The effect of switching insulin treatment to exenatide based therapy in uncontrolled type 2 diabetes mellitus patients

Objective: In patients with uncontrolled type 2 diabetes mellitus (T2DM) on insulin therapy, increasing the insulin doses is most commonly preferred as the first choice to achieve glycaemic control. We evaluated the efficacy of initiating exenatide combination with oral antidiabetics (OAD) instead of insulin therapy. Methods: We examined all 61 uncontrolled T2DM patients had greater than 2 ng/ml C-peptide levels and were switched from insulin and metformin therapy to exenatide combination with OAD in the period of 2015 – 2017. For examination, the patients were divided into 3 groups according to their insulin regimen as basal insulin alone, biphasic insulin and basal-bolus insulin groups. The fasting blood glucose (FBG), HbA1c and C-peptide levels of the patients were recorded before and at the 6th month of treatment. Results: After the 6th month of the exenatide-based treatment, results show that the HbA1c levels were significantly lower than which had been evaluated before this treatment. By the end of the study, 14 of the 61 patients treated with exenatide and OAD achieved to decrease the HbA1c levels under 7.0%. FBG also decreased with the exenatide and OAD treatment (p=0.008). Conclusion: We demonstrated that in order to achieve glycaemic control, exenatide-based therapy could be a better therapeutic option than increasing insulin doses with insulin and metformin treatment in patients who have uncontrolled T2DM with insulin regimens.