The Vascular Effects of Exenatide Versus Metformin in Patients With Pre-Diabetes
The Vascular Effects of Exenatide Versus Metformin in Patients With Pre-Diabetes
The purpose of this study is to compare the effects of exenatide versus metformin on vascular
 health with chronic (3-month) therapy and during a 2-hour period following a meal in patients
 with pre-diabetes. It is predicted that exenatide will improve vascular health to a greater
 degree compared to metformin.
Inclusion Criteria:

 -  Greater than or equal to 18 years old

 -  Impaired glucose tolerance: 2-hr oral glucose tolerance test (OGTT) plasma glucose
 >140 mg/dL OR impaired fasting glucose: fasting glucose > or = 100 mg/dL OR elevated
 glycosylated hemoglobin: Hemoglobin A1c > or = 5.7%

 -  Abdominal obesity: waist circumference >102 cm (men) and >88 cm (women)

 -  Stable cardiovascular medication regimen (or other medications known to affect
 endothelial function) at least 1 month prior to enrollment and throughout the study

 Exclusion Criteria:

 -  Type 2 diabetes

 -  Current use of glycemic control medications within one month of randomization

 -  Fasting glucose >126 mg/dL

 -  Current use of weight loss medication

 -  Previous weight loss surgery

 -  History of severe gastrointestinal disease

 -  Standard clinical contraindications to exenatide or metformin therapy

 -  Unstable angina

 -  Heart failure

 -  Stroke or coronary artery bypass graft within 3 months of screening

 -  Women who are currently pregnant or planning to become pregnant

 -  Breastfeeding women

 -  Clinically significant liver disease

 -  Creatinine > 1.5 mg/dL

 -  Hepatic function greater than 3 times upper limit of normal

 -  Patients who are mentally incompetent and cannot sign a Patient Informed Consent