, exenatide therapy may help patients improve their clinical outcomes with lifestyle modification programs,” they add.

The results of this study confirm previous research on the benefits of exenatide treatment for patients with Type 2 diabetes, as reported by MedWire News.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Helen Albert

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