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Exenatide, Rosiglitazone Combo Beneficial in Type 2 Diabetes

Added to metformin, approach associated with improved glycemic control, insulin sensitivity

THURSDAY, May 27 (HealthDay News) -- The addition of exenatide and rosiglitazone to metformin in type 2 diabetes is associated with glycemic control benefits, improvements in β-cell function and insulin sensitivity, and weight loss, according to research published in the May issue of Diabetes Care.

Ralph A. DeFronzo, M.D., of the University of Texas Health Science Center in San Antonio, and colleagues analyzed data from 137 subjects with type 2 diabetes who were taking metformin; 73 participated in clamp studies to assess insulin secretion and sensitivity. Subjects were randomized to receive exenatide, rosiglitazone, or both for 20 weeks in addition to their metformin.

The researchers found that A1C declined in all the groups, but fell the most with exenatide plus rosiglitazone. Rosiglitazone was associated with weight gain, but the other two regimens led to weight loss. At the 20th week, the exenatide groups had higher first- and second-phase insulin secretion compared to the rosiglitazone group. Insulin sensitivity was higher in the exenatide plus rosiglitazone group compared to the exenatide group.

"Although studies of longer duration and with a larger number of subjects will be necessary to examine the long-term effects of combination therapy with exenatide plus a thiazolidinedione in type 2 diabetic patients inadequately controlled on metformin, the present results indicate that this combination improves both insulin resistance and the defect in insulin secretion," the authors conclude.

Several co-authors disclosed financial relationships with pharmaceutical companies, including Eli Lilly and Amylin, which employ some co-authors.

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