Hormonal
Synthetic exendin-4 (exenatide) significantly reduces both fasting and postprandial plasma glucose in patients with type 2 diabetes through glucose-dependent insulin secretion, glucagon suppression, and slowed gastric emptying.
For patients with Type 2 Diabetes, synthetic exendin-4 (exenatide) is an effective treatment that lowers blood sugar both after meals and while fasting. It works by boosting insulin only when blood sugar is high, suppressing excess glucagon, and slowing down how fast food leaves the stomach. While it requires twice-daily injections and may cause temporary nausea, it offers a distinct advantage over some older medications by not causing hypoglycemia and potentially preserving beta-cell function.
In conclusion, AC293 acutely and markedly reduces fasting and postprandial glucose concentrations in patients with type 2 diabetes. During fasting, glucose-dependent enhancement of insulin secretion and suppression of glucagon secretion are the predominant mechanisms, and postprandially, slowing of gastric emptying is additionally operative.
Why this rating
Small sample sizes (n=24 and n=13) but rigorous crossover design and statistical significance.
Source
Synthetic Exendin-4 (Exenatide) Significantly Reduces Postprandial and Fasting Plasma Glucose in Subjects with Type 2 Diabetes
Orville Kolterman et al. · The Journal of Clinical Endocrinology & Metabolism · 2003
DOI 10.1210/jc.2002-021545
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