Morbid Obesity in Diabetes Mellitus Type 2 and Exenatide

Abstract

Worldwide, the prevalence of diabetes and obesity is increasing in recent years in developed countries. The first step of treatment is changes in lifestyle and in case of failure to initiate drug treatment. In our case, the patient with morbid obesity and glucose intolerance to metformin therapy was initiated without achieving weight loss and loss of glycemic control after 6 months of treatment. It was decided to add exenatide as an alternative to bariatric surgery. At the end of the study (12 months), it showed a weight reduction of 20.8% (Table 1), 20.83% BMI, glycosylated hemoglobin decrease of 2 points, and improved the lipid profile. So exenatide may be an acceptable option in the use of patient profile. It would be necessary to seek a new alternative treatment with minimal side effects and less healthcare costs.

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M. Ibañez Gil, A. Ruiz, A. Torres, A. Hernández Cascales, P. Alarcon and M. Hellín Gil, "Morbid Obesity in Diabetes Mellitus Type 2 and Exenatide," Pharmacology & Pharmacy, Vol. 5 No. 2, 2014, pp. 149-152. doi: 10.4236/pp.2014.52020.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] F. J. Tebar Masso and F. J. Escobar, “Diabetes Mellitus in Clinical Practice,” Pan American Publishing, Los Angeles, 2009.
[2] “CDER Drug and Biologic Approvals for Calendar Year 2005,” U.S. Food and Drug Administration, 2008.
[3] M. C. Buncke, M. Diamant, A. Corner, B. Eliasson, J. L. Malloy, R. M. Shaginian, et al., “One-Year Treatment with Exenatide Improves Beta-Cell Function, Insulin Compare with Glargine, in Metformin-Treat Type 2 Diabetic Patients: A Randomized, Controlled Trial,” Diabetes Care, Vol. 32, No. 5, 2009, pp. 762-768.
http://dx.doi.org/10.2337/dc08-1797
[4] M. E. Tushuizen, C. M. Buncke, P. J. Pouwels, J. H. van Waesberghe, M. Diamant and R. J. Heine, “Incretinmimetics as a Novel Option for Hepatic Steatosis Therapeutic,” Liver Internatioanl, Vol. 26, No. 8, 2006, pp. 1015-1017.
http://dx.doi.org/10.1111/j.1478-3231.2006.01315.x
[5] T. D. Adams, R. E. Gress, S. C. Smith, et al., “Long-Term Mortality after Gastric Bypass Surgery,” The New England Journal of Medicine, Vol. 357, No. 8, 2007, pp. 753-761. http://dx.doi.org/10.1056/NEJMoa066603
[6] R. Nandagopal, R. J. Brown and K. I. Rother, “Resolution of Type 2 Diabetes Following Bariatric Surgery: Implications for Adults and Adolescents,” Diabetes Technology & Therapeutics, Vol. 12, No. 8, 2010, pp. 671-677.
http://dx.doi.org/10.1089/dia.2010.0037
[7] D. G. Parkes, R. Pittner, C. Jodka, et al., “Insulinotropic Actions of Exendin-4 and Glucagon-Like Peptide 1 in Vivo and in Vitro,” Metabolism, Vol. 50, No. 5, 2001, pp. 583-589. http://dx.doi.org/10.1053/meta.2001.22519
[8] K. G. Alberti, P. Zimmet and J. Shaw, “Metabolic Syndrome—A New Worldwide Definition. A Consensus Statement from the International. Diabetes Federation,” Diabetic Medicine, Vol. 23, No. 5, 2006, pp. 469-480.
http://dx.doi.org/10.1111/j.1464-5491.2006.01858.x
[9] G. S. Berenson, S. R. Srinivasan, W. Bao, W. P. Newman 3rd, R. E. Tracy and W. A. Wattigney, “Association between Multiple Cardiovascular Risk Factors and Atherosclerosis in Children and Young Adults. The Bogalusa Heart Study,” The New England Journal of Medicine, Vol. 338, No. 23, 1998, pp. 1650-1656.
http://dx.doi.org/10.1056/NEJM199806043382302
[10] N. M. McGrath, G. N. Parker and P. Dawson, “Early Presentation of Type 2 Diabetes Mellitus in Young New Zealand Maori,” Diabetes Research and Clinical Practice, Vol. 43, No. 3, 1999, pp. 205-209.
http://dx.doi.org/10.1016/S0168-8227(99)00003-0
[11] A. Fleischman and E. T. Rhodes, “Management of Obesity, Insulin Resistance and Type 2 Diabetes in Children: Consensus and Controversy,” Diabetes, Metabolic Syndrome and Obesity, Vol. 2, 2009, pp. 185-202.
[12] M. C. Riddle, R. R. Henry, T. H. Poon, et al., “Exenatide Elicits Sustained Glycemic Reduction and Control of Body Weight Progressive in Patients with Type 2 Diabetes Inadequately Controlled by Sulphonylureas with or without Metformin,” Diabetes/Metabolism Research and Reviews, Vol. 22, No. 6, 2006, pp. 483-491.
http://dx.doi.org/10.1002/dmrr.646
[13] “2007 Safety Alerts for Drugs, Biologics, Medical Devices, and Dietary Supplements,” U.S. Food and Drug Administration, 2008.
[14] Byetta (Exenatide) FDA Warning.
http://www.fda.gov/safety/medwatch/safetyinformation/safetyalertsforhumanmedicalproducts/ucm079781.htm
[15] “Lilly’s Once-Weekly Byetta May Have Cancer Risk,” Pharmalot News, 2010.
[16] F. Halperin, J. R. Ingelfinger and G. T. McMahon, “Management of Type 2 Diabetes—Polling Results,” The New England Journal of Medicine, Vol. 358, No. 7, 2008, p. e8.

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