1. Osborne K.B., Davies S.J., Coppini D.V.
An Audit of a Nurse Led Initiation Service in Obese Type II Diabetic Subjects Suggests a Trend in Continuing Weight Loss for at Least 20 Months After the Start of Treatment
Osborne K.B., Davies S.J., Coppini D.V.
Aim
To audit the nurse led Exenatide service in obese Type II diabetic subjects to discover if weight loss and reduction in Hba1c is sustained for at least 20 months after start of treatment.
Method
Type II subjects with BMI >35kg-m2
with Hba1c >8%
Already on 1-2 oral diabetic agents.
At risk of weight gain if further tablet or insulin medication we initiated No history of pancreatitis.
Nurse led group sessions of 5-8 subjects.
Total of 50 subjects: 54% male (no difference in outcome between male and female subjects)
Age 55.5±7.9 years.
Duration of diabetes 9±4.7 range 1-34 years.
Information Collected
Starting weight and Hba1c recorded.
Followed by serial weight, Hba1c measurements.
Timing between 1 to 20 months.
Results
Hba1c improved from 9.7± 1.2% to 8.8±1.4% (p<0.001)
Body weight lessened from 114.6±18.9kg to 108.7± 16.9kg (p<0.0001)
Overtime Hba1c showed a gradual
rise of 0.1
But weight continued to reduce by 0.2
Conclusion
We found that Exenatide has a benefit on both glycaemic control and weight loss. Although the effect on the Hba1c lessens over time the impact on the weight seems to persist over several months. We acknowledge that a larger patient samples are needed to confirm the significance of these important observations.

2. Osborne K.B., Davies S.J., Coppini D.V.
An Audit of a Nurse-Led Exenatide Initiation Service in Obese Type II Diabetic Subjects Suggests a Trend in Continuing Weight Loss for at Least 20 Months
Osborne K.B., Davies S.J., Coppini D.V.
Aim
An audit of a nurse-led Exenatide service in obese Type 2 diabetic subjects to assess weight loss and HbA1c improvements up to 20 months after initiation of treatment.
Methods
Patient were considered for treatment with exenatide based on the following:-
Type2 DM, BMI >35kg-m2.
HbA1c >8%.
1 or more oral anti-diabetic agents.
Risk of weight gain from addition of other treatments (e.g. insulin, glitazone).
No history of pancreatitis or gall stones.
50 subjects attended group sessions (each of 5-8 subjects).
54% male
Age 55.5 ± 7.9 years.
Duration of diabetes 9.0 ± 4.7 (1-34) years.
Baseline and serial weight and HbA1c measurements were recorded up to a maximum 20 month period.
Results
Mean HbA1c improved from 9.7±1.2% to 8.8 ±1.4% (p<0.001).
Mean body weight decreased from ±18.9 kg to 108.7±16.9kg (p<0.0001).
HbA1c showed a trend in rise over time despite a continuing weight reduction over the 20 month audit period.
Conclusion
Exenatide treatment has a benefit on both glycaemic control and weight reduction in obese subjects with type 2 diabetes.
Although subjects had a wide range of diabetes duration, the impact on weight seems to persist over several months, despite a trend in rise in HbA1c.
We acknowledge a relatively small sample size and the importance of larger scale observational studies to consolidate these interesting observations.