Improved Glycemic Control and Reduction of Cardiometabolic Risk Factors in Subjects with Type 2 Diabetes and Metabolic Syndrome Treated with Exenatide in a Clinical Practice Setting

Background: Type 2 diabetes mellitus (T2DM) with the presence of metabolic syndrome (MetS) carries increased risk for cardiovascular disease. Adjunctive exenatide treatment in patients with T2DM is associated with improvements in glycemic control coupled with progressive weight reduction. We evaluated exenatide use on glycosylated hemoglobin A1c (HbA(1c)) and cardiometabolic risk factors in patients with T2DM and MetS in a single clinical practice setting. Methods: A retrospective analysis of clinical data extracted from the records of 176 adult patients with T2DM and MetS (106 women, 70 men) who received exenatide along with existing therapeutic regimes from 2005 to 2007 was performed. HbA1c, lipid profiles, blood pressure, and anthropometric measures were evaluated at baseline and after 16 (+/- 4) weeks of exenatide therapy. Results: Mean HbA1c was significantly reduced from baseline in 16 weeks (P < 0.001), with 68% of patients achieving HbA(1c) < 7%. Total, high-density lipoprotein-, and low-density lipoprotein- cholesterol levels decreased significantly. This decline was not attributable to changes in lipid-lowering agents. Significant reductions were also noted in body mass index, mean body weight, and abdominal girth (AG) with the addition of exenatide. Additional analyses showed 76% of subjects lost weight. Lessening of AG was much more pronounced in female compared with male subjects with diabetes (P < 0.032). No consistent changes in blood pressure were observed. Conclusions: We found that addition of exenatide to an existing treatment regimen in patients with T2DM and MetS resulted in significant reductions in HbA1c along with decline in lipids, AG, and body weight. This indicates improvement in these patients' metabolic profiles.