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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThree-year data from the Efficacy of Exenatide Once Weekly and Once-Daily Insulin Glargine in Patients With Metformin Alone or in Combination With Sulfonylurea trial [DURATION-3; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00641056\u0026amp;atom=%2Fspmdc%2F13%2F11%2F15.atom\u0022\u003ENCT00641056\u003C\/a\u003E] have confirmed previously reported 26- and 84-week results demonstrating the superiority of the exenatide regimen for glycemic and weight control, and lowered risk of hypoglycemia [Diamant M et al. \u003Cem\u003ELancet\u003C\/em\u003E 2010; Diamant M et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2012].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia Diabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInsulin\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInsulin\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThree-year data from the Efficacy of Exenatide Once Weekly and Once-Daily Insulin Glargine in Patients With Metformin Alone or in Combination With Sulfonylurea trial [DURATION-3; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00641056\u0026amp;atom=%2Fspmdc%2F13%2F11%2F15.atom\u0022\u003ENCT00641056\u003C\/a\u003E] have confirmed previously reported 26- and 84-week results demonstrating the superiority of the exenatide regimen for glycemic and weight control, and lowered risk of hypoglycemia [Diamant M et al. \u003Cem\u003ELancet\u003C\/em\u003E 2010; Diamant M et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 2012].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EDURATION-3 was an open-label, randomized, controlled study of patients with type 2 diabetes mellitus comparing once-weekly injection of exenatide, a glucagon-like peptide-1 receptor agonist, to titrated insulin glargine. Michael Trautmann, MD, Diabetologist and Consultant, Hamburg, Germany, reported the 3-year results, noting that this study was unique in that it compared the two injectable therapies over 3 years in patients who had not achieved an HbA1C level of \u0026lt;7% during treatment with metformin alone or in combination with sulfonylurea.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe 456 enrolled patients were randomized to exenatide 2 mg QW (n=233) or titrated insulin glargine QD (n=223). All patients received metformin with or without sulfonylurea. The study consisted of a 26-week core study period followed by a 130-week controlled extension period. A substantial proportion of participants completed the 156-week regimen (60% in the exenatide arm and 66% in the insulin glargine arm). The baseline characteristics of the intention-to-treat (ITT) subjects and the completers were similar, notably concerning HbA1C level (\u223c8.3%) and duration of diabetes (\u223c8 years).\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EDr. Trautmann reported that in the ITT population, mean HbA1C levels at 3 years were significantly lower with exenatide (7.3\u00b10.07%) versus insulin glargine (7.5\u00b10.07%; p=0.033; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Similarly, in the completer population, mean HbA1C levels at 3 years were significantly lower with exenatide (7.1\u00b10.08%) versus insulin glargine (7.4\u00b10.08%; p=0.022). The similarity of the findings in the ITT and completer populations emphasizes the representative nature of the 3-year data. Furthermore, significantly more patients in the exenatide arm achieved HbA1C targets of \u22646.5% at 3 years (24% vs 15%; p=0.02 [ITT population]; 28% vs 18% [completer population]).\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/11\/15\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Incidence of Minor Hypoglycemia at 3 Years\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-408555073\u0022 data-figure-caption=\u0022Incidence of Minor Hypoglycemia at 3 Years\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/11\/15\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/11\/15\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/13\/11\/15\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/13889\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-6\u0022 class=\u0022first-child\u0022\u003EIncidence of Minor Hypoglycemia at 3 Years\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EQD=once daily; QW=once weekly; SU=sulfonylurea.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from M Trautman, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-7\u0022\u003EPatients in the exenatide group gained body weight (mean, \u22122.49\u00b10.28 kg) while those receiving insulin glargine lost body weight (mean, +2.01\u00b10.28 kg). There was a significant difference between the groups for the change in body weight from baseline to 3 years (mean difference, \u22124.51\u00b10.37 kg; p\u0026lt;0.001).\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ESixty-eight percent of patients in the exenatide arm displayed both reduced HbA1C and body weight at 3 years compared with only 34% in the insulin glargine arm. Fasting serum glucose was also significantly decreased in patients receiving exenatide (mean, \u221231.16 mg\/dL) versus those receiving insulin glargine (mean, \u221247.74 mg\/dL; p\u0026lt;0.001).\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe safety profile of both drugs at 3 years echoed the previous 26- and 84-week results. While subjects receiving exenatide were more prone to gastrointestinal maladies including nausea, vomiting, and diarrhea than those receiving insulin glargine (16% vs 2%; 6% vs 3%; 14% vs 7%, respectively), most adverse events occurred in the first 26 weeks in the exenatide group. Consistent with the better longer-term tolerance of exenatide, the positive rate for anti-exenatide antibodies decreased from 56% at 26 weeks to 19% at 3 years.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003EExenatide was associated with significantly fewer incidents of hypoglycemia than insulin glargine when used in combination with metformin alone (p\u0026lt;0.001) or with metformin plus sulfonylurea (p\u0026lt;0.001; \u003Ca id=\u0022xref-fig-1-2\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E).\u003C\/p\u003E\u003Cp id=\u0022p-11\u0022\u003EDr. Trautmann concluded that exenatide is superior to insulin glargine in terms of sustained glycemic control and weight loss, and in lessening the risk of hypoglycemia.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/11\/15.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nznqs2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznqs2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}