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.
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.
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
large number of patients. It also
caused an increase in heart rate and
lowering of blood pressure
studies are necessary to confirm the safety of weekly exenatide.