Effects Of Exenatide On Remission In Patients With Ketosis-prone Type 2 Diabetes

Objective:To investigate the clinical characteristics of ketosis-prone diabetics and the influencing factors of their remission.Methods:A total of 82 ketosis-prone diabetics admitted to The People’s Hospital of Hunan Province from January 2008 to May 2010 were enrolled. Blood pressure, body height, body weight, waist circumference, hip circumference and other general information were recorded, and blood glucose, blood ketones, blood gas analysis, glycated hemoglobin (HbAlc), blood lipids, insulin autoantibodies, fasting and postprandial C peptide were detected to investigate the clinical characteristics of ketosis-prone diabetics. Six months later, general information were recorded, and fasting and postprandial blood glucose were detected again in order to determine whether they reached remission. According to islet autoantibody, the course of disease, gender, Body Mass Index(BMI), levels of fasting C peptide, blood glucose, blood lipids, the patients were divided into different groups, and the remission rate between the groups were compared after six months. Results:1. Compared with the antibody-positive group (n=13), the average age of the antibody-negative group (n=69) were older, and the blood pressure, body mass index, serum triglyceride, fasting C peptide, postprandial C peptide were higher, and the blood ketone and HDL-C were lower, the differences were statistically significant (P<0.05). Compared with the Ab- KPD with long course group (>1 year, n=21), the average age of the Ab-KPD with short course group (≤1 year, n=48) was younger, and the proportion of male, the body mass index, waist-hip ratio, serum triglyceride were higher, the differences were statistically significant (P<0.05).2. Compared with the corresponding control group, the remission rate of the antibody-negative group (n=69), short course group(≤1 year, n=48), obese and overweight group (BMI≥25kg/m2, n=22), high fasting C-peptide group (fasting C-peptide≥0.9ng/ml, or 300pmol/L, n=23), hyperlipidemia group (n=27) were higher after six months, the differences were statistically significant (P<0.05).Conclusions:1. The antibody-negative KPD with short course had a lager proportion of male, and always with obesity and hyperlipidemia. 2. The KPD without islet autoantibody, with course of disease≤1 year, with BMI≥25kg/m2, with fasting C-peptide≥0.9ng/ml, and with hyperlipidemia were more vulnerable to achieve remission.Objective:To investigate the effects of exenatide on remission in type 2 diabetics, ketosis-prone type 2 diabetics and type 2 diabetics with different courses.Methods:A total of 57 type 2 diabetics admitted to The People’s Hospital of Hunan Province from November 2009 to October 2010 were enrolled. The patients were divided into the exenatide group (n=31) and the control group (n=26), and the course of disease, body mass index, fasting and postprandial C-peptide, blood lipids and original treatment of the two groups were matched. Blood glucose, glycated hemoglobin (HbAlc), fasting and postprandial C peptide, insulin were detected, and glucose monitoring for 72 hours, intravenous glucose tolerance test were also performed. The patients were grouped as follows:(1) the exenatide group (group A, n=31) and the control group (group B, n=26). (2) the KPD of exenatide group (group C, n=10) and the KPD of control group (group D, n=10). (3) the patients of exenatide group with short course (group E, n=19) and the patients of exenatide group with long course (group F, n=12). The remission rate of the groups were compared.Results:1. After 3 months of treatment, the prevalence of remission in group A was higher than that in group B (16.13%vs 0%, P<0.05). Levels of fasting and postprandial glucose, HbA1C, the time percentage of hypoglycemia and hyperglycemia of patients in group A were lower at 3 months following exenatide treatment than that of pre-treatment (P<0.05). Compared with group B, the levels of postprandial C-peptide of patients in group A were decreased at 1 month,2 months and 3 months after treatment(P<0.05).2. Levels of fasting and postprandial glucose in group C tended to decrease(P>0.05). The HbA1C was lower, and the AUC of intravenous glucose tolerance test of patients in group C was higher at 3 months following exenatide treatment than that of pre-treatment (P<0.05). Compared with group D, the levels of fasting and postprandial C peptide of patients in group C were decreased(P<0.05).3. Compared with group F, the levels of fasting and postprandial glucose, fasting C peptide, AUC of intravenous glucose tolerance test of patients in group E were decreased at 3 months after treatment (P< 0.05). Conclusions:1. Exenatide treatment can help the type 2 diabetics to achieve remission, and had a potential to decrease the blood glucose fluctuation.2. Exenatide treatment can help the ketosis-prone type 2 diabetics to achieve remission, and can promote the temporary phase insulin secretion.3. Exenatide had a more apparent effect on type 2 diabetics with short course, and can promote the temporary phase insulin secretion.Objective:To investigate the effects of exenatide on cardiovascular risk factors in type 2 diabetics, ketosis-prone type 2 diabetics and type 2 diabetics with different courses.Methods:A total of 57 patients admitted to The People’s Hospital of Hunan Province from November 2009 to October 2010 were enrolled. The patients were divided into the exenatide group (n=31) and the control group (n=26), and the course of disease, body mass index, fasting and postprandial C-peptide, blood lipids and original treatment of the two groups were matched. Blood pressure, body height, body weight, waist circumference, hip circumference were recorded, and blood lipids, high-sensitivity C-reactive protein (Hs-CRP) were detected. The patients were Grouped as follows:(1) the exenatide group (group A, n=31) and the control group (group B, n=26). (2) the KPD of exenatide group (group C, n=10) and the KPD of control group (group D, n=10). (3) the patients of exenatide group with short course (group E, n=19) and the patients of exenatide group with long course (group F, n=12). The cardiovascular risk factors of the groups were compared.Results:1. The body weight and blood pressure of patients in group A were lower at 3 months following exenatide treatment than that of pre-treatment (P<0.05),2. The body weight and blood pressure of patients in group C were lower at 3 months following exenatide treatment than that of pre-treatment (P<0.05). The HDL tended to increase, and the LDL tended to decrease(P >0.05).3. The body weight and blood pressure of patients in group E were lower at 3 months following exenatide treatment than that of pre-treatment (P<0.05), and the HDL tended to increase(P>0.05). Conclusions:1. Exenatide treatment can reduce body weight and blood pressure in type 2 diabetics.2. Exenatide treatment can reduce body weight and blood pressure in patients with ketosis-prone type 2 diabetes, and was expected to regulate blood lipids.3. Exenatide had a more apparent effect on body weight and blood pressure in type 2 diabetics with short course.