Short-Term Changes in Hematologic Inflammatory Indices During Exenatide Therapy in Patients with Type 2 Diabetes Mellitus

Background: Inflammation plays an important role in the pathogenesis of type 2 diabetes mellitus (T2DM) and the development of complications. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used to treat T2DM. Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are simple biomarkers of inflammation. This study evaluated the effects of six-month exenatide therapy on these parameters. Methods: This single-center retrospective cohort study evaluated 100 adult patients with type 2 diabetes who initiated exenatide treatment and maintained a stable baseline treatment regimen for 6 months (no medication changes for at least 6 months). Clinical, biochemical, and blood count parameters were compared at the start of treatment (month 0) and at months 3 and 6. Results: At the start of treatment, patients' weight decreased from 111.1±24.4 kg to 104.7±20.8 kg after 6 months (p<0.001). Initial HbA1c values decreased from 68.6±20.3 mmol/mol (8.43±1.86%) to 60.9±16.1 mmol/mol (7.72±1.47%) at 6 months (p<0.001). NLR remained unchanged throughout the study, while PLR showed a transient increase at 3 months (p=0.03) but returned to baseline at 6 months. Furthermore, ALT values were significantly lower at 6 months compared to baseline (p=0.048). Conclusions: These findings suggest that exenatide therapy may be associated with improvements in metabolic parameters and a modest reduction in MPV. However, given the retrospective design and the lack of direct assessment of treatment adherence and persistence, these results should be interpreted with caution.