EXENATIDE ADD TO METFORMIN- THE EVIDENCE FOR ACHIEVING GLYCEMIC CONTROL IN TYPE 2 DIABETES

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Article Title:	EXENATIDE ADD TO METFORMIN- THE EVIDENCE FOR ACHIEVING GLYCEMIC CONTROL IN TYPE 2 DIABETES
Authors:	Narcisa Daniela Mihailescu
Affiliation:	”Vasile Goldis” Western University
Abstract:	The treatment options for type 2 diabetes mellitus (T2DM) have increased significantly over the past 10 to 15 years. Incretin hormones, which are found in the gastrointestinal system and other tissues, are integral to glucose homeostasis, increasing insulin secretion, reducing glucagon secretion, slowing gastric emptying, and enhancing early satiety. Enhancement of the incretin system with GLP-1(glucagon like peptide 1) receptor agonists and DPP-4(dipeptidyl peptidase 4) is effective in reestablishing glucose homeostasis. Exenatide, a twice-daily injectable GLP-1 receptor agonist, was approved in 2005 by the FDA for the treatment of type 2 diabetes mellitus (T2DM).The author suggests to evaluate the efficacy and safety of exenatide in patients with T2DM not adequately controlled with metformin (1500-2500 mg/d); primary endpoint: HbA1C(glycosylated hemoglobin) change after 48 weeks, secondary endpoint: fasting plasma glucose, postprandial glucose, body weight change, hypoglycemia, adverse events. The study was conducted on the Emergency Clinical County Hospital of Arad, Diabetes Mellitus Department, during June 2011-July 2012 and comprises 24 patients admitted in the hospital for diabetological disorders, treat with metformin 1500-2500 mg daily.
Keywords:	incretin effect, DPP-4, GLP-1, GIP, exenatide
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*Correspondence:	Narcisa Mihailescu, Arad County Hospital, Feleacului str. no. 1 E-mail:narcisamihailescu@yahoo.com