Acta clinica Croatica, Vol. 52. No. 3., 2013.
Professional paper
Relationship of Vascular Complications and Exenatide Therapy Failure in Type 2 Diabetic Patients
Kristina Blaslov
orcid.org/0000-0002-9747-8742
Karin Zibar
Tomislav Bulum
Lea Duvnjak
Abstract
Exenatide is an incretin mimetic that acts through glucagon-like peptide 1 receptor accepted as a successful novel glucose-lowering agent in type 2 diabetes. The aim of this study was to explore the possible predictive factors for exenatide efficacy among baseline characteristics of type 2 diabetic patients. We observed basic anthropometric measurements, laboratory findings and diabetic complications in ninety-one type 2 diabetic patients starting exenatide therapy. There were forty-six (50.5%) male and forty-five (49.5%) female patients, median age 58 (31-76) years, body mass index 38.95}4.35 kg/m2, duration of diabetes 10 (1-30) years and HbA1c level 8.3}1.4%. Thirty (33%) patients stopped therapy because of glycemic dysregulation during 105 (21-390) days on therapy. These patients differed statistically significantly from those that continued therapy according to the following seven variables: higher fasting glucose blood concentration (11.5 mmol/L (5.6-20) vs. 10.2 mmol/L (5-19), higher serum creatinine concentration (93 μmol/L (44-149) vs. 72 μmol/L (44-124), more frequent diabetic complications including retinopathy (56.7% vs. 27.9%), chronic kidney disease (43.7% vs. 24.7%), coronary artery disease (53.3% vs. 31.1%) and peripheral artery disease (60% vs. 34.4%), and less often concomitant metformin and exenatide therapy (62% vs. 82%). Bivariate logistic regression identified peripheral artery disease, coronary artery disease, retinopathy, and chronic kidney disease as risk factors for glycemic dysregulation on exenatide therapy. We found reasonable to consider that a higher rate of microvascular and macrovascular complications may indicate failure of exenatide therapy in the majority of patients.
Keywords
Exenatide; Glucagon-like peptide 1; Diabetes mellitus, type 2; Vascular complications, diabetic
Hrčak ID:
116718
URI
Publication date:
1.9.2013.
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