Date of Graduation

Winter 12-15-2010

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

James Fergusson

Abstract

Background: Type II diabetes is characterized by hyperglycemia, insulin resistance or having impairment with insulin secretion. Patients are traditionally treated with oral medication and lifestyle modification before adding insulin to their treatment. Exenatide is an adjunct subcutaneous therapy to improve glycemic control and weight loss

Method: The focus of this study was to review clinical trials of exetanide on diabetes mellitus type II. A thorough review of clinical trials from 2000 to 2010, pertaining to exetanide versus standard oral hypoglycemic were selected and analyzed. One double-blind, two triple-blind, and randomized control trials were identified by systematic literature search using PubMed, Cochrane, Medline and CINHAL search engines. The comprehensive literature search resulted in a total of 36 articles that were analyzed thoroughly, but only three articles were chosen.

Results: The 30 week study from DeFronzo et al. (2005) demonstrate HbA(1c) changes from baseline +/- SE for each group were -0.78 +/- 0.10% (10 microg), -0.40 +/- 0.11% (5 microg), and +0.08 +/- 0.10% (placebo; intent to treat; adjusted P < 0.002). The Buse et al. study show HbA(1c) changes from baseline were -0.86 +/- 0.11, -0.46 +/- 0.12, and 0.12 +/- 0.09% (+/-SE) in the 10-microg, 5-microg, and placebo arms, respectively (adjusted P < 0.001). Zinman et al. 16 week study demonstrate a mean HbA1c decrease of 0.89% ± 0.09% in the exenatide group (p<0.001)

Conclusion: Exenatide demonstrates improved glycemic control, reduced body weight, and reduced fasting blood glucose in type II diabetic patients who have failed to achieve glycemic control with traditional oral hyperglycemic medications

Keywords: Diabetes Type II, exenatide, metformin, sulfonylurea, and thiazolidinedione

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