Kontrol altında olmayan tip 2 diyabetes mellitus hastalarında insülin tedavisinden eksenatid bazlı tedaviye geçişin etkinliği

Year 2020, Volume: 45 Issue: 3, 820 - 826, 30.09.2020

Cem Onur Kıraç , Suleyman Ipekci , Süleyman Baldane , Hüseyin Tezcan Levent Kebapcilar

Abstract

Amaç: İnsülin tedavisi altındaki kontrolsüz tip 2 diyabetes mellitus hastalarında glisemik kontrolü sağlamak için en sık tercih edilen yöntem insülin dozlarını arttırmaktır. Bu çalışmada, bu grup hastalarda insülin tedavisi yerine eksenatid ile oral antidiyabetik (OAD) kombinasyonunun etkisini değerlendirdik.
Gereç ve Yöntem: 2015-2017 arasında, C-peptid düzeyleri 2 ng/ml’nin üzerinde olan, insülin ve metformin tedavisi altında kontrolsüz seyrederken eksenatid ve OAD tedavisine geçilen 61 hasta çalışmaya alındı. Hastalar kullandıkları insulin rejimlerine göre, sadece bazal insülin, bifazik insülin ve bazal-bolus insülin grubu olarak 3 gruba ayrıldı. Hastaların tedavi değişikliği öncesi ve tedavinin 6. ayında açlık kan şekerleri, HbA1c ve C-peptid düzeylerine bakıldı.
Bulgular: Eksenatid bazlı tedavinin 6. ayında HbA1c düzeylerinde tedavi değişikliği öncesine göre anlamlı azalma görüldü. Çalışmanın sonunda, eksenatid ve OAD tedavisi alan 61 hastanın 14’ünde HbA1c değeri %7’nin altına düştü. Eksenatid ve OAD tedavisiyle açlık kan şekerinde de azalma görüldü.
Sonuç: Bu çalışmada insülin ve metformin tedavisi altındayken kontrolsüz seyreden T2DM hastlarında eksenatid bazlı tedaviye geçişin glisemik kontrolü sağlamakta insülin dozunu arttırmaktan daha iyi bir tedavi seçeneği olduğunu gösterdik.

Keywords

c-peptide, exenatide, insulin treatment, Type 2 diabetes mellitus

Supporting Institution

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Project Number

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Thanks

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Effect of switching insulin treatment to exenatide based therapy in uncontrolled type 2 diabetes mellitus patients

Abstract

Purpose: In patients with uncontrolled type 2 diabetes mellitus (T2DM) on insulin therapy, increasing the insulin doses is most commonly preferred as the first choice to achieve glycaemic control. We evaluated the efficacy of initiating exenatide combination with oral antidiabetics (OAD) instead of insulin therapy.
Materials and Methods: We examined all 61 uncontrolled T2DM patients had greater than 2 ng/ml C-peptide levels and were switched from insulin and metformin therapy to exenatide combination with OAD in the period of 2015 – 2017. For examination, the patients were divided into 3 groups according to their insulin regimen as basal insulin alone, biphasic insulin and basal-bolus insulin groups. The fasting blood glucose (FBG), HbA1c and C-peptide levels of the patients were recorded before and at the 6th month of treatment.
Results: After the 6th month of the exenatide-based treatment, results show that the HbA1c levels were significantly lower than which had been evaluated before this treatment. By the end of the study, 14 of the 61 patients treated with exenatide and OAD achieved to decrease the HbA1c levels under 7.0%. FBG also decreased with the exenatide and OAD treatment.
Conclusion: We demonstrated that in order to achieve glycaemic control, exenatide-based therapy could be a better therapeutic option than increasing insulin doses with insulin and metformin treatment in patients who have uncontrolled T2DM with insulin regimens. 

Keywords

insulin treatment, exenatide, diabetes mellitus

Project Number

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