title: A direct comparison of long- and short-acting GLP-1 receptor agonists (taspoglutide once weekly and exenatide twice daily) on postprandial metabolism after 24 weeks of treatment.
abstract: OBJECTIVE
  T-emerge 2 was a randomized, open-label, 24-week trial comparing subcutaneous taspoglutide 10 mg weekly (Taspo10), taspoglutide 20 mg weekly (Taspo20; titrated after 4 weeks of Taspo10), with exenatide 10 mcg BID (Exe; after 4 weeks of Exe 5 mcg) in patients inadequately controlled on metformin, a thiazolidinedione, or both. T-emerge 2 showed that once-weekly Taspo provided better glycaemic control than Exe. This report focuses on a subset of T-emerge 2 participants undergoing a standardized liquid meal comparing Taspo to Exe, which has been previously shown to lower postprandial glucose.
  
  
  METHODS
  Meal tolerance tests (MTT) were performed at baseline and at week 24 in a subset of Taspo10, Taspo20 and Exe patients (n = 42, 39 and 67, respectively). Blood samples for glucose, insulin, glucagon and C-peptide were obtained before and after (30, 60, 90, 120 and 180 min) ingestion of a standardized liquid meal.
  
  
  RESULTS
  The 2-h postprandial, mean 0-3 h and iAUC0-3 h glucose during the MTT was reduced to a similar extent in all groups and the time profile of the postprandial glucose showed a similar pattern. Taspo10 and Taspo20, but not Exe, significantly increased insulin from baseline (both mean and iAUC0-3 h). Although changes from baseline in C-peptide were not significant within any treatment group, the mean change from baseline (both mean 0-3 h and iAUC0-3 h) was significantly increased in Taspo10 vs. Exe. Mean glucagon showed significant decreases in all groups.
  
  
  CONCLUSIONS
  Taspoglutide and Exe improved postprandial glucose tolerance to a similar extent but possibly with different intimate mechanisms.
authors.affiliation: Institute of Clinical Physiology, CNR, Pisa, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gastaldelli
authors.forename: B
authors.initials: B
authors.lastname: Balas
authors.forename: R
authors.initials: R
authors.lastname: Ratner
authors.forename: J
authors.initials: J
authors.lastname: Rosenstock
authors.forename: B
authors.initials: B
authors.lastname: Charbonnel
authors.forename: G B
authors.initials: GB
authors.lastname: Bolli
authors.forename: M
authors.initials: M
authors.lastname: Boldrin
authors.forename: R
authors.initials: R
authors.lastname: Balena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002096:C-Peptide / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D000077270:Exenatide; D005260:Female; D005934:Glucagon / Q000378:metabolism; D000067757:Glucagon-Like Peptide-1 Receptor; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D008297:Male; D062407:Meals; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010455:Peptides / Q000627:therapeutic use*; D019518:Postprandial Period; D018027:Receptors, Glucagon / Q000819:agonists*; D016896:Treatment Outcome; D014688:Venoms / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D000077270:Exenatide; D005934:Glucagon; D000067757:Glucagon-Like Peptide-1 Receptor; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D010455:Peptides; D018027:Receptors, Glucagon; D014688:Venoms; C000593833:GLP1R protein, human; C517652:hemoglobin A1c protein, human; C541736:taspoglutide
keywords: incretin therapy; insulin resistance; insulin secretion; type 2 diabetes