title: Effects of exenatide and liraglutide on 24-hour glucose fluctuations in type 2 diabetes.
abstract: We evaluated the influence of short-term treatment with exenatide twice daily or liraglutide once daily on daily blood glucose fluctuations in 40 patients with type 2 diabetes inadequately controlled by sulfonylureas. The patients in a multicenter, open-label trial were randomly assigned to receive add-on exenatide (10 μg/day, n = 21) or add-on liraglutide (0.3-0.9 mg/day, n = 19), and underwent 24-hour continuous subcutaneous glucose monitoring. There was no significant between-group difference in glucose fluctuations during the day, as assessed by calculating mean amplitude of glycemic excursion (MAGE) and standard deviation (SD). However, the mean blood glucose levels at 3 hours after breakfast and dinner were significantly lower in the exenatide group than the liraglutide group (breakfast: 127.3 ± 24.1 vs. 153.4 ± 28.7 mg/dL; p = 0.006, dinner: 108.7 ± 17.3 vs. 141.9 ± 24.2 mg/dL; p < 0.001). In contrast, mean blood glucose levels and their SD were significantly lower between 0000 h and 0600 h in the liraglutide group than the exenatide group (average glucose: 126.9 ± 27.1 vs. 107.1 ± 24.0 mg/dL; p = 0.029, SD: 15.2 ± 10.5 vs. 8.7 ± 3.8; p = 0.020). Both groups had similar glucose fluctuations despite differences in 24-hour blood glucose profiles. Therefore, each of these agents may have advantages or disadvantages and should be selected according to the blood glucose profile of the patient.
authors.affiliation: Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Jo
authors.initials: J
authors.lastname: Nagakura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Masataka
authors.initials: M
authors.lastname: Taguri
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Tsuchiya
authors.forename: Erina
authors.initials: E
authors.lastname: Shigematsu
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Morita
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Kadonosono
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Terauchi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D004334:Drug Administration Schedule; D004351:Drug Resistance; D004359:Drug Therapy, Combination / Q000009:adverse effects; D000077270:Exenatide; D005947:Glucose / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis; D006943:Hyperglycemia / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007279:Injections, Subcutaneous; D007564:Japan; D000069450:Liraglutide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D018670:Monitoring, Ambulatory; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D040521:Subcutaneous Tissue / Q000187:drug effects / Q000378:metabolism; D013453:Sulfonylurea Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D014688:Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000077270:Exenatide; C057619:glimepiride; D005947:Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human; D007004:Hypoglycemic Agents; D000069450:Liraglutide; D010455:Peptides; D013453:Sulfonylurea Compounds; D014688:Venoms