Efficacy of exenatide: clinical research shows that exenatide can effectively reduce glycosylated hemoglobin, fasting and postprandial blood glucose, reduce body mass and improve β Cell function, increase insulin sensitivity, and have good tolerance and low risk of hypoglycemia. It is applicable to the patients who only use metformin, sulfonylureas or metformin combined with sulfonylureas but still have poor blood glucose control. Exenatide monotherapy can be used for patients with type 2 diabetes whose blood sugar is still poor after diet and exercise treatment. When combined with rosiglitazone, it can also offset the increase in body mass caused by rosiglitazone, and improve β For patients with type 1 diabetes who play an accumulative role in cell function and increasing insulin sensitivity and whose condition is still not stable after the addition of metformin, exenatide is added after the consent of patients and their families, and good results are achieved in the short term.

A foreign study on type 1 diabetes patients treated with insulin pump also showed that exenatide once a week as an adjuvant treatment can significantly reduce glycosylated hemoglobin, body mass and insulin consumption. Fan Hui and others used exenatide in patients with type 2 diabetes combined with non-alcoholic fatty liver disease, and found that exenatide can reduce ALT, AST γ- GT and other liver enzyme indexes, so as to alleviate nonalcoholic fatty liver disease. In addition, exenatide can also reduce the level of malondialdehyde in blood, increase the level of superoxide dismutase and reduced glutathione, thereby inhibiting the oxidative stress state in diabetes patients with autonomic neuropathy, and significantly improving the function of autonomic nerves. The neuroprotective effect of exenatide is also reflected in reducing the degeneration and apoptosis of retinal ganglion cells, thus protecting the retinal function of patients with diabetes retinopathy.

Bunck et al. found that exenatide impurities improved β The function of cells was better than insulin glargine. Diamant et al. randomly added exenatide or insulin glargine on the basis of existing hypoglycemic drugs in a 26 week open parallel trial. The results showed that exenatide was more effective than insulin glargine once a week. In a randomized controlled study of type 2 diabetes patients, exenatide was found to be more effective than insulin glargine in improving cardiovascular risk markers such as high-sensitivity C-reactive protein and vascular endothelial function.

Our research also shows that exenatide has the same hypoglycemic effect as insulin in type 2 diabetes, especially in obese patients, but hypoglycemic events are significantly reduced, body weight is reduced and islets are improved β The cell effect was obvious. In comparison with weight loss surgery, although exenatide was inferior to weight loss surgery in reducing body mass, there was no significant difference in blood glucose and glycosylated hemoglobin between the two groups (P>0 05）

Adverse reactions: The main adverse reactions of exenatide are dose dependent mild to moderate nausea, vomiting, diarrhea and other gastrointestinal discomfort. However, with the extension of treatment time, nausea and vomiting will be alleviated and rarely recur.

A systematic evaluation shows that exenatide has mild adverse reactions and can be used to treat patients with type 2 diabetes whose blood sugar cannot be effectively controlled by oral hypoglycemic drugs. However, the follow-up time of the study is short, and its long-term safety needs further testing

Certificate. Among adults with type 2 diabetes in the United States, exenatide increases the probability of hospitalization for acute pancreatitis with GLP-1 based treatment. A retrospective study also showed that there was a difference in the incidence rate of acute pancreatitis between diabetes and fmoc-osu non diabetes patients. Although there was no significant correlation between the incidence of acute pancreatitis and the use of exenatide, it did not rule out the possibility of increasing the risk of acute pancreatitis. However, in general, exenatide twice a day is safe and well tolerated in the treatment of type 2 diabetes. The incidence of most adverse events, including serious adverse events, was similar in the exenatide treated group and the control drug treated patients.