OBJECTIVES: Exenatide twice daily (exenatide) and liraglutide once daily, GLP-1 receptor agonists, have demonstrated improvements in glycemic outcomes for patients with type 2 diabetes (T2D) in randomized clinical trials. We evaluated A1c outcomes for patients initiating exenatide or liraglutide in a real-world setting. METHODS: This retrospective cohort study used data from the Medical Quality Improvement Consortium of ambulatory medical practices that use Centricity Office from GE Healthcare IT as their electronic medical record. Patients with T2D receiving a prescription between Jun 2005 and May 2011 were identified (exenatide=61,485; liraglutide=9,316). Baseline A1c measures were documented from 45 days prior to 15 days after initiating exenatide or liraglutide with follow-up measures documented at 6 months+45 days. An ANCOVA model including baseline A1c, age, gender, concomitant glucose-lowering medications, and modified Charlson Comorbidity Index (CCI) was used to estimate least squares mean A1c. RESULTS:   Mean(SD) age was 55(12) and 55(12), CCI 2.0(1.3) and 2.1(1.3), % male 41% and 42% for exenatide and liraglutide patients, respectively. Baseline BMI was 38.4(7.8) and 37.9(7.7) for exenatide and liraglutude patients, respectively, who had baseline and 6 month BMI data. Of patients not at A1c goal of <7.0% at baseline, the mean(SD) baseline A1c was 8.7(1.4) for exenatide and 8.6%(1.3) for liraglutide, and at 6 months was 8.0%(1.6) for exenatide and 7.9%(1.6) for liraglutide; 29.8% of patients receiving exenatide and 30.8% of patients receiving liraglutide achieved <7% A1c goal at 6 months. At baseline, 47% of exenatide patients were prescribed 10 mcg BID daily; 7.7% and 83.9% of liraglutide patients were prescribed 1.2 and 1.8 mg daily, respectively. At 6 months, 66% of exenatide patients were prescribed 10 mcg BID daily; 11.2% and 75.4% were prescribed liraglutide 1.2 and 1.8 mg daily, respectively. CONCLUSIONS: In this retrospective cohort study, glycemic outcomes similarly improved for patients initiating exenatide or liraglutide.