Effects of exenatide usage on body weight, fasting blood sugar, lipid profile, and hemoglobin A1C levels in type 2 diabetes mellitus patients

Aim: Diabetes mellitus is a widespread global public health issue characterized by chronic disturbances in glucose metabolism, and the majority of patients are comprised of individuals with type 2 diabetes, many of whom are overweight or obese, both in our country and worldwide. GLP-1 receptor agonists are among the agents used in the treatment of type 2 diabetes. Positive effects on weight and glycemic control have been reported in clinical trials. Exenatide, the first member of the GLP-1 RA class, is an analog of natural GLP-1, exhibiting a 53% homology, and it is resistant to DPP-4 degradation. In our study, we investigated the effects of twice daily exenatide treatment on weight, HbA1C, fasting plasma glucose, lipid profile, blood pressure, ALT and AST values. Methods: The study was conducted by retrospectively collecting data from 199 patients who were followed up at the Endocrinology and Metabolic Diseases Outpatient Clinic between August 2014 and August 2021 at Namık Kemal University School of Medicine. Results: Of the 199 patients included in our study, 157 (78.9%) were female, and 43 (21.6%) were male. The mean age of the patients was 51.93 (±10.15 years), and the mean duration of type 2 diabetes was 105.98 (±68.34 months). The average duration of exenatide use was 16.88 (12±17 months), with 72 (36.2%) patient used for 6 months or less, 43 (21.6%) patient used for 7 to 12 months, and 84 (42.2%) patient used for 13 months or more. Baseline mean values were as follows: weight 107.34 ± 19.30 kg, BMI 41.64 ± 7.47 kg/m2, HbA1C 7.45 ± 1.50%, fasting blood glucose 149.41 ± 50.15 mg/dL, systolic blood pressure 143.63 ± 17.14 mmHg, diastolic blood pressure 88.41 ± 9.13 mmHg, ALT 25.24 ± 16.06 U/L, AST 22.20 ± 11.70 U/L. After 6 months of treatment, there was an average weight loss of 7.04 kg (p<0,001), and by the 12th month, the average weight loss reached 9.62 kg (p<0,001), and this reduction was maintained through 2 years (p<0.001). After 6 months of treatment, there was an average reduction of 0.63% in HbA1C (p<0,001), 11.88 mg/dL in fasting plasma glucose (p<0,001), 5.84 mmHg in systolic blood pressure (p<0,001), 3.9 mmHg in diastolic blood pressure (p<0,001), 3.62 U/L in ALT (p<0,001), and 2.52 U/L in AST (p<0,001). These reductions were maintained through 2 years. No statistically significant difference was found through 2 years in the lipid profile. Conclusion: A 2-year or shorter exenatide treatment has demonstrated an improvement in glycemic control, weight loss, hepatic markers, and blood pressure.