Abstract

Objective: Exenatide improves post-prandial glycemic excursions in type 2 diabetes. This could benefit type 1 diabetes as well. We aimed to determine an effective and safe glucose-lowering adjuvant exenatide dose in adolescents with type 1 diabetes.

Research design: Eight subjects completed a three-part double-blinded randomized controlled study of pre-meal exenatide. Two doses of exenatide (1.25 and 2.5 mcg) were compared to insulin monotherapy. Prandial insulin dose was reduced by 20%. Gastric emptying and hormones were analyzed for 300 min post-meal.

Results: Treatment with both doses of exenatide vs. insulin monotherapy significantly reduced glucose excursions over 300 minutes (p<0.0001). Exenatide administration failed to suppress glucagon but delayed gastric emptying (p<0.004).

Conclusions: Adjunctive exenatide therapy reduces post-prandial hyperglycemia in adolescents with type 1 diabetes. This reduction in glucose excursion occurs despite reduction in insulin dose. We suggest that exenatide has therapeutic potential as adjunctive therapy in type 1 diabetes.