Combo Therapy Effectively Reduces HbA1c in Patients With Poorly Controlled Diabetes
Exenatide and pioglitazone combination therapy safely and effectively reduces hemoglobin A1c (HbA1c) in patients with poorly controlled type 2 diabetes, according to a recent study.
The study included 101 participants from the Qatar Study with very poor glycemic control (defined as HbA1c above 10%) and a long duration of diabetes who were receiving the maximum or near-maximum doses of sulfonylurea and metformin. Participants were randomly assigned to receive either pioglitazone and weekly exenatide (combination therapy group) or basal and prandial insulin (insulin therapy group) in order to reach and maintain HbA1c below 7.0%.
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_________________________________________________________________________________________________________________________________________________At baseline, the mean HbA1c was 11.5% ± 0.2% in the combination therapy group and was 11.2% ± 0.2% in the insulin therapy group.
Participants who received combination therapy experienced a significant decrease in HbA1c at 6 months compared with those in the insulin therapy group (HbA1c 6.7% ± 0.1% vs 7.4% ± 0.1%, respectively). These results were found to be independent of sex, ethnicity, and body mass index.
Additionally, participants who received insulin therapy experienced significant increases in weight gain and a 2.5-fold higher rate of hypoglycemia compared with those who received the combination therapy.
“Exenatide/pioglitazone combination therapy is an effective and safe therapeutic option in patients with poorly controlled [type 2 diabetes] receiving metformin plus sulfonylurea with very high HbA1c (>10%),” the researchers concluded.
—Melissa Weiss
Reference:
Abdul-Ghani M, Migahid O, Megahed A, DeFronzo RA, Zirie M, Jayyousi A. Efficacy of exenatide plus pioglitazone vs basal/bolus insulin in T2DM patients with very high HbA1c, J Clin Endocrinol Metab. 2017:102(7): 2162–2170. https://doi.org/10.1210/jc.2016-3423.