Selected Posters

Reported by Joelle Escoffery, PhD

Trends in Glycemic Control and Treatment From 1988 to 2002 Among US Adults With Type 2 Diabetes.
Suh D-C, Plauschinat CA, Choi IS.

Data from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and NHANES 1999-2002 were used to examine trends in diabetes care. From NHANES III to NHANSE 1999-2002, the age-adjusted prevalence of type 2 diabetes increased from 6.3 % to 8.3%. Insulin monotherapy use decreased over time, whereas use of insulin in combination with oral agents increased from the earlier to the later time frame. Although mean A1C decreased in pharmacologically-treated patients, it increased significantly among patients treated with diet. Percentage of patients meeting glycemic targets decreased from 46.2% to 45.1%, with improvements seen in pharmacologically-treated patients and decline observed in patients treated with diet.

Exenatide Maintained glycemic control With Associated Weight Reduction Over 2 Years in Patients With Type 2 Diabetes
Henry R, Ratner RE, Stonehouse AH, et al.

When administered as a twice-daily subcutaneous injection, the incretin mimetic exenatide improves glycemic control and promotes weight loss in patients with type 2 diabetes. Patients in this study were inadequately controlled with either metformin and/or sulfonylurea (SU) therapy and participated in the Phase 3 exenatide and open-label extension study. At the time of study analysis, patients had received ≥2 years of exenatide therapy. The goal of this study was to test the effects of twice-daily exenatide injection (10 mcg) on glycemic control, HOMA-B, body weight, safety, and tolerability. A total of 283 patients completed the study. Results showed that patients had a 1.1% decrease in A1C, a 25.2% mg/dL decrease in fasting plasma glucose, and a 4.7 kg decrease in weight compared with baseline. After 2 years of treatment, 50% of patients received an A1C of ≤7%, and 31% of patients achieved an A1C of ≤6.5%. Exenatide was fairly well tolerated in this study, and the most frequent adverse events were gastrointestinal.

A1C at Entry in Clinical Trials: A Systematic Review of 93 Clinical Trials in Diabetes, 2000-2004
de Leiva A, Toft AD, Frandsen KB.

A medline search for clinical trials in type 2 diabetes was conducted for the purpose of characterizing A1C at study entry. Studies limiting enrollment to patients with A1C ≥8.5% or studies using A1C after a wash out period were excluded so not to artificially inflate average glycemic control. A total of 93 trials were identified for study inclusion. Results showed that the weighted mean A1C was 9.07% for patients not previously treated with insulin therapy and 8.51% for patients who had received prior insulin therapy. Although it is not surprising that patients in clinical trials demonstrated suboptimal glycemic control, the fact that previous insulin therapy was associated with only a .5% decrease in A1C was unexpected.