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Title: Feasibility of once weekly exenatide-LAR and enhanced diabetes care in Indigenous Australians with type 2 diabetes (Long-acting-Once-Weekly-Exenatide laR-SUGAR, 'Lower SUGAR' study).
Austin Authors: Ekinci, Elif I ;Pyrlis, Felicity ;Hachem, Mariam;Maple-Brown, Louise J;Brown, Alex;Maguire, Graeme;Churilov, Leonid ;Cohen, Neale
Affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Western Clinical School, University of Melbourne, Melbourne, Victoria, Australia
Department of Endocrinology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
The Florey Institute of Neuroscience and Mental Health
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Medicine (University of Melbourne)
Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia
Issue Date: Sep-2021
Publication information: Internal Medicine Journal 2021; 51(9): 1463-1472
Abstract: Diabetes is 3-4 times more prevalent in Indigenous Australians with blood glucose levels often above target range. Once weekly formulations of exenatide(exenatide-LAR) have demonstrated significantly greater improvements in glycaemic management with no increased risk of hypoglycaemia and with reductions in bodyweight but have not been studied in Indigenous Australians. To assess the feasibility and metabolic effects of once weekly supervised injection of exenatide-LAR in addition to standard care in Indigenous Australians with type 2 diabetes. Two communities in Central Australia with longstanding specialist clinical outreach services were allocated by random coin toss to receive once-weekly exenatide-LAR injection with weekly nurse review and adjustment of medication for 20 weeks (community with exenatide-LAR) or to weekly nurse review in addition to standard care over 20 weeks (community without exenatide-LAR). The primary outcome was the feasibility of an intensive diabetes management model of care with and without weekly supervised exenatide-LAR. Secondary outcomes included change in HbA1c. Thirteen participants from the community with exenatide-LAR and nine participants from the community without exenatide-LAR were analysed. Eighty-five percent of individuals in the community with exenatide-LAR and 67% in the community without exenatide-LAR attended more than half of clinic visits. Median difference in the change in HbA1c from baseline to final visit, adjusted for baseline HbA1c, between the community with exenatide-LAR and the community without exenatide-LAR was -3.1%, 95% CI (-5.80%, -0.38%; P = 0.03). Weekly exenatide-LAR combined with weekly nurse review demonstrated greater improvements in HbA1c, highlighting its potential for use in remote communities.
DOI: 10.1111/imj.15428
ORCID: 0000-0003-2372-395X
Journal: Internal Medicine Journal
PubMed URL: 34142743
Type: Journal Article
Subjects: Indigenous Australians
type 2
Appears in Collections:Journal articles

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