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https://hdl.handle.net/2440/139130
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Type: | Journal article |
Title: | Feasibility of once weekly exenatide-LAR and enhanced diabetes care in Indigenous Australians with type 2 diabetes (Long-acting-Once-Weekly-Exenatide laR-SUGAR, ‘Lower SUGAR’ study) |
Author: | Ekinci, E.I. Pyrlis, F. Hachem, M. Maple-Brown, L.J. Brown, A. Maguire, G. Churilov, L. Cohen, N. |
Citation: | Internal Medicine Journal, 2021; 51(9):1463-1472 |
Publisher: | Wiley |
Issue Date: | 2021 |
ISSN: | 1444-0903 1445-5994 |
Statement of Responsibility: | Elif I. Ekinci, Felicity Pyrlis, Mariam Hachem, Louise J. Maple-Brown, Alex Brown, Graeme Maguire, Leonid Churilov, and Neale Cohen |
Abstract: | Background: Diabetes is 3-4 times more prevalent in Indigenous Australians with blood glucose levels often above target range. Once weekly formulations of exenatide(exenatide-LAR) have demonstrated significantly greater improvements in glycaemic management with no increased risk of hypoglycaemia and with reductions in bodyweight but have not been studied in Indigenous Australians. Aims: To assess the feasibility and metabolic effects of once weekly supervised injection of exenatide-LAR in addition to standard care in Indigenous Australians with type 2 diabetes. Methods: Two communities in Central Australia with longstanding specialist clinical outreach services were allocated by random coin toss to receive once-weekly exenatide-LAR injection with weekly nurse review and adjustment of medication for 20 weeks (community with exenatide-LAR) or to weekly nurse review in addition to standard care over 20 weeks (community without exenatide-LAR). The primary outcome was the feasibility of an intensive diabetes management model of care with and without weekly supervised exenatide-LAR. Secondary outcomes included change in HbA1c. Results: Thirteen participants from the community with exenatide-LAR and nine participants from the community without exenatide-LAR were analysed. Eighty-five percent of individuals in the community with exenatide-LAR and 67% in the community without exenatide-LAR attended more than half of clinic visits. Median difference in the change in HbA1c from baseline to final visit, adjusted for baseline HbA1c, between the community with exenatide-LAR and the community without exenatide-LAR was -3.1%, 95% CI (-5.80%, -0.38%; P = 0.03).Conclusions: Weekly exenatide-LAR combined with weekly nurse review demonstrated greater improvements in HbA1c, highlighting its potential for use in remote communities. |
Keywords: | diabetes Indigenous Australians exenatide-LAR hyperglycaemia remote type 2 |
Rights: | © 2021 Royal Australasian College of Physicians |
DOI: | 10.1111/imj.15428 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/1054312 http://purl.org/au-research/grants/nhmrc/1078477 http://purl.org/au-research/grants/nhmrc/1137563 |
Published version: | http://dx.doi.org/10.1111/imj.15428 |
Appears in Collections: | Medicine publications |
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