title: Combination Therapy With Exenatide Plus Pioglitazone Versus Basal/Bolus Insulin in Patients With Poorly Controlled Type 2 Diabetes on Sulfonylurea Plus Metformin: The Qatar Study.
abstract: The Qatar Study was designed to examine the efficacy of combination therapy with exenatide plus pioglitazone versus basal/bolus insulin in patients with long-standing poorly controlled type 2 diabetes mellitus (T2DM) on metformin plus a sulfonylurea.
  
  
  
  The study randomized 231 patients with poorly controlled (HbA1c>7.5%, 58 mmol/mol) T2DM on a sulfonylurea plus metformin to receive1) pioglitazone plus weekly exenatide (combination therapy) or2) basal plus prandial insulin (insulin therapy) to maintain HbA1c<7.0% (53 mmol/mol).
  
  
  
  After a mean follow-up of 12 months, combination therapy caused a robust decrease in HbA1cfrom 10.0 ± 0.6% (86 ± 5.2 mmol/mol) at baseline to 6.1 ± 0.1% (43 ± 0.7 mmol/mol) compared with 7.1 ± 0.1% (54 ± 0.8 mmol/mol) in subjects receiving insulin therapy. Combination therapy was effective in lowering the HbA1cindependent of sex, ethnicity, BMI, or baseline HbA1c. Subjects in the insulin therapy group experienced significantly greater weight gain and a threefold higher rate of hypoglycemia than patients in the combination therapy group.
  
  
  
  Combination exenatide/pioglitazone therapy is a very effective and safe therapeutic option in patients with long-standing poorly controlled T2DM on metformin plus a sulfonylurea.
authors.affiliation: Diabetes Research, Academic Health System, Hamad General Hospital, Doha, Qatar abdulghani@uthscsa.edu.|Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Abdul-Ghani
authors.affiliation: Diabetes Research, Academic Health System, Hamad General Hospital, Doha, Qatar.
authors.forename: Osama
authors.initials: O
authors.lastname: Migahid
authors.affiliation: Diabetes Research, Academic Health System, Hamad General Hospital, Doha, Qatar.
authors.forename: Ayman
authors.initials: A
authors.lastname: Megahed
authors.affiliation: Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: John
authors.initials: J
authors.lastname: Adams
authors.affiliation: Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Curtis
authors.initials: C
authors.lastname: Triplitt
authors.affiliation: Division of Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX.
authors.forename: Ralph A
authors.initials: RA
authors.lastname: DeFronzo
authors.affiliation: Diabetes Research, Academic Health System, Hamad General Hospital, Doha, Qatar.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Zirie
authors.affiliation: Diabetes Research, Academic Health System, Hamad General Hospital, Doha, Qatar.
authors.forename: Amin
authors.initials: A
authors.lastname: Jayyousi
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D000077270:Exenatide; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage / Q000627:therapeutic use*; D000077205:Pioglitazone; D011780:Qatar; D013453:Sulfonylurea Compounds / Q000627:therapeutic use*; D045162:Thiazolidinediones / Q000008:administration & dosage / Q000627:therapeutic use*; D014688:Venoms / Q000008:administration & dosage / Q000627:therapeutic use*; D015430:Weight Gain
chemical_list: D001786:Blood Glucose; D000077270:Exenatide; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin; D010455:Peptides; D000077205:Pioglitazone; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; D014688:Venoms