Effects of short‐acting exenatide added three times daily to insulin therapy on bone metabolism in type 1 diabetes
Nicklas J. Johansen, Thomas F. Dejgaard, Asger Lund, Camilla Schlüntz, Bolette Hartmann, Jens J. Holst, Tina Vilsbøll, Henrik U. Andersen, Filip K. Knop
Abstract
Abstract Aim To evaluate the efficacy of the short‐acting glucagon‐like peptide‐1 receptor agonist, exenatide, added to insulin therapy in type 1 diabetes on bone mineral density and bone turnover markers. Materials and Methods In a randomized, double‐blinded, parallel‐group trial, 108 individuals with type 1 diabetes aged 18 years or older on basal‐bolus therapy with HbA1c 59‐88 mmol/mol (7.5%‐10.0%) and body mass index of more than 22.0 kg/m 2 were randomized (1:1) to preprandial subcutaneous injection of 10 μg exenatide (Byetta) before breakfast, lunch, and dinner over 26 weeks as add‐on treatment to insulin therapy. Results Exenatide elicited a body weight reduction of 4.4 kg compared with placebo, but no between‐group differences in bone mineral density, as assessed by whole‐body, hip, lumbar, and forearm dual‐energy X‐ray absorptiometry following 26 weeks of treatment, were observed. Fasting plasma levels of C‐terminal telopeptides of type I collagen, a marker of bone resorption, and amino‐terminal propeptide of type I procollagen, a marker of bone formation, were unchanged by exenatide compared with placebo after 26 weeks. Conclusions Despite an exenatide‐induced body weight reduction, no changes in bone metabolism were observed with exenatide added to insulin therapy in type 1 diabetes after 26 weeks.