- In patients with type 1 diabetes mellites (T1DM), the addition of short-acting exenatide to standard insulin therapy for 26-weeks was not associated with a reduction in glycated haemoglobin A1c (HbA1c) level, post-prandial glycaemic excursions, and glycaemic variability.
- Exenatide reduced bodyweight and prandial and total insulin requirements without increasing the risk for hypoglycaemia.
Why this matters
- Findings suggest short-acting exenatide does not seem to have a future as a standard add-on treatment to insulin therapy in T1DM.
- However, future studies are warranted to determine whether patients with T1DM (those with overweight or obesity and severe postprandial hyperglycaemia requiring high prandial insulin doses) may benefit from exenatide therapy.
- MAG1C trial included 105 patients with T1DM who received multiple daily insulin injections and were randomly assigned to receive subcutaneous exenatide (10μg; n=52) or placebo (n=53) for 26-weeks.
- Main outcome: between-group difference in HbA1c level after 26-weeks.
- Funding: AstraZeneca.
- After 26 weeks, no significant difference was observed between exenatide and placebo in:
- HbA1c level (estimated treatment difference [ETD], -1.1 mmoL/moL; 95% CI, -3.4 to 1.2; P=.36);
- mean amplitude of glycaemic excursion (ETD, 0.7; 95% CI, -0.2 to 1.6; P=.47); and
- continuous overall net glycaemic action for 60 min (ETD, 0.1; 95% CI, -0.5 to 0.7; P=.96).
- After 26-weeks, exenatide vs placebo significantly reduced:
- total insulin requirement (ETD, -9.0 [95% CI, -5.9 to -12.1] units/day P<.0001>
- prandial insulin dose (ETD, -8.5 [95% CI, -11.2 to -5.7] units/day; P<.0001 and>
- body weight (ETD, 4.4 [95% CI, -5·4 to -3·3] kg; P<.001>
- Small sample size.