Byetta (exenatide): a new type of drug for type 2 diabetes
Byetta is the brand name for a new drug (scientific name is exenatide). What is exciting about this drug is that it is the first to market of a class of drugs known as incretin mimetics. What that means is that they mimic a naturally occuring incretin hormone with an unwieldy name: glucagon-like peptide-1, docs call it GLP-1 for short.
GLP-1 is produced by the intestines. It stimulates insulin secretion in response to food. People with type 2 diabetes secrete less GLP-1 than people without diabetes. Byetta (exenatide) is similar in its action to this naturally occuring substance. This drug is not going to be used in type 1 diabetes as people with that condition cannot make insulin. They need to be treated with insulin.
Here's the good news about this drug:
1. It improves blood sugar control by lowering glucose levels after a meal and when fasting. Because it improves long-term control of glucose, hemoglobin A1c levels(HbA1c) improve.
2. Byetta (exenatide) stimulates insulin secretion only when blood sugar is high and it improves the way insulin is secreted (called the first phase insulin response). This may eventually turn out to be better than injecting insulin in some people with type 2 diabetes.
3. Most people who used Byetta (exenatide) in long-term clinical research studies also lost weight -- not alot (~5 or 6 pounds) but they kept it off for duration of the study. That's right, here's a drug that can both improve glucose levels and is associated with weight loss! Some people with type 2 diabetes find they gain weight on insulin injections, particularly if they are taking multiple doses.
Here's the bad news:
1. It must be administered by injection (subcutaneously, just under the skin). It is usually administered twice a day--before the morning and evening meals. However, the drug is available in a pre-filled pen-like injection device that can make it relatively easy to use.
2. In the clinical trials, some people developed antibodies to the drug and this was associated, in some of those, with reduced effectiveness of the drug.
Right now, the FDA has approved Byetta as an adjunct to existing oral medicines, like Glucophage® (metformin), and/or a sulfonylurea like Amaryl® (glimepiride), Glucotrol® (glipizide), Micronase® (glyburide), and others.
It is anticipated that it may eventually be approved as a stand alone drug.
There is another type of drug (called DPP-IV inhibitors) coming down the pike that also act via GLP-1 (they protect naturally occuring GLP-1 from being broken down). They will be taken orally. These drugs appear to improve glucose over the long term (HbA1cs come down). They don't, however, have the benefit of being associated with weight loss.
If you have are having trouble getting your blood glucoses in control on your current regimen, chat with your doctor about whether exenetide would be a good medicine for you. There are lots of benefits of getting and keeping your glucose in good control while you continue to lose weight and exercise.
(Want support from peers with diabetes or pre-diabetes? There's a PEERtrainer team just for you. Go to www.peertrainer.com, click on teams and look for the "Got diabetes or prediabetes" team)