背景： Exenatide 是腸泌素類似物及GLP-1 接受體致效劑，可以改善空腹與飯後血糖控制，也可藉由減緩胃排空及抑制食慾達到減重效果。本研究目的為評估第二型糖尿病病人使用exenatide 之療效及安全性。
方法： 以回溯性世代研究之方式，資料蒐集2011年1月至2012年7月於本院住院期間，曾使用exenatide 併用其他口服降血糖藥物或胰島素治療的第二型糖尿病病人。收納條件為第二型糖尿病病人同時併用口服降血糖藥品、胰島素和exenatide 治療者，排除條件包括：一、年齡小於18 歲；二、使用exenatide 治療期間，曾更換兩種以上的降血糖藥品；或三、治療期間過短，使用exenatide 不足6 個月者。
結果： 研究共納入25 名糖尿病病人，平均體重為86.2 ± 14.0 kg，身體質量指數為33.2 ± 4.5 kg/m2，HbA1c為10.8 ± 1.4%。在使用exenatide 大於六個月後，體重及身體質量指數皆明顯降低，分別為-4.72 ± 3.66 kg及-1.81 ± 1.39 kg/m2 (p < 0.0001)。平均糖化血色素檢驗值也減少1.10 ± 4.78% (p = 0.0049)。較多噁心、嘔吐等胃腸道方面副作用，而發生低血糖的機率不高。
結論： 第二型糖尿病病人使用exenatide 合併口服降血糖或胰島素治療六個月後，可以改善病人的體重、BMI及糖化血色素檢驗值。
Objects: Exenatide is an incretin mimetic and GLP-1 analogue, it appears to improve fasting and postprandial glycemic control. It also can lead to weight loss by slowing gastric emptying and suppressing appetite. This study aimed to evaluate the efficacy and safety of exenatide therapy in patients with type 2 diabetes.
Methods: In this retrospective cohort study, patients were included as those visited Keelung Chang Gung Memorial Hospital, during the period of January 1, 2011 to July 31, 2012. Subjects with type 2 diabetes were enrolled if they were treated combined use of oral hypoglycemic drugs or insulin and exenatide. Exclusion criteria were those who (1) were less than 18 years old; (2) changed more than 2 kinds of hypoglycemic agents with exenatide treatment; (3) or used exenatide less than 6 months.
Results: A total of 25 patients were included in the study. The mean baseline values ( ± SE) for weight,BMI and HbA1c were 86.2 (14.0) kg, 33.2 (4.5) kg/m2, and 10.8% (1.4%), respectively. Significant decreases in body weight and BMI of 4.72 kg and 1.81 kg/m2 were observed at 6 months, respectively (p < 0.0001). Similar, the mean glycated hemoglobin (HbA1c) level decreased 1.10% ± 4.78 (p = 0.0049). The most frequent adverse events were gastrointestinal in nature, such as nausea and vomiting. Incidence of hypoglycemia was low.
Conclusions: The results suggest that a 6-month exenatide therapy combined use of oral hypoglycemic drugs or insulin significantly improved patients’ body weights and HbA1c levels.
