Exenatide in Conjunction with Basal Insulin for Diabetes

Exenatide (Byetta) augments pancreatic insulin secretion, suppresses glucagon secretion, and slows gastric emptying; the drug, which does not cause weight gain, is approved for use with all oral hypoglycemic agents but not with insulin. In this industry-sponsored trial, 261 patients with type 2 diabetes who were receiving glargine insulin were randomized to receive twice-daily injections of either exenatide or placebo. At baseline, glycosylated hemoglobin (HbA_1c) levels were >7.0%, and patients were receiving about 50 units of insulin daily; patients on oral hypoglycemic agents before enrollment continued taking them.

During the trial, daily insulin doses increased by a mean of 13 units among exenatide recipients and 20 units among placebo p…