Effect of exenatide twice daily according to different meal schedules on glycemic control and variability in patients with type 2 diabetes mellitus
Document title: Effect of exenatide twice daily according to different meal schedules on glycemic control and variability in patients with type 2 diabetes mellitus
Journal: Revista mexicana de endocrinología metabolismo & nutrición
Database: PERIÓDICA
System number: 000415991
ISSN: 2339-9643
Authors: 1
1
1
1
Institutions: 1Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco. México
Year:
Season: Jul-Sep
Volumen: 3
Number: 3
Pages: 129-136
Country: México
Language: Inglés
Document type: Artículo
Approach: Experimental, caso clínico
Spanish abstract Objetivo: Evaluar el efecto de exenatida aplicada 2 veces al día en diferentes horarios de ingesta de alimento, sobre variabilidad y control glucémicos en pacientes con diabetes mellitus tipo 2 (DM2). Materiales y métodos: Ensayo clínico aleatorizado, abierto, en 18 adultos con DM2, sobrepeso u obesidad e inadecuado control glucémico con metformina como monoterapia. La glucosa de ayuno fue < 12 mmol/l y la hemoglobina glucosilada A1c entre 7 y 9%. Todos los pacientes recibieron exenatida (5 µg, 2/día) subcutánea durante cuatro semanas y continuaron la metformina durante el estudio. Se distribuyeron al azar seis sujetos a cada horario de aplicación preprandial de exenatida: a) desayuno y comida; b) desayuno y cena, o c) comida y cena. Al inicio y cuatro semanas después, se midió glucosa cada hora durante 24 h. Se calcularon el área bajo la curva (ABC) de glucosa y variabilidad glucémica; esta última mediante la media de la amplitud de las excursiones de glucosa (MAEG). Resultados: La administración de exenatida antes del desayuno y la comida disminuyó significativamente la glucosa de ayuno y ABC de glucosa. La MAEG fue similar en los tres grupos. Conclusiónes: Exenatida antes del desayuno y la comida parece lograr mejor control glucémico
English abstract Objective: To assess the effect of exenatide twice daily according to different meal schedules on glycemic control and variability in patients with type 2 diabetes mellitus. Materials and methods: A randomized, open clinical trial was performed in 18 adults with type 2 diabetes mellitus who were overweight or obesity and inadequate glycemic control with metformin as monotherapy. Fasting glucose was < 12 mmol/l and glycated hemoglobin A1c between 7-9%. All patients received exenatide (5 μg twice daily) subcutaneously for four weeks and continued taking metformin at the same dose throughout the study. A randomized distribution of six subjects was conducted to each of the following pre-prandial times of application of exenatide: (i) breakfast and lunch, (ii) breakfast and dinner, or (iii) lunch and dinner. At the beginning and four weeks later, glucose concentrations were measured every hour during a 24-hour period. Area under the curve of glucose and glycemic variability according to the mean amplitude of glycemic excursions was calculated. Results: Exenatide administration before breakfast and lunch significantly decreased fasting glucose and area under the curve of glucose after the intervention. The mean amplitude of glycemic excursions was similar in the three groups. Conclusions: Exenatide before breakfast and lunch appears to achieve better glycemic control
Disciplines: Medicina
Keyword: Farmacología,
Metabolismo y nutrición,
Exenatida,
Variabilidad,
Control glicémico,
Diabetes mellitus tipo 2
Keyword: Medicine,
Metabolism and nutrition,
Pharmacology,
Exenatide,
Variability,
Glycemic control,
Diabetes mellitus type 2
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