Diabetes Obes Metab: The effect of adding short-acting exenatide to basal insulin therapy three times a day on bone metabolism in patients with type 1 diabetes

Background: Compared with healthy people, patients with type 1 diabetes have a three-fold increase in fracture risk, among which the risk of hip fracture increases nearly four-fold, and the mortality rate also increases
.

The risk may depend on blood sugar control, independent age and gender

Part of the increased risk of hip fracture in type 1 diabetes is due to decreased bone density

Materials and methods: The MAG1C trial is a 26-week randomized, double-blind, placebo-controlled clinical trial.
108 patients who received basal insulin therapy were over 18 years old, had a body mass index >22kg/m ² , and had a HbA1c of 59- 88 mmol/mol (7.
5%-10.
0%) type 1 diabetes patients were randomly (1:1) given 10μg exenatide (Byetta) before breakfast, lunch and dinner as a supplement to insulin therapy for a total of 26 weeks
.

Exclusion criteria included insulin pump therapy, unconscious hypoglycemia, diabetic gastroparesis, impaired renal function, and proliferative retinopathy

²

It is planned to conduct 4 follow-up visits in the 0th week (randomization), 4th week, 12th week and 26th week (end of treatment), and fasting starts at 10:00 the night before the visit
.

Hologic Discovery QDR series 82800 Apex 3.

Results: Compared with placebo, Exenatide lost 4.
4 kg of body weight, but after 26 weeks of treatment, through dual-energy X-ray bone mineral density measurement of the whole body, hip joint, lumbar spine and forearm, the difference between the two groups was observed There is no difference in bone density
.

After 26 weeks, compared with placebo, the fasting plasma levels of the c-terminal peptide of type I collagen (a marker of bone resorption) and the N-terminal propeptide of type I collagen (a marker of bone formation) did not change in Exenatide compared with placebo.

Exenatide lost 4.

Table 1 Bone density measured by dual-energy x-ray bone densitometer

Table 1 Bone density measured by dual-energy x-ray bone densitometer

Table 2 Biomarkers of bone turnover

Table 2 Biomarkers of bone turnover

Figure In patients with type 1 diabetes, the effect of short-acting exenatide three times a day on bone resorption (CTX assessment) and bone formation (P1NP assessment) compared with placebo
.

A.

Figure In patients with type 1 diabetes, the effect of short-acting exenatide three times a day on bone resorption (CTX assessment) and bone formation (P1NP assessment) compared with placebo

Although Exenatide induced weight loss, no changes in bone metabolism were observed after adding Exenatide to insulin therapy for type 1 diabetes for 26 weeks

 Johansen NJ, Dejgaard TF, Lund A,et al.

Effects of short-acting exenatide added three times daily to insulin therapy on bone metabolism in type 1 diabetes.
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