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The most frequent type of diabetes is type 2. Your body does not utilise insulin adequately if you have type 2 diabetes. As a result, the pancreas produces more insulin to compensate. Over time, the pancreas cannot keep up and generates barely enough insulin to maintain appropriate blood glucose levels. Some people are more likely than others to develop type 2 diabetes. It is widespread among Americans and Latinos. Adults are more likely than children to develop type 2 diabetes.
The American Diabetes Association (ADA) advises glycemic control and cardiovascular risk factors linked with type 2 diabetes as objective goals (Taylor, 2013). The article by Alison Meloni and Jenny Han has discussed the result of a research study conducted on the modes of treatment of patients with type-2 diabetes (Meloni, DeYoung, Han, Best, & Grimm, 2013). The researchers explained in the article the reason why diabetes is associated with a higher risk of adverse cardiovascular outcomes and proposed ways to improve the conditions of the patients who have type-2 diabetes.
The authors have looked at the role glycemic control plays in the reduction of cardiovascular factors that often put patients who have type-2 diabetes at a high risk of death. Long-term management of patients with type 2 diabetes should not only target glycemic control but also check on cardiovascular risk factors such as lipids, body weight, and blood pressure. In the research article, the authors have projected the retrospective analysis; it calculates the absolute increase of using exenatide once weekly versus the oral intake of insulin glargine. The study is similar to the goals established by American Diabetes Association in treating patients with type-2 diabetes (American Diabetes Association, 2014).
The researchers describe the research methodology applied to ascertain the outcomes; the method involved absolute increase and the number needed to treat calculated by comparing the percentage of patients treated in the three-study method. The methodology was in line with the requirements of the American Diabetes Association (American Diabetes Association, 2014). The researchers were, therefore, careful to use an effective method to get the results from the tests.
The patient data was retrospectively analyzed separately from three double-blind label controlled trials, which emerged in a randomized manner through 26 weeks by the American diabetes association. The data was afterward calculated by comparing the percentage of patients treated with metformin, sit gliptin, pioglitazone, or insulin glargine. Each trial performed as per the ethical principles stated in the Declaration of Helsinki (Meloni, DeYoung, Han, Best, & Grimm, 2013).With the local label approval, the researchers administered standard doses of medications.
An ethics review board reviewed each of the four trial methods and individual patient consent before the procedure began. All three durations had a slightly different number of populations of patients. The study shows that for exenatide versus metformin, exenatide QW is superior to metformin and that they both provided similar improvements in glycemic control (Meloni, DeYoung, Han, Best, & Grimm, 2013). It also shows that the Absolute Benefit Increase (ABI) significantly favored exenatide QW over metformin.
In the case of Exenatide versus Sit gliptin, the study shows that Exenatide QW is superior as patients treated attained the HbA1c goals of < 7 percentage ≤6.5percentage compared to patients treated with sit gliptin. The ABI favored it over sit gliptin, as it was much beneficial and for each HbA1c and FBG single goal and all the composite goals established for the research attained (Meloni, DeYoung, Han, Best, & Grimm, 2013). In respect of exenatide QW versus pioglitazone, the authors found out that, the ABI favored the exenatide for both HbA1c and single goals. As for the case of Exenatide QW versus insulin glargine, a more substantial number of patients treated with exenatide QW reached the HbA1c goals without weight gain or hypoglycemia.
The authors also discussed the side effects noted from the patients that took part in the research during the study. The most common side effects included diarrhea, headache, nausea, and reactions on the injection body part. In a patient survey, more than half of the patients stated that they would be willing to take an injection once weekly if the medication promoted weight loss.
The researchers noted that intensive glycemic control is significantly associated with weight gain and increased the risk of hypoglycemia in some particular medications. It also reduces patients’ quality of life. From the three studies, the findings were that between 23 percent and 15 percent of the patients were not already at the baseline goal, were able to reach the composite goals using exenatide QW.
This analysis assessed the therapy differences in achieving therapeutic goals with therapies commonly used for glycemic control in patients with type-2 diabetes. The researchers concluded that exenatide QW proved to be more efficient and beneficial in comparison to other widely used glucose-lowering treatments. In my opinion, Exenatide QW provides much help to patients in attaining the majority of the ADA recommended therapeutic goals. The different clinical procedures were found to be ineffective in helping patients reach a majority of the therapeutic targets supported by the American Diabetes Association as compared to exenatide QW. Attainment of the ADA suggested goals would provide a lot of benefit for patients who have type-two diabetes. Achieving therapeutic targets will reduce the risk of cardiovascular factors posed by type two diabetes patients, and as such, emphasis on American Diabetes Association-recommended therapeutic goals should be extensive.
American Diabetes Association. (2014). Standards of Medical Care in Diabetes—2014. Diabetes
Care , 37 (1), S14-S80.
Meloni, A. R., DeYoung, M. B., Han, J., Best, J. H., & Grimm, M. (2013). Treatment of patients
with type 2 diabetes with exenatide once weekly versus oral glucose-lowering
medications or insulin glargine:Achievement of glycemic and cardiovascular goals
. Cardiovascular Diabetology , 12 (48), 1-14.
Taylor, R. (2013). Type 2 Diabetes. Diabetes Care , 36 (4), 1047-1055.
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