Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience

Roberto Anichini,1 Sabrina Cosimi,2 Alberto Di Carlo,3 Paola Orsini,4 Alessandra De Bellis,1 Giuseppe Seghieri,1 Flavia Franconi,5 Fabio Baccetti6 1Diabetes Unit, Spedali Riuniti, Pistoia, Italy; 2Diabetes Unit, Hospital of Versilia, Camaiore (LU), Italy; 3Diabetes Unit, Hospital of Lucca, Italy; 4D...

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Autores principales:	Anichini R, Cosimi S, Di Carlo A, Orsini P, De Bellis A, Seghieri G, Franconi F, Baccetti F
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/ed8b4944f710455799e614e25aa957db
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spelling	oai:doaj.org-article:ed8b4944f710455799e614e25aa957db2021-12-02T08:06:36ZGender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience1178-7007https://doaj.org/article/ed8b4944f710455799e614e25aa957db2013-04-01T00:00:00Zhttp://www.dovepress.com/gender-difference-in-response-predictors-after-1-year-exenatide-therap-a12685https://doaj.org/toc/1178-7007Roberto Anichini,1 Sabrina Cosimi,2 Alberto Di Carlo,3 Paola Orsini,4 Alessandra De Bellis,1 Giuseppe Seghieri,1 Flavia Franconi,5 Fabio Baccetti6 1Diabetes Unit, Spedali Riuniti, Pistoia, Italy; 2Diabetes Unit, Hospital of Versilia, Camaiore (LU), Italy; 3Diabetes Unit, Hospital of Lucca, Italy; 4Diabetes Unit, Hospital of Livorno, Italy; 5Department of Biochemical Sciences, University of Sassari, Italy; 6Diabetes Unit, Hospital of Massa, Italy Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID) in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. Patients and methods: We considered a cohort of 315 (154 male/161 female) patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas), who were given exenatide (10 µg/BID) and who fully completed 4 months, 8 months, and 12 months of follow-ups. Results: Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A1c (HbA1c), it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037), and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018). Target glycemic response (1-year HbA1c ≤ 7%) was achieved in a significantly higher proportion of males than females (38% versus 27%;Χ2 = 4.66; P = 0.03). Target weight loss expressed as 1-year weight percent fall from baseline ≥ 75th percentile (8.5%) was significantly higher in females at 8 and 12 months (P < 0.05; for both). One-year glycemic target response was inversely related to baseline HbA1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy) was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic response only in women (P = 0.009). Target 1-year weight loss was predicted by longer diabetes duration among males and by lower baseline HbA1c among females. Finally, no significant difference between genders was noted as to gastrointestinal side effects after exenatide therapy. Conclusion: According to this “real world” experience, predictors of glycemic control and body weight loss after 12 months of exenatide BID therapy are different between genders in type 2 diabetes. Keywords: GLP-1 agonist therapy, exenatide BID, type 2 diabetes, real world settingAnichini RCosimi SDi Carlo AOrsini PDe Bellis ASeghieri GFranconi FBaccetti FDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2013, Iss default, Pp 123-129 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Anichini R Cosimi S Di Carlo A Orsini P De Bellis A Seghieri G Franconi F Baccetti F Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
description	Roberto Anichini,1 Sabrina Cosimi,2 Alberto Di Carlo,3 Paola Orsini,4 Alessandra De Bellis,1 Giuseppe Seghieri,1 Flavia Franconi,5 Fabio Baccetti6 1Diabetes Unit, Spedali Riuniti, Pistoia, Italy; 2Diabetes Unit, Hospital of Versilia, Camaiore (LU), Italy; 3Diabetes Unit, Hospital of Lucca, Italy; 4Diabetes Unit, Hospital of Livorno, Italy; 5Department of Biochemical Sciences, University of Sassari, Italy; 6Diabetes Unit, Hospital of Massa, Italy Purpose: To investigate whether gender affects therapeutic response by exenatide twice a day (BID) in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. Patients and methods: We considered a cohort of 315 (154 male/161 female) patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas), who were given exenatide (10 µg/BID) and who fully completed 4 months, 8 months, and 12 months of follow-ups. Results: Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A1c (HbA1c), it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037), and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018). Target glycemic response (1-year HbA1c ≤ 7%) was achieved in a significantly higher proportion of males than females (38% versus 27%;Χ2 = 4.66; P = 0.03). Target weight loss expressed as 1-year weight percent fall from baseline ≥ 75th percentile (8.5%) was significantly higher in females at 8 and 12 months (P < 0.05; for both). One-year glycemic target response was inversely related to baseline HbA1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy) was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic response only in women (P = 0.009). Target 1-year weight loss was predicted by longer diabetes duration among males and by lower baseline HbA1c among females. Finally, no significant difference between genders was noted as to gastrointestinal side effects after exenatide therapy. Conclusion: According to this “real world” experience, predictors of glycemic control and body weight loss after 12 months of exenatide BID therapy are different between genders in type 2 diabetes. Keywords: GLP-1 agonist therapy, exenatide BID, type 2 diabetes, real world setting
format	article
author	Anichini R Cosimi S Di Carlo A Orsini P De Bellis A Seghieri G Franconi F Baccetti F
author_facet	Anichini R Cosimi S Di Carlo A Orsini P De Bellis A Seghieri G Franconi F Baccetti F
author_sort	Anichini R
title	Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
title_short	Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
title_full	Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
title_fullStr	Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
title_full_unstemmed	Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
title_sort	gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/ed8b4944f710455799e614e25aa957db
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Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: a real world experience

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