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1). To partly override the baseline between group difference in BMI and triglycerides (Tab. 1), we performed between group comparisons of deltas (��; change between 26th month and baseline) in continuous variables. ��(BMI) (?2.5 �� 1.8 vs. 0.1 �� 1.4; p<0.001) and ��(triglycerides) (?37 �� 16 vs. ?10 �� 14; p=0.022) were significantly lower in exenatide compared to insulin glargine group. There was no other between group �� difference. In this study, a similar reduction in HbA1c was observed after 26-month treatment of either exenatide or insulin glargine in patients with T2DM previously inadequately controlled with metformin monotherapy. This reduction was independent of age and BMI at baseline. However, higher rate of patients achieved the glycemic goal of HbA1c < 7% in exenatide group. As expected, higher rate of hypoglycemia was observed in insulin glargine group. Gastrointestinal ABT 263 adverse events, mainly nausea, were transient and clinically non-significant. BMI reduction was observed in exenatide group, whereas BMI remained essentially unchanged in insulin glargine group. Comparable effects were observed in lipid profile in both groups, whereas neither agent had an effect on blood pressure. Other head-to-head studies have provided similar results. In a 26-week, multicenter, open label, randomized trial, exenatide (10 ��g twice daily) reduced HbA1c similarly to insulin glargine (once daily) [9]. Body weight decreased 2.3 kg with exenatide and increased 1.8 kg with insulin glargine. Nocturnal hypoglycemia occurred less frequently selleck chemical with exenatide, whereas gastrointestinal adverse events, including nausea, vomiting and diarrhea were more common in the exenatide group. In another 16-week multicenter, open-label, randomized, crossover study, treatment with either exenatide (10 ��g twice daily) or insulin glargine (once daily) was associated with similar improvement in HbA1c, independent of treatment order [12], whereas only exenatide therapy was associated with significant reduction in body weight. In another 26-week multicenter, open-label, randomized trial, treatment, either exenatide (10 ��g twice daily) or insulin glargine (once daily) failed to significantly Flavoprotein decrease HbA1c. There were more treatment-related adverse events, but lower rate of nocturnal hypoglycaemia and greater efficacy in weight decrease with exenatide [11]. In a more recent 12-month, retrospective study based on a large electronic medical record database, greater reductions in HbA1c and BMI were observed in exenatide compared with insulin glargine-treated patients [10]. There is also a 84-week, multicenter, open label, randomized trial in which insulin glargine was compared to exenatide once weekly [13], which, however, is not currently widely available.
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