Gender difference in response predictors after 1-year exenatide therapy twice daily in type 2 diabetic patients: A real world experience
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PURPOSE: To investigate whether gender affects therapeutic response by exenatide twice a day (BID) in type 2 diabetes by using a database concerning patients monitored by five outpatient clinics in Tuscany, Italy. PATIENTS AND METHODS: We considered a cohort of 315 (154 male/161 female) patients experiencing therapeutic failure while on oral therapy (metformin, or combination therapy metformin + sulphonylureas), who were given exenatide (10 μg/BID) and who fully completed 4 months, 8 months, and 12 months of follow-ups. RESULTS: Among patients stratified by gender and well matched for age, body mass index, and hemoglobin A1c (HbA1c), it was found that the length of disease was longer in females than in males (12 ± 8 years versus 10 ± 7 years; P = 0.037), and the ratio of patients on metformin to those on combination therapy was higher in men (P = 0.018). Target glycemic response (1-year HbA1c ≤ 7%) was achieved in a significantly higher proportion of males than females (38% versus 27%; χ(2) = 4.66; P = 0.03). Target weight loss expressed as 1-year weight percent fall from baseline ≥ 75th percentile (8.5%) was significantly higher in females at 8 and 12 months (P < 0.05; for both). One-year glycemic target response was inversely related to baseline HbA1c levels and diabetes duration among males, while metformin therapy (compared to oral combination therapy) was a significant predictor of better glycemic targets among females. Homeostasis model assessment-B, measured in 117 patients, predicted hypoglycemic response only in women (P = 0.009). Target 1-year weight loss was predicted by longer diabetes duration among males and by lower baseline HbA1c among females. Finally, no significant difference between genders was noted as to gastrointestinal side effects after exenatide therapy. CONCLUSION: According to this "real world" experience, predictors of glycemic control and body weight loss after 12 months of exenatide BID therapy are different between genders in type 2 diabetes.
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In a cohort study using exenatide twice daily after metformin failure, after 12 months a higher percentage of male subjects achieved HbA1c target ≤7% compared to females (38% vs. 27%, p = 0.03).
“After 12 months of treatment, a higher percentage of male subjects achieved HbA1c target (≤7% or 53 mmol/mL) compared to females (38% vs. 27%, p = 0.03).”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [22]
Predictors of achievement of annual glycemic targets differed between sexes: for males, lower baseline HbA1c levels were associated with increased likelihood of glycemic control; for females, history of previous management exclusively with metformin monotherapy was linked with lower probability of treatment failure (OR 0.321).
“For males, lower baseline HbA1c levels were associated with increased likelihood of accomplishing glycemic control, whereas for females, history of previous management exclusively with metformin monotherapy was linked with lower probability of treatment failure (OR 0.321) [22].”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [22]
The sex-specific properties of GLP-1 RAs have not been adequately investigated.
“Due to the relatively recent authorization for clinical use for the treatment of T2DM, the sex-specific properties of these agents have not been adequately investigated [21,22].”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [22]
In a cohort study, after a 12-month period of exenatide treatment, 33% of women achieved weight loss targets compared to 17% of men.
“Similar results were presented in another cohort study in which after a 12-month period of exenatide treatment, 33% of women achieved weight loss targets compared to 17% of men [22].”
From Sex Differences in Response to Treatment with Glucagon-like Peptide 1 Receptor Agonists: Opportunities for a Tailored Approach to Diabetes and Obesity Care (2022) · cites this paper as [22]
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High-Dose Liraglutide and SGLT2 Inhibitor: A Promising Combination
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Sleep and Circadian Effects on the Incretin System
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Exendin-4 Exacerbates Burn-Induced Mortality in Mice by Switching to Th2 Response
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Cardiovascular Risk in Women with Type 2 Diabetes: Still an Enigma?
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Sex differences in central endozepine expression and regulation of appetite
Geisler, C. E., Applebey, S. V., Chichura, K. S., Pelletier, C., Belser, D. L., Hu, J., Harris, E. P., Levine, C. M., Parent, M. B., Bangasser, D. A., et al. (2025) · Physiology & Behavior · doi:10.1016/j.physbeh.2025.115003
- Authors
- Seghieri, G., Anichini, Cosimi, S., Carlo, D., Bellis, D., Franconi, Orsini, P., & Baccetti
- Affiliations
- Ospedale Versilia (IT)
- University of Sassari (IT)
- Ospedale di Livorno (IT)
- Corresponding author
- Seghieri, Giuseppe
- ORCID
- Seghieri, Giuseppe
- Venue
- Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
- Publisher
- Informa UK Limited
- Published
- 2013-04
- Volume
- 6
- Pages
- 123
- ISSN
- 1178-7007 (ISSN-L)
- PMC
- PMC3626369
- OpenAlex
- W2002677568
- Cited by
- 63
- References
- 36
- Citations by year
- 2026: 1 · 2025: 12 · 2024: 4 · 2023: 7 · 2022: 9 · 2021: 6 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 5 · 2016: 1 · 2015: 3 · 2014: 5
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Diabetes Metabolic Syndrome and Obesity (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion)
- Funders
- American Diabetes Association
- Fondazione Cassa di Risparmio di Pistoia e Pescia
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- exenatide twice daily, type 2 diabetes, sex differences, glycemic control, HbA1c, weight loss, predictors of treatment response, metformin, diabetes duration, HOMA-IR, gastrointestinal adverse effects, real-world evidence
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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