Exenatide injection is the first approved GLP-1 analog drug

Exenatide injection is the first approved GLP-1 analog drug, which has a variety of physiological activities such as stimulating the proliferation and differentiation of pancreatic islet p cells, reducing the rate of gastric emptying, and promoting satiety. In addition, animal experiments and small clinical studies suggest that it can also promote the proliferation of necessary B cells and inhibit the apoptosis of p cells. Therefore, many scholars believe that this drug is an ideal drug for the treatment of type 2 diabetes.

Because exenatide is a GLP and exenatide impurities. 1 receptor agonist, it is not easy to be rapidly degraded by dipeptidyl peptidase IV (DPP-IV) after entering the circulation in the body. It plays a role by specifically activating the GLP-1 receptor to inhibit the rise of postprandial blood glucose; And biguanide hypoglycemic drugs (such as metformin) play a role mainly by reducing the production of liver sugar, reducing the absorption of sugar by the intestine, and increasing the uptake and utilization of peripheral sugar. It can be seen that the mechanism of action of exenatide is very different from that of traditional biguanide hypoglycemic drugs. Because the mechanism of action of the two drugs is different, this may be the reason why exenatide has a better effect on patients with poor blood glucose control of metformin. However, exenatide is mainly excreted through the kidney, so it is not suitable for moderate to severe renal damage or end-stage.

This study shows that the addition of pioglitazone and exenatide injection can reduce HbA in patients with poor blood glucose control by metformin. FBS and PBS. Take pioglitazone for 8 and 16 weeks, HbA,. HbA was decreased by (1.4 ± 0.3)% and (2.3 ± 0.2)% respectively after subcutaneous injection of exenatide for 8 weeks and 16 weeks,. They decreased by (1.7 ± 0.4)% and (2.7 ± 0.4)%, respectively. At the same time, at the 16th week of treatment, 25.0% fmoc-osu of the patients taking pioglitazone reached the goal of reducing blood sugar by ADA, while 45.8% of the patients receiving exenatide subcutaneous injection reached the goal of reducing blood sugar by ADA (P<0.05). Therefore, exenatide controls HbA,. The effect is better than pioglitazone. In addition, the drug safety observation results showed that the incidence of adverse reactions of exenatide and pioglitazone was similar