OBJECTIVES: Six-month real-world outcomes were previously reported for exenatide, a GLP-1 receptor agonist for the treatment of type- 2 diabetes (T2D). A1C reductions were -0.7%, weight reductions were -2.8 kg, and BMI reductions were -0.94 kg/m2. The current 18 month analysis evaluated A1C, weight, and BMI outcomes to establish real-world durability of glycemic control and weight loss in patients using exenatide. METHODS: Data were extracted from the General Electric electronic medical record database from January 1, 2000 to December 31, 2007. Adults with T2D per ICD-9 codes, ≥2 fasting blood glucose levels ≥126 mg/dL, or A1C >7.0% starting exenatide in or after 2005 were included. Patients had 2+ additional prescription orders including at least one 12 to 18 months after the initial prescription to indicate ongoing therapy, and had prior prescription orders for metformin, a sulfonylurea, or a thiazolidinedione alone or in combination. A1C, weight and BMI were documented at exenatide initiation (-45 to + 15d) and at 18 months (±45d). Outcomes were evaluated in those with baseline and follow-up A1C, weight and BMI measures. RESULTS: In 102 study patients, baseline A1C was 8.2+1.1%, weight was 111 ± 12.3 kg. Baseline BMI was 38.6≥±7.4 kg/m2 in those with baseline and follow up data (n=89). After 18 months of exenatide therapy, mean (±SEM) A1C decrease was -0.7(±0.2)% (p<.001), weight decrease was -4.7(±0.7) kg (p<.001), and BMI decrease was -0.8 (±0.3) kg/m2 (p<.001). A total of 72.0% had an A1C reduction, 76.7% lost weight, and 57.0% had reductions in A1C and weight. Mean A1C reduction was identical and weight loss was approximately 2 kg greater at 18 months relative to 6 month cohort exenatide outcomes. CONCLUSIONS: Exenatide therapy was associated with significant reductions in A1C, weight and BMI at 18 months. These reductions demonstrate treatment durability with exenatide and continuous benefit from long term therapy.