The study suggests that for patients with poor metformin treatment, the blood glucose control effect of the exenatide group is better than that of repaglinide. The reason may be that the hypoglycemic mechanisms of the two groups are different. Exenatide impurities plays a hypoglycemic role by specifically binding to GLP-1 receptor and controlling the rise of postprandial blood glucose; Repaglinide mainly inhibits the outflow of potassium ions from B cells, depolarizes the cell membrane, opens calcium channels, and influx of calcium ions, promoting insulin secretion. This study also found that exenatide can significantly reduce BMI, TG and TC levels, suggesting that exenatide has the effect of reducing cardiovascular events. Moreover, exenatide did not significantly increase adverse reactions. It is suggested that exenatide is also safe in the treatment of type 2 diabetes.

Exenatide was originally a glucagon like peptide-1 (GLP-1) analog isolated from the saliva of Shira monitor lizard in North America. After artificial synthesis, it became the first GLP-1 analog approved for marketing. Pharmacological studies have found that it has similar biological effects to natural GLP. 1, binds to GLP-1 receptor, exerts physiological effects similar to GLP-1, stimulates insulin expression in a Glucose dependent manner, inhibits glucagon secretion, and effectively controls blood glucose. Other scholars found through animal model research that exenatide can also effectively improve the function of pancreatic B cells. This study supports the conclusion of the above scholars that the C-peptide at 2h after meal in the exenatide treatment group is significantly higher than that in the control group treated with repaglinide.