Efficacy and safety of meal-time administration of short-acting exenatide for glycaemic control in type 1 diabetes (MAG1C): a randomised, double-blind, placebo-controlled trial

The Lancet. Diabetes & Endocrinology
Nicklas J JohansenFilip K Knop

Abstract

In type 2 diabetes, long-acting GLP-1 receptor agonists lower fasting plasma glucose and improve glycaemic control via their insulinotropic and glucagonostatic effects. In type 1 diabetes, their efficacy as an add-on treatment to insulin therapy is modest. Short-acting GLP-1 receptor agonists also lower postprandial glucose excursions in type 2 diabetes by decelerating gastric emptying rate. We aimed to test the efficacy of a short-acting GLP-1 receptor agonist in type 1 diabetes. In the single-centre, parallel-group, randomised, double-blind, placebo-controlled MAG1C trial, patients with type 1 diabetes on multiple daily injection therapy aged 18 years and older with HbA1c 59-88 mmol/mol (7·5-10·0%) and a BMI of more than 22·0 kg/m2 were randomly assigned (1:1) through a computer-generated randomisation list to preprandial subcutaneous injection of 10 μg exenatide (Byetta) or placebo three times daily for 26 weeks as an add-on treatment to usual insulin therapy. Clinically assessed insulin titration was done by study staff. Participants and investigators were masked to treatment allocation. The primary endpoint was between-group difference in HbA1c after 26 weeks. Data were analysed with a baseline-adjusted linear mixed model ...Continue Reading

Citations

Jun 3, 2020·The Journal of Clinical Endocrinology and Metabolism·Maria J Redondo, Fida Bacha
Jun 24, 2020·Diabetes, Obesity & Metabolism·Kevan C HeroldRuth S Weinstock
Jul 4, 2020·Current Opinion in Endocrinology, Diabetes, and Obesity·Anna CasuUNKNOWN Advancing Care for Type 1 Diabetes, Obesity Network (ACT1ON)
Feb 18, 2021·Diabetologia·Bernt Johan von ScholtenMatthias von Herrath
Oct 18, 2020·Molecular Metabolism·Michael A NauckJuris J Meier
Sep 25, 2021·Journal of Diabetes Science and Technology·Melissa-Rosina PasquaAhmad Haidar
Sep 1, 2021·Diabetes, Obesity & Metabolism·Thomas F DejgaardUNKNOWN ADJUNCT ONE and ADJUNCT TWO Investigators

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