Year 2022,
Volume: 39 Issue: 3, 798 - 802, 30.08.2022
Kağan Güngör
,
Serkan Öztürk
,
Bülent Can
,
Mehmet Sargın
References
- Tong L, Pan C, Wang H et al. Impact of delaying treatment intensification with a glucagon-like peptide-1 receptor agonist in patients with type 2 diabetes uncontrolled on basal insulin: A longitudinal study of a US administrative claims database. Diabetes Obes Metab. 2018;20: 831–839.
- Prasad-Reddy L, Isaacs D. A clinical review of GLP-1 receptor agonists: efficacy and safety in diabetes and beyond. Drugs in Context 2015;4:212283.
- Tran S, Retnakaran R, Zinman B, et al. Efficacy of glucagon-like peptide-1 receptor agonists compared to dipeptidyl peptidase-4 inhibitors for the management of type 2 diabetes: A meta-analysis of randomized clinical trials. Diabetes Obes Metab. 2018;20 Suppl 1:68-76.
- Drucker DJ. The role of gut hormones in glucose homeostasis. J Clin Invest. 2007;117(1):24-32.
- Knopa FK, Brøndena A, Vilsbølla T. Exenatide: pharmacokinetics, clinical use, and future directions Expert Opinion on Pharmacotherapy 2017;18(6):555-571.
- Wadden TA, Hollander P, Klein S et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: The SCALE Maintenance randomized study. International Journal of Obesity 2013;37:1443–1451.
- Wang X, Liu J, Li C et al. Impaired secretion of active GLP-1 in patients with hypertriglyceridaemia: A novel lipotoxicity paradigm? Diabetes Metab Res Rev. 2018;34:e2964.
- Demir S, Temizkan S, Sargin M. C-Peptide Levels Predict the Effectiveness of Dipeptidyl Peptidase-4 Inhibitor Therapy. J Diabetes Res. 2016, 4509603.
- Jones AG, Hattersley T. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabetic Med. 2013;30:803–817.
- Jones AG, McDonald TJ, Shields BM et al. Markers of b-Cell Failure Predict Poor Glycemic Response to GLP-1 Receptor Agonist Therapy in Type 2 Diabetes. Diabetes Care 2016; 39:250–257.
- DeFronzo RA, Ratner RE, Han J, Kim DD, Fineman MS, Baron AD. Effects of exenatide (exendin-4) on glycaemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes. Diabetes Care 2005;28:1092–1100.
- Buse JB, Henry RR, Han J, Kim DD, Fineman MS, Baron AD, Exenatide-113 Clinical Study Group. Effects of exenatide (exendin-4) on glycaemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes. Diabetes Care 2004;27:2628–2635.
- Kendall DM, Riddle MC, Rosenstock J, Zhuang D, Kim DD, Fineman MS et al. Effects of exenatide (exendin-4) on glycaemic control over 30 weeks in patients with type 2 diabetes treated with metformin and a sulfonylurea. Diabetes Care 2005;28:1083–1091.
- Barnett AH, Burger J, Johns D, Brodows R, Kendall DM, Roberts A et al. Tolerability and efficacy of exenatide and titrated insulin glargine in adult patients with type 2 diabetes previously uncontrolled with metformin or a sulfonylurea: a multinational, randomized, open-label, two-period, crossover non-inferiority trial. Clin Ther 2007;29:2333–2348.
- Apovian CM, Bergenstal RM, Cuddihy RM, et al. Effects of exenatide combined with lifestyle modification in patients with type 2 diabetes. Am J Med. 2010;123(468):e469–e417.
- Derosa G, Franzetti IG, Querci et al. Exenatide plus metformin compared with metformin alone on b-cell function in patients with Type 2 diabetes. Diabetic Medicine 2012;29(12):1515-23.
- Saisho Y. Postprandial C-peptide to glucose ratio as a marker of cell function: implication for the management of type 2 diabetes. Int J Mol Sci 2016;17:744-753.
- Landgraf W, Owens DR, Frier BM. Fasting C-peptide, a biomarker for hypoglycaemia risk in insulin-naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL. Diabetes Obesity Metabolism 2020;22(3):315-323.
- Leighton E, Sainsbury CAR. Jones GC. A Practical Review of C-Peptide Testing in Diabetes. Diabetes Ther 2017;8:475–487.
- Kim YM, Cha BS, Kim DJ, et al. Predictive clinical parameters for therapeutic efficacy of rosiglitazone in Korean type 2 diabetes mellitus. Diabetes Res Clin Pract. 2005;67:43–52.
- Bluher M, Lubben G, Paschke R. Analysis of the relationship between the Pro12Ala variant in the PPAR-gamma2 gene and the response rate to therapy with pioglitazone in patients with type 2 diabetes. Diabetes Care. 2003;26:825–31.
- Oh TJ, Jung HS, Bae JH, et al. Clinical characteristics of the responders to dipeptidyl peptidase-4 inhibitors in Korean subjects with type 2 diabetes. J Korean Med Sci. 2013;28:881–7.
- Takabe M, Matsuda T, Hirota Y, et al. C-peptide response to glucagon challenge is correlated with improvement of early insulin secretion by liraglutide treatment. Diabetes Res Clin Pract. 2012;98:e32–5.
- Iwao T, Sakai K, Sata M. Postprandial serum C-peptide is a useful parameter in the prediction of successful switching to liraglutide monotherapy from complex insulin therapy in Japanese patients with type 2 diabetes. Journal of Diabetes and Its Complications 2013;27:87–91.
FASTING PLASMA C-PEPTIDE LEVEL PREDICTS THE RESPONSE OF GLUCAGON-LIKE PEPTIDE-1 AGONIST (EXENATIDE) ADD ON TO METFORMIN MONOTHERAPY IN OBESE TYPE 2 DIABETICS
Year 2022,
Volume: 39 Issue: 3, 798 - 802, 30.08.2022
Kağan Güngör
,
Serkan Öztürk
,
Bülent Can
,
Mehmet Sargın
Abstract
Fasting Plasma C-peptide Level Predicts the Response of Glucagon-like Peptide-1 Agonist (Exenatide) Addition to Metformin Monotherapy in Obese Type 2 Diabetics
ABSTRACT
Aim: to evaluate the predictive ability of serum C-peptide level to attain glycemic control targets by adding a glucagon-like peptide-1 receptor agonist (GLP1-RA) to metformin monotherapy in patients with type 2 diabetes and obesity.
Materials and methods: This is a retrospective study, in which we enrolled 44 consecutive obese type 2 diabetic patients who were on metformin monotherapy and have inadequate glycemic control (HbA1c >7% and <10%). Twice daily GLP1-RA (10 mcg exenatide injection) was added to the treatment. Regardless of the initial HbA1c level, treatment success was considered as an HbA1c level below 7%.
Results: When we compared the initial and the sixth month measurements of body weight, BMI, fasting glucose and c-peptide, we found a reduction for all parameters (p<0.01). 27 (61.4%) patients were achieved treatment success. Baseline C-peptide level was correlated with HbA1c at sixth month (r:0.4, p:0.01). Baseline fasting plasma c-peptide level was an independent predictor of successful glycemic control [exp.B: 6.6 (1.63-26-9) p:0.008]. Baseline plasma C-peptide level of 2.56 ng/mL was the best cut-off value for prediction of treatment success.
Conclusion: Initial fasting plasma c-peptide level can predict the treatment response of the GLP1-RA add on to metformin monotherapy in obese type 2 diabetics.
Keywords: C-peptide, type 2 diabetes, GLP-1 RA, exenatide
References
- Tong L, Pan C, Wang H et al. Impact of delaying treatment intensification with a glucagon-like peptide-1 receptor agonist in patients with type 2 diabetes uncontrolled on basal insulin: A longitudinal study of a US administrative claims database. Diabetes Obes Metab. 2018;20: 831–839.
- Prasad-Reddy L, Isaacs D. A clinical review of GLP-1 receptor agonists: efficacy and safety in diabetes and beyond. Drugs in Context 2015;4:212283.
- Tran S, Retnakaran R, Zinman B, et al. Efficacy of glucagon-like peptide-1 receptor agonists compared to dipeptidyl peptidase-4 inhibitors for the management of type 2 diabetes: A meta-analysis of randomized clinical trials. Diabetes Obes Metab. 2018;20 Suppl 1:68-76.
- Drucker DJ. The role of gut hormones in glucose homeostasis. J Clin Invest. 2007;117(1):24-32.
- Knopa FK, Brøndena A, Vilsbølla T. Exenatide: pharmacokinetics, clinical use, and future directions Expert Opinion on Pharmacotherapy 2017;18(6):555-571.
- Wadden TA, Hollander P, Klein S et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: The SCALE Maintenance randomized study. International Journal of Obesity 2013;37:1443–1451.
- Wang X, Liu J, Li C et al. Impaired secretion of active GLP-1 in patients with hypertriglyceridaemia: A novel lipotoxicity paradigm? Diabetes Metab Res Rev. 2018;34:e2964.
- Demir S, Temizkan S, Sargin M. C-Peptide Levels Predict the Effectiveness of Dipeptidyl Peptidase-4 Inhibitor Therapy. J Diabetes Res. 2016, 4509603.
- Jones AG, Hattersley T. The clinical utility of C-peptide measurement in the care of patients with diabetes. Diabetic Med. 2013;30:803–817.
- Jones AG, McDonald TJ, Shields BM et al. Markers of b-Cell Failure Predict Poor Glycemic Response to GLP-1 Receptor Agonist Therapy in Type 2 Diabetes. Diabetes Care 2016; 39:250–257.
- DeFronzo RA, Ratner RE, Han J, Kim DD, Fineman MS, Baron AD. Effects of exenatide (exendin-4) on glycaemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes. Diabetes Care 2005;28:1092–1100.
- Buse JB, Henry RR, Han J, Kim DD, Fineman MS, Baron AD, Exenatide-113 Clinical Study Group. Effects of exenatide (exendin-4) on glycaemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes. Diabetes Care 2004;27:2628–2635.
- Kendall DM, Riddle MC, Rosenstock J, Zhuang D, Kim DD, Fineman MS et al. Effects of exenatide (exendin-4) on glycaemic control over 30 weeks in patients with type 2 diabetes treated with metformin and a sulfonylurea. Diabetes Care 2005;28:1083–1091.
- Barnett AH, Burger J, Johns D, Brodows R, Kendall DM, Roberts A et al. Tolerability and efficacy of exenatide and titrated insulin glargine in adult patients with type 2 diabetes previously uncontrolled with metformin or a sulfonylurea: a multinational, randomized, open-label, two-period, crossover non-inferiority trial. Clin Ther 2007;29:2333–2348.
- Apovian CM, Bergenstal RM, Cuddihy RM, et al. Effects of exenatide combined with lifestyle modification in patients with type 2 diabetes. Am J Med. 2010;123(468):e469–e417.
- Derosa G, Franzetti IG, Querci et al. Exenatide plus metformin compared with metformin alone on b-cell function in patients with Type 2 diabetes. Diabetic Medicine 2012;29(12):1515-23.
- Saisho Y. Postprandial C-peptide to glucose ratio as a marker of cell function: implication for the management of type 2 diabetes. Int J Mol Sci 2016;17:744-753.
- Landgraf W, Owens DR, Frier BM. Fasting C-peptide, a biomarker for hypoglycaemia risk in insulin-naïve people with type 2 diabetes initiating basal insulin glargine 100 U/mL. Diabetes Obesity Metabolism 2020;22(3):315-323.
- Leighton E, Sainsbury CAR. Jones GC. A Practical Review of C-Peptide Testing in Diabetes. Diabetes Ther 2017;8:475–487.
- Kim YM, Cha BS, Kim DJ, et al. Predictive clinical parameters for therapeutic efficacy of rosiglitazone in Korean type 2 diabetes mellitus. Diabetes Res Clin Pract. 2005;67:43–52.
- Bluher M, Lubben G, Paschke R. Analysis of the relationship between the Pro12Ala variant in the PPAR-gamma2 gene and the response rate to therapy with pioglitazone in patients with type 2 diabetes. Diabetes Care. 2003;26:825–31.
- Oh TJ, Jung HS, Bae JH, et al. Clinical characteristics of the responders to dipeptidyl peptidase-4 inhibitors in Korean subjects with type 2 diabetes. J Korean Med Sci. 2013;28:881–7.
- Takabe M, Matsuda T, Hirota Y, et al. C-peptide response to glucagon challenge is correlated with improvement of early insulin secretion by liraglutide treatment. Diabetes Res Clin Pract. 2012;98:e32–5.
- Iwao T, Sakai K, Sata M. Postprandial serum C-peptide is a useful parameter in the prediction of successful switching to liraglutide monotherapy from complex insulin therapy in Japanese patients with type 2 diabetes. Journal of Diabetes and Its Complications 2013;27:87–91.