(HealthDay News) — For patients with long-standing poorly controlled type 2 diabetes mellitus (T2DM) on metformin plus a sulfonylurea, combination therapy with exenatide and pioglitazone is effective and safe, according to a study published online in Diabetes Care.

Muhammad Abdul-Ghani, MD, PhD, from Hamad General Hospital in Doha, Qatar, and colleagues randomized 231 patients with poorly controlled T2DM on a sulfonylurea plus metformin to receive combination therapy (pioglitazone plus weekly exenatide) or insulin therapy (basal plus prandial insulin) to maintain hemoglobin A1c (HbA1c) <7.0%.

The researchers found that combination therapy decreased HbA1c from 10.0% ± 0.6% at baseline to 6.1% ± 0.1% after a mean follow-up of 12 months, compared with 7.1% ± 0.1% in those receiving insulin therapy. Combination therapy reduced the HbA1c, regardless of sex, ethnicity, body mass index, or baseline HbA1c. Compared with patients in the combination therapy group, subjects in the insulin therapy group experienced significantly greater weight gain and a three-fold higher rate of hypoglycemia.

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“Combination exenatide/pioglitazone therapy is a very effective and safe therapeutic option in patients with long-standing poorly controlled T2DM on metformin plus a sulfonylurea,” the authors write.

One author disclosed financial ties to pharmaceutical companies, including Astra Zeneca, which provided the exenatide.

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  1. Abdul-Ghani M, Migahid O, Megahed A, et al. Combination Therapy With Exenatide Plus Pioglitazone Versus Basal/Bolus Insulin in Poorly Controlled Patients With Type 2 Diabetes on Sulfonylurea Plus Metformin: The Qatar Study. Diabetes Care. 17 January 2017. doi: 10.2337/dc16-1738. [Epub ahead of print]