Effect of short‐acting exenatide administered three times daily on markers of cardiovascular disease in type 1 diabetes: A randomized double‐blind placebo …

NJ Johansen, TF Dejgaard, A Lund… - Diabetes, Obesity …, 2020 - Wiley Online Library
NJ Johansen, TF Dejgaard, A Lund, C Schlüntz, EL Larsen, HE Poulsen, JP Goetze…
Diabetes, Obesity and Metabolism, 2020Wiley Online Library
Aims To investigate the effect of adding the short‐acting glucagon‐like peptide 1 receptor
agonist (GLP‐1RA) exenatide to insulin treatment on markers of cardiovascular risk in type 1
diabetes. Materials and methods In a randomized, double‐blind, parallel‐group trial, 108
individuals with type 1 diabetes aged≥ 18 years on multiple daily injection therapy with a
body mass index> 22.0 kg/m2 and glycated haemoglobin concentration of 59 to 88
mmol/mol (7.5%− 10.0%) were randomized (1: 1) to preprandial subcutaneous injection of …
Aims
To investigate the effect of adding the short‐acting glucagon‐like peptide 1 receptor agonist (GLP‐1RA) exenatide to insulin treatment on markers of cardiovascular risk in type 1 diabetes.
Materials and methods
In a randomized, double‐blind, parallel‐group trial, 108 individuals with type 1 diabetes aged ≥18 years on multiple daily injection therapy with a body mass index >22.0 kg/m2 and glycated haemoglobin concentration of 59 to 88 mmol/mol (7.5%−10.0%) were randomized (1:1) to preprandial subcutaneous injection of 10 μg exenatide (Byetta®) or placebo three times daily over 26 weeks as add‐on treatment to existing insulin therapy. Reported markers of cardiovascular risk were secondary endpoints and were analyzed in a baseline‐adjusted linear mixed model in the intention‐to‐treat population. The primary results of this study, the MAG1C (Meal‐time Administration of exenatide for Glycaemic control in type 1 diabetes Cases) trial, were previously reported.
Results
Exenatide changed total fat mass by −2.6 kg (95% confidence interval [CI] −3.6; −1.6; P < 0.0001) and lean body mass by −1.1 kg (95% CI −1.9; −0.4; P = 0.01) compared with placebo, as assessed by dual‐energy X‐ray absorptiometry. Fat mass reductions were similar for central and peripheral fat mass. Exenatide did not change levels of interleukin‐2 or ‐6; tumour necrosis factor‐α; C‐reactive protein; N‐terminal prohormone of brain natriuretic peptide; or 8‐oxo‐7,8‐dihydroguanosine (RNA oxidation marker) and 8‐oxo‐7,8‐dihydro‐2′‐deoxyguanosine (DNA oxidation marker).
Conclusions
Exenatide added to insulin therapy in type 1 diabetes for 26 weeks resulted in body weight loss primarily from fat mass reduction, but had no effect on biomarkers of cardiovascular disease risk.
Wiley Online Library