Effects of exenatide on metabolic parameters/control in obese Japanese patients with type 2 diabetes

• Published in: Endocrine Journal Vol. 61; no. 4; pp. 365 - 372
• Main Authors: Tokuda, Masaru, Katsuno, Tomoyuki, Ochi, Fumihiro, Miyakoshi, Kana, Kusunoki, Yoshiki, Murai, Kazuki, Miuchi, Masayuki, Hamaguchi, Tomoya, Miyagawa, Jun-ichiro, Namba, Mitsuyoshi
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2014
• Subjects: Adult; Aged; Anti-Obesity Agents - administration & dosage; Anti-Obesity Agents - adverse effects; Anti-Obesity Agents - therapeutic use; Anticholesteremic Agents - administration & dosage; Anticholesteremic Agents - adverse effects; Anticholesteremic Agents - therapeutic use; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Body Mass Index; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Exenatide; Female; Follow-Up Studies; Gastrointestinal Agents - administration & dosage; Gastrointestinal Agents - adverse effects; Gastrointestinal Agents - therapeutic use; Glucagon-Like Peptide 1 - agonists; Humans; Hyperglycemia - prevention & control; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Incretin; Injections, Subcutaneous; Japan; Male; Middle Aged; Nausea - chemically induced; Obesity; Obesity - blood; Obesity - complications; Obesity - drug therapy; Obesity - metabolism; Peptides - administration & dosage; Peptides - adverse effects; Peptides - therapeutic use; Type 2 diabetes mellitus; Venoms - administration & dosage; Venoms - adverse effects; Venoms - therapeutic use; Weight Loss - drug effects
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ14-0009

The effects of exenatide on glycemic control, lipid metabolism, blood pressure, and gastrointestinal symptoms were investigated in obese Japanese patients with type 2 diabetes mellitus. Twenty-six outpatients were enrolled and administered 5 μg of exenatide twice daily. If there was insufficient weight loss and/or insufficient improvement in glycemic control, the dose was increased to 10 μg twice daily. Follow-up was continued until the 12th week of administration. Hemoglobin A1c, glycoalbumin, fasting plasma glucose, body weight, fasting serum C-peptide, serum lipids, blood pressure, and pulse rate were measured before and after the observation period. In the initial phase of exenatide therapy, each patient received a diary to record gastrointestinal symptoms. During treatment with exenatide, hemoglobin A1c decreased significantly and serum C-peptide increased significantly. Body weight, low-density lipoprotein cholesterol, and systolic blood pressure decreased significantly. Nausea was the most frequent gastrointestinal symptom and occurred in 16 patients. Its onset was noted at a mean of 1.7 h after injection, the mean duration was 1.1 h, and it continued for a mean of 9.3 days after the initiation of administration. Patients with nausea showed a significant decrease in hemoglobin Alc, glycoalbumin, or body weight compared with those without nausea. These findings suggest that a more marked improvement in metabolic parameters by exenatide can be partly dependent on the manifestation of gastrointestinal symptoms.