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Document Details : Title: Glycaemic control and evolution of weight in patients with type 2 diabetes intensified to three insulin regimens after therapeutic failure to exenatide Author(s): BUYSSCHAERT M, PARIS I, SELVAIS PH, ORIOT PH, PREUMONT V, UCL EXENATIDE GROUP Journal: Acta Clinica Belgica Volume: 67 Issue: 4 Date: 2012 Pages: 250-254 DOI: 10.2143/ACB.67.4.1003074 Abstract : The aim of this multicentre and observational study was to evaluate in a real life setting glycated haemoglobin A1c, (HbA1c) as well as body weight outcomes in patients with type 2 diabetes in whom insulin was initiated after unsatisfactory response to exenatide, combined with maximal dosages of metformin and a sulfonylurea. We included 81 patients. In 56 patients, data were available after 6-8 and in 42 after 9-12 month’s follow-up.Age and duration of diabetes were 57 ± 11 and 11 ± 6 years, respectively. Body mass index (BMI) was 32.4 ± 6.9 kg/m². Insulin was initiated with a basal insulin injection (22%), premixed insulin injections (48%) or a basal prandial scheme (30%). In the 6-8 and 9-12 month’s cohorts, HbA1c decreased from 9.3 ± 1.4 to 8.2 ± 1.2% and from 9.3 ± 1.3 to 8 ± 1.1%, respectively (p < 0.0001). However, only 9 and 12% of subjects reached a target HbA1c of less than 7.0%, respectively. About half of the patients had HbA1c levels equal or higher than 8.0%. Insulin doses were progressively increased during the follow-up period. Insulin treatment was associated with a significant body weight increase (5-7 kg) (p < 0.0001). In conclusion, a high proportion of patients remained above the HbA1c targets after 6-12 month’s treatment, despite a progressive increase in insulin dosages. Insulin treatment was associated with a marked weight gain. |
