Once Weekly Exenatide for Type 2 Diabetes in Trial for Better Blood Sugar Control

Exenatide is a new drug used to treat type 2 diabetes. Type 2 diabetes occurs in adults.  Once diagnosed, the patient is advised lifestyle modifications with a sugar- free diet and exercise.  If the blood sugar does not come under control, the patient is prescribed oral tablets.  Two or more different types of tablets may be required if the blood sugar is still high.  In the later stages if the sugar control is inadequate, insulin is added to the treatment. Exenatide is used either alone or in combination with antidiabetes drugs.  The patient should continue with diet control and exercise while taking exenatide.  Exenatide belongs to a class of drugs called incretins.  It increases insulin secretion and reduces glucagon levels in the body when the blood glucose levels are high.  [Glucagon is a hormone that increases blood glucose level]. It also slows down the emptying of food by the stomach; thus it slows down digestion and reduces absorption of glucose.   All these effects reduce blood glucose levels and help to control diabetes.

Exenatide is injected just under the skin twice daily at a dose of 5 to 10 mcg within 60 minutes before breakfast and dinner. It causes side effects like nausea, vomiting, headache and dizziness.  Most of the side effects occur during initial treatment.  It may increase episodes of low blood sugar. It should not be used for patients allergic to the drug, those with pancreatitis, severe kidney disease, or severe digestive tract disease. Use of exenatide with insulin has not been studied as yet and hence is not recommended.

The main disadvantage of exenatide is that is has to be administered as an injection twice daily.   A weekly preparation is now being tested out.  Such a preparation will be very convenient to use due to its dosing schedule.

  Researchers have compared the effect of weekly exenatide with that of insulin glargine for patients with type 2 diabetes already taking other drugs but without complete control of blood sugar levels.  They have found that exenatide improves control of blood glucose levels and at the same time causes weight loss in these patients.  In this study, weekly exenatide did not result in an increase in episodes of low blood sugar.  It however did cause nausea and vomiting in a large number of patients.  It also caused an increase in heart rate and lowering of blood pressure.  Further studies are necessary to confirm the safety of weekly exenatide.

Source-Medindia