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Combination therapy effective for improving HbA1c in type 2 diabetes
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Combination therapy with exenatide and pioglitazone is superior to insulin only in adults with poorly controlled type 2 diabetes, study findings show.
Muhammad Abdul-Ghani, MD, PhD, of Hamad General Hospital in Qatar and the division of diabetes at the University of Texas Health Science Center at San Antonio, and colleagues evaluated data from the Qatar Study on 231 adults (mean age, 52 years) with poorly controlled type 2 diabetes randomly assigned to insulin therapy (n = 108) or combination therapy with exenatide (Bydureon, AstraZeneca) and pioglitazone (Actos, Takeda; n = 123) to determine the safety and efficacy of each. Follow-up was conducted for a mean 12.4 months in the combination group and 12.1 months in the insulin-only group.
Baseline HbA1c levels were identical between the two groups and decreased through the first 6 months. Participants in the combination group had lower HbA1c (6.7%) compared with the insulin-only group (7.4%; P < .0001) at 6 months.
The American Diabetes Association treatment goal of an HbA1c less than 7% was reached by more of the combination group (83%) compared with the insulin-only group (53%; P = .003). The same was true for participants reaching an HbA1c goal of less than 6.5% (combination group, 50% vs. insulin-only group, 13%; P < .0001). Both groups had similar decreases in fasting plasma glucose.
The insulin-only group experienced a greater weight increase (4.2 kg) compared with the combination group (2.1 kg; P < .0001).
No serious adverse events were reported by either of the treatment groups.
“The present results demonstrate that combination therapy with pioglitazone plus exenatide is a very effective and safe therapeutic option in patients with poorly controlled, long-standing [type 2 diabetes] on metformin plus a sulfonylurea,” the researchers wrote. “Continued follow-up will be required to ascertain how long the beneficial effects of combination therapy are maintained.” – by Amber Cox
Disclosure: Abdul-Ghani reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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