Clinical Effectiveness of Intravenous Exenatide Infusion in Perioperative Glycemic Control after Coronary Artery Bypass Graft Surgery A Phase II/III Randomized Trial

{Background: We aimed to assess the clinical effectiveness of intravenous exenatide compared to insulin in perioperative blood glucose control in coronary artery bypass grafting surgery patients. Methods: Patients more than 18 yr old admitted for elective coronary artery bypass grafting were included in a phase II/III nonblinded randomized superiority trial. Current insulin use and creatinine clearance of less than 60 ml/min were exclusion criteria. Two groups were compared: the exenatide group, receiving exenatide (1-h bolus of 0.05 mu g/min followed by a constant infusion of 0.025 mu g/min), and the control group, receiving insulin therapy. The blood glucose target range was 100 to 139 mg/dl. The primary outcome was the proportion of patients who spent at least 50% of the study period within the target range. The consumption of insulin (C-insulin) and the time to start insulin (T-insulin) were compared between the two groups. Results: In total, 53 and 51 patients were included and analyzed in the exenatide and control groups, respectively (age: 70 +/- 9 vs. 68 +/- 11 yr; diabetes mellitus: 12 [23%] vs. 10 [20%]). The primary outcome was observed in 38 (72%) patients in the exenatide group and in 41 (80%) patients in the control group (odds ratio [95% CI] = 0.85 [0.34 to 2.11]; P = 0.30). C-insulin was significantly lower (60 [40 to 80] vs. 92 [63 to 121] U, P < 0.001), and T-insulin was significantly longer (12 [7 to 16] vs. 7 [5 to 10] h