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Comparing the effects of twice-daily exenatide and insulin on renal function in patients with type 2 diabetes mellitus: secondary analysis of a randomized controlled trial
This is a secondary analysis of a randomized controlled trial (RCT) on the effects of the glucagon-like peptide-1 receptor agonists exenatide and insulin aspartate 30 injection on carotid intima-media thickness. Here, we report the renal outcomes of the intervention in patients with type 2 diabetes...
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Published in: | Journal of investigative medicine 2022-10, Vol.70 (7), p.1529-1535 |
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creator | Zhang, Jie Xian, Tong-Zhang Wu, Ming-Xiao Li, Chen Wang, Weihao Man, Fuli Zhang, Xianbo Wang, Xiaoxia Pan, Qi Guo, Lixin |
description | This is a secondary analysis of a randomized controlled trial (RCT) on the effects of the glucagon-like peptide-1 receptor agonists exenatide and insulin aspartate 30 injection on carotid intima-media thickness. Here, we report the renal outcomes of the intervention in patients with type 2 diabetes mellitus (T2DM). Data from the RCT study was used to evaluate the effect of exenatide or insulin given for 52 weeks on estimated glomerular filtration rate (eGFR) in patients with T2DM. The primary end point was the change in the eGFR from baseline between the exenatide and insulin groups in normal versus overweight patients and patients with obesity. The secondary end point was the correlation between change in eGFR and oxidative stress, glycemic control, and dyslipidemia. There was a significant difference in eGFR between the insulin and exenatide groups at 52 weeks (p=0.0135). Within the insulin group, the eGFR remained below baseline at 52 weeks in all patients, and there was an increase in body weight in the normal group compared with the overweight patients and patients with obesity. The opposite was observed in the exenatide group. A decrease in body weight was prominent in the exenatide group at 52 weeks (p |
doi_str_mv | 10.1136/jim-2021-002237 |
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Here, we report the renal outcomes of the intervention in patients with type 2 diabetes mellitus (T2DM). Data from the RCT study was used to evaluate the effect of exenatide or insulin given for 52 weeks on estimated glomerular filtration rate (eGFR) in patients with T2DM. The primary end point was the change in the eGFR from baseline between the exenatide and insulin groups in normal versus overweight patients and patients with obesity. The secondary end point was the correlation between change in eGFR and oxidative stress, glycemic control, and dyslipidemia. There was a significant difference in eGFR between the insulin and exenatide groups at 52 weeks (p=0.0135). Within the insulin group, the eGFR remained below baseline at 52 weeks in all patients, and there was an increase in body weight in the normal group compared with the overweight patients and patients with obesity. The opposite was observed in the exenatide group. A decrease in body weight was prominent in the exenatide group at 52 weeks (p<0.05), the eGFR was below baseline in overweight patients and patients with obesity and significantly above baseline in the normal group (p<0.05). The eGFR was positively correlated to 8-oxo-7,8-dihydroguanosine in the insulin group (p<0.05) but not the exenatide group. It can be concluded that compared with insulin, exenatide may improve renal function in overweight patients and patients with obesity more than in normal-weight patients with T2DM, but a further RCT is needed to confirm this effect.</description><identifier>ISSN: 1081-5589</identifier><identifier>EISSN: 1708-8267</identifier><identifier>DOI: 10.1136/jim-2021-002237</identifier><identifier>PMID: 35725020</identifier><language>eng</language><publisher>Los Angeles, CA: BMJ Publishing Group Ltd</publisher><subject>Antidiabetics ; Blood pressure ; Body mass index ; Cholesterol ; Clinical trials ; Creatinine ; Diabetes ; GLP-1 receptor agonists ; Glucagon ; Glucose ; Hemoglobin ; High density lipoprotein ; Inflammation ; Insulin ; Kidney diseases ; Lipids ; Lipoproteins ; Metabolic disorders ; Mortality ; Obesity ; Original research ; Overweight ; Oxidative stress ; Peptides ; Plasma ; renal insufficiency ; Statistical analysis ; Weight control</subject><ispartof>Journal of investigative medicine, 2022-10, Vol.70 (7), p.1529-1535</ispartof><rights>American Federation for Medical Research 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2022 American Federation for Medical Research</rights><rights>2022 American Federation for Medical Research 2022. No commercial re-use. See rights and permissions. Published by BMJ.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b333t-76b571a9d0091690bad84bb8555b139dea10e54d8fc4873fdc14c1571bc28c003</citedby><cites>FETCH-LOGICAL-b333t-76b571a9d0091690bad84bb8555b139dea10e54d8fc4873fdc14c1571bc28c003</cites><orcidid>0000-0002-6958-7562</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2734650887/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2734650887?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21376,21394,27924,27925,33611,33612,33769,33770,43733,43814,74221,74310</link.rule.ids></links><search><creatorcontrib>Zhang, Jie</creatorcontrib><creatorcontrib>Xian, Tong-Zhang</creatorcontrib><creatorcontrib>Wu, Ming-Xiao</creatorcontrib><creatorcontrib>Li, Chen</creatorcontrib><creatorcontrib>Wang, Weihao</creatorcontrib><creatorcontrib>Man, Fuli</creatorcontrib><creatorcontrib>Zhang, Xianbo</creatorcontrib><creatorcontrib>Wang, Xiaoxia</creatorcontrib><creatorcontrib>Pan, Qi</creatorcontrib><creatorcontrib>Guo, Lixin</creatorcontrib><title>Comparing the effects of twice-daily exenatide and insulin on renal function in patients with type 2 diabetes mellitus: secondary analysis of a randomized controlled trial</title><title>Journal of investigative medicine</title><addtitle>J Investig Med</addtitle><description>This is a secondary analysis of a randomized controlled trial (RCT) on the effects of the glucagon-like peptide-1 receptor agonists exenatide and insulin aspartate 30 injection on carotid intima-media thickness. Here, we report the renal outcomes of the intervention in patients with type 2 diabetes mellitus (T2DM). Data from the RCT study was used to evaluate the effect of exenatide or insulin given for 52 weeks on estimated glomerular filtration rate (eGFR) in patients with T2DM. The primary end point was the change in the eGFR from baseline between the exenatide and insulin groups in normal versus overweight patients and patients with obesity. The secondary end point was the correlation between change in eGFR and oxidative stress, glycemic control, and dyslipidemia. There was a significant difference in eGFR between the insulin and exenatide groups at 52 weeks (p=0.0135). Within the insulin group, the eGFR remained below baseline at 52 weeks in all patients, and there was an increase in body weight in the normal group compared with the overweight patients and patients with obesity. The opposite was observed in the exenatide group. A decrease in body weight was prominent in the exenatide group at 52 weeks (p<0.05), the eGFR was below baseline in overweight patients and patients with obesity and significantly above baseline in the normal group (p<0.05). The eGFR was positively correlated to 8-oxo-7,8-dihydroguanosine in the insulin group (p<0.05) but not the exenatide group. It can be concluded that compared with insulin, exenatide may improve renal function in overweight patients and patients with obesity more than in normal-weight patients with T2DM, but a further RCT is needed to confirm this effect.</description><subject>Antidiabetics</subject><subject>Blood pressure</subject><subject>Body mass index</subject><subject>Cholesterol</subject><subject>Clinical trials</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>GLP-1 receptor agonists</subject><subject>Glucagon</subject><subject>Glucose</subject><subject>Hemoglobin</subject><subject>High density lipoprotein</subject><subject>Inflammation</subject><subject>Insulin</subject><subject>Kidney diseases</subject><subject>Lipids</subject><subject>Lipoproteins</subject><subject>Metabolic disorders</subject><subject>Mortality</subject><subject>Obesity</subject><subject>Original research</subject><subject>Overweight</subject><subject>Oxidative stress</subject><subject>Peptides</subject><subject>Plasma</subject><subject>renal insufficiency</subject><subject>Statistical analysis</subject><subject>Weight control</subject><issn>1081-5589</issn><issn>1708-8267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ALSLI</sourceid><sourceid>BGRYB</sourceid><sourceid>M0O</sourceid><recordid>eNqFkU1rFTEUhgdRbK2u3QbcCHZsPiaTjLty8QsKbnQ9ZJIzbS6Z5JpkaK9_yT_pqSMIgrrKyeE575uct2meM_qaMdFf7P3ScspZSynnQj1oTpmiutW8Vw-xppq1UurhpHlSyh6ZXg78cXMipOKScnrafN-l5WCyj9ek3gCBeQZbC0kzqbfeQuuMD0cCdxBN9Q6IiY74WNbgI0mRZOwHMq_RVo9XbB6Qg4gSt77ekHo8AOHEeTNBhUIWCMHXtbwhBWyKzuQjSppwLP6nqSEZHdLiv4EjCNScQsCyZm_C0-bRbEKBZ7_Os-bLu7efdx_aq0_vP-4ur9pJCFFb1U9SMTM4SgfWD3QyTnfTpKWUExODA8MoyM7p2XZaidlZ1lmGI5Pl2lIqzpqXm-4hp68rlDouvlh8uYmQ1jLicgcuZCc6RF_8ge7TmvFDSCnR9ZJqtPgX1Ss90F4ojtTFRtmcSskwj4fsF9zQyOh4n_aIaY_3aY9b2jhxvk0Ucw2_Nf-Ov9rwadn_n_4Bozi4jw</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Zhang, Jie</creator><creator>Xian, Tong-Zhang</creator><creator>Wu, Ming-Xiao</creator><creator>Li, Chen</creator><creator>Wang, Weihao</creator><creator>Man, Fuli</creator><creator>Zhang, Xianbo</creator><creator>Wang, Xiaoxia</creator><creator>Pan, Qi</creator><creator>Guo, Lixin</creator><general>BMJ Publishing Group Ltd</general><general>SAGE Publications</general><general>Sage Publications Ltd</general><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AM</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BGRYB</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K7.</scope><scope>K9.</scope><scope>M0O</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6958-7562</orcidid></search><sort><creationdate>20221001</creationdate><title>Comparing the effects of twice-daily exenatide and insulin on renal function in patients with type 2 diabetes mellitus: secondary analysis of a randomized controlled trial</title><author>Zhang, Jie ; 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Here, we report the renal outcomes of the intervention in patients with type 2 diabetes mellitus (T2DM). Data from the RCT study was used to evaluate the effect of exenatide or insulin given for 52 weeks on estimated glomerular filtration rate (eGFR) in patients with T2DM. The primary end point was the change in the eGFR from baseline between the exenatide and insulin groups in normal versus overweight patients and patients with obesity. The secondary end point was the correlation between change in eGFR and oxidative stress, glycemic control, and dyslipidemia. There was a significant difference in eGFR between the insulin and exenatide groups at 52 weeks (p=0.0135). Within the insulin group, the eGFR remained below baseline at 52 weeks in all patients, and there was an increase in body weight in the normal group compared with the overweight patients and patients with obesity. The opposite was observed in the exenatide group. A decrease in body weight was prominent in the exenatide group at 52 weeks (p<0.05), the eGFR was below baseline in overweight patients and patients with obesity and significantly above baseline in the normal group (p<0.05). The eGFR was positively correlated to 8-oxo-7,8-dihydroguanosine in the insulin group (p<0.05) but not the exenatide group. It can be concluded that compared with insulin, exenatide may improve renal function in overweight patients and patients with obesity more than in normal-weight patients with T2DM, but a further RCT is needed to confirm this effect.</abstract><cop>Los Angeles, CA</cop><pub>BMJ Publishing Group Ltd</pub><pmid>35725020</pmid><doi>10.1136/jim-2021-002237</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-6958-7562</orcidid></addata></record> |
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subjects | Antidiabetics Blood pressure Body mass index Cholesterol Clinical trials Creatinine Diabetes GLP-1 receptor agonists Glucagon Glucose Hemoglobin High density lipoprotein Inflammation Insulin Kidney diseases Lipids Lipoproteins Metabolic disorders Mortality Obesity Original research Overweight Oxidative stress Peptides Plasma renal insufficiency Statistical analysis Weight control |
title | Comparing the effects of twice-daily exenatide and insulin on renal function in patients with type 2 diabetes mellitus: secondary analysis of a randomized controlled trial |
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