{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:37:53Z","timestamp":1789504673298,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,8,5]],"date-time":"2014-08-05T00:00:00Z","timestamp":1407196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005890","name":"Ministry of Health of the People's Republic of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005890","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Science Fund","award":["81025005"],"award-info":[{"award-number":["81025005"]}]},{"name":"Eli Lilly and Co."},{"name":"Amylin Pharmaceuticals, Inc."},{"name":"Bristol-Myers Squibb"},{"name":"Astra Zeneca"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Progressive \u03b2\u2010cell dysfunction hinders the maintenance of glycaemic control in type 2 diabetes, but comparative data on \u03b2\u2010cell\u2010protective therapies are lacking in the early stage of type 2 diabetes. Here we evaluated the comparative glycaemic efficacy and impact on \u03b2\u2010cell function of three antihyperglycaemic agents that have a \u03b2\u2010cell\u2010protective effect, exenatide, insulin and pioglitazone, in newly diagnosed patients with type 2 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and methods<\/jats:title><jats:p>In this 48\u2010week, multicentre, parallel\u2010group study, 416 patients newly diagnosed with type 2 diabetes were randomly assigned 1\u00a0:\u00a01\u00a0:\u00a01 to receive exenatide, insulin or pioglitazone. The primary end\u2010point was the change in glycosylated haemoglobin (HbA1c) from baseline. Secondary end\u2010points included effects on weight, blood pressure, lipid profiles and \u03b2\u2010cell function assessed by homeostasis model assessment, fasting proinsulin:insulin (<jats:styled-content style=\"fixed-case\">PI<\/jats:styled-content>\/I), disposition index (<jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content>) and acute insulin response (<jats:styled-content style=\"fixed-case\">AIR<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At week 48, mean [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>)] HbA<jats:sub>1c<\/jats:sub> changes from baseline were \u22121.8% (\u22121.55% to \u22122.05%) with exenatide, \u22121.7% (\u22121.52% to \u22121.96%) with insulin and \u22121.5% (\u22121.23% to \u22121.71%) with pioglitazone. Treatment differences were \u22120.20% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22120.46% to 0.06%) for exenatide versus insulin (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.185), and \u22120.37% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> \u22120.63% to \u22120.12%) for exenatide versus pioglitazone (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002). Significant improvements from baseline in <jats:styled-content style=\"fixed-case\">AIR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> PI<\/jats:styled-content>\/I and <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content> were observed with all treatments, with the greatest improvements in <jats:styled-content style=\"fixed-case\">DI<\/jats:styled-content>, as well as weight, blood pressure and lipid profile, observed with exenatide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>All three agents showed efficacy regarding glycaemic control and metabolic benefits; however, exenatide showed the greatest efficacy. \u03b2\u2010cell function improved in all treatment groups; hence, early initiation of \u03b2\u2010cell\u2010protective therapy may halt the decline in \u03b2\u2010cell function in type 2 diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/joim.12293","type":"journal-article","created":{"date-parts":[[2014,7,16]],"date-time":"2014-07-16T07:27:46Z","timestamp":1405495666000},"page":"137-150","source":"Crossref","is-referenced-by-count":50,"title":["Comparison of the effects on glycaemic control and \u03b2\u2010cell function in newly diagnosed type 2 diabetes patients of treatment with exenatide, insulin or pioglitazone: a multicentre randomized parallel\u2010group trial (the <scp>CONFIDENCE<\/scp> study)"],"prefix":"10.1111","volume":"277","author":[{"given":"W.","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism Guangdong Provincial Key Laboratory of Diabetology the Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Drum Tower Hospital Affiliated to Nanjing University Medical School Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Zhongda Hospital Institute of Diabetes Medical School Southeast University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Guangdong Provincial Key Laboratory of Diabetology the Third Affiliated Hospital of Sun Yat\u2010sen University Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Beijing Hospital of the Ministry of Public Health Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology the First Affiliated Hospital of Nanjing Medical University Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology the Affiliated Hospital of Guangdong Medical College Zhanjiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Affiliated Hospital of Guiyang Medical College Guizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology the First Affiliated Hospital Chongqing Medical University Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology the Affiliated Hospital of Inner Mongolia Medical University Hohhot 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