Clinical Audit – A Retrospective Database Analysis

The clinical experience of combing Exenatide (Byetta) in combination with Insulin in type 2 diabetes: A retrospective database analysis.

What is this study about?

At the present time NICE recommend considering adding Exenatide as third-line therapy to metformin and sulfonylurea when HbA1c ≥ 7.5% or other higher level agreed with the patient. In addition the patient should be considered for Exenatde treatment if BMI ≥ 35.0 kg/m2. For patients with BMI < 35kg/m2. Exenatide should be considered if insulin would have significant occupational implications or weight loss would be beneficial. Exenatide therapy should only be continued if a beneficial metabolic response occurs (at least 1.0 percentage point HbA1c reduction and a weight loss of at least 3% at 6 months)1. Currently NICE has not developed guidelines regarding combination of Insulin and Exenatide for people with type 2 diabetes.

The Bournemouth Diabetes and Endocrine Centre (BDEC) has been using Exenetide for more than 3 years. From our database we have identified that by Oct 2008 there were 206 patients on Exenatide treatment including 102 who were on combined treatment of Exenatide and Insulin.

Reference

1. National Institute for Health and Clinical Excellence. NICE clinical guideline 87. Type 2 diabetes: newer agents. May 2009.

How will this study help people with type 2 diabetes?

This practice evaluation audit will give us a better understanding about the use of Exenatide in “real world” setting, which might help to improve further our patient care.