title: 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.
abstract: 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. HbA(1c), lipid profiles, blood pressure, and anthropometric measures were evaluated at baseline and after 16 (+/-4) weeks of exenatide therapy.
  
  
  RESULTS
  Mean HbA(1c) 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 HbA(1c) along with decline in lipids, AG, and body weight. This indicates improvement in these patients' metabolic profiles.
authors.affiliation: Metabolic Center of Louisiana Research Foundation, Baton Rouge, Louisiana 70808, USA. rbhushan@mc-la.com
authors.forename: Rajat
authors.initials: R
authors.lastname: Bhushan
authors.forename: Karen E
authors.initials: KE
authors.lastname: Elkind-Hirsch
authors.forename: Madhu
authors.initials: M
authors.lastname: Bhushan
authors.forename: William J
authors.initials: WJ
authors.lastname: Butler
authors.forename: Kelly
authors.initials: K
authors.lastname: Duncan
authors.forename: Ory
authors.initials: O
authors.lastname: Marrioneaux
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D004232:Diuretics / Q000627:therapeutic use; D000077270:Exenatide; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000188:drug therapy*; D010455:Peptides / Q000627:therapeutic use*; D012189:Retrospective Studies; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D014688:Venoms / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose; D004232:Diuretics; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D007328:Insulin; D010455:Peptides; D013453:Sulfonylurea Compounds; D014688:Venoms; D000077270:Exenatide