Six-month exenatide improves HOMA hyperbolic product in type 2 diabetic patients mostly by enhancing beta-cell function rather than insulin sensitivity.
(2010) Diabetes & Metabolism — Vol. 36, n° 4, p. 293-298 (2010)
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- (en) OBJECTIVE: This study aimed to determine whether or not the improvement of glycaemic control with 6-month exenatide therapy in type 2 diabetic patients with secondary failure to combined oral therapy is related to amelioration of beta-cell function and/or insulin sensitivity and their combined product. RESEARCH DESIGN AND METHODS: Thirty-three patients with type 2 diabetes were investigated. Their beta-cell function and insulin sensitivity were measured using Homoeostasis Model Assessment [HOMA-B, HOMA-S and HOMA hyperbolic product (BxS)]. Additional endpoints included changes in weight, HbA(1c) and plasma adiponectin, as well as baseline clinical and biological characteristics, as potential predictors of HbA(1c) response. RESULTS: After 6months, unadjusted HOMA-B increased from 33+/-24% to 43+/-23% (P=0.0210), whereas there was no significant change in HOMA-S (from 58+/-35% to 61+/-40%). The hyperbolic product increased by a relative 70% (from 15+/-7% to 22+/-15%; P=0.0055). Body mass index decreased from 32.2+/-5.1kg/m(2) to 31.0+/-4.8kg/m(2) (P<0.0001) and HbA(1c) from 8.8+/-1.0% to 7.6+/-1.2% (P<0.0001). No change was observed in adiponectin concentrations. Higher baseline HbA(1c) values were a significant predictor of therapeutic response. CONCLUSION: Exenatide significantly increased HOMA-B and hyperbolic product over a 6-month treatment period with no overall change in insulin sensitivity, despite weight loss. Thus, improved beta-cell function rather than increased insulin sensitivity accounts for the bulk of HbA(1c) reduction following 6months of exenatide treatment.
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Preumont, V., Buysschaert, M., Hermans, M., & Brichard, S. (2010). Six-month exenatide improves HOMA hyperbolic product in type 2 diabetic patients mostly by enhancing beta-cell function rather than insulin sensitivity. Diabetes & Metabolism, 36(4), 293-298. https://doi.org/10.1016/j.diabet.2010.02.001 (Original work published 2010)