- Short-acting exenatide (Byetta), alone or with basal insulin, is safe and improves glycemic control in general medicine and surgery inpatients with type 2 diabetes (T2D).
Why this matters
- Guidelines recommend basal-bolus insulin regimens for hospitalized patients with T2D, but these regimens are inconvenient and can cause hypoglycemia.
- Multicenter, open-label trial, 150 patients with blood glucose (BG) 140-400 mg/dL randomly assigned to receive 5 μg twice daily exenatide alone or combined with basal insulin alone or basal-bolus regimen.
- Funding: AstraZeneca.
- Overall mean hospital BGs:
- exenatide alone: 177.1 mg/dL;
- exenatide+basal-bolus: 166.1 mg/dL; and
- exenatide+basal insulin: 154.1 mg/dL (P=.03 overall).
- Proportion of readings in target 70-180 mg/dL range:
- exenatide: 62.3%;
- exenatide+basal-bolus: 63.3%;
- exenatide+basal insulin: 77.7% (P=.005 vs basal-bolus; P=.07 vs exenatide alone).
- Hypoglycemia (BG
- exenatide: 0%;
- exenatide+basal-bolus: 12%; and
- exenatide+basal insulin: 6% (P=.06 overall).
- exenatide: 5 and 1;
- exenatide+basal-bolus: 1 and 0; and
- exenatide+basal insulin: 5 and 3 (P=.017 overall).
- Small sample sizes.
- No masking.