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Clinical Information
- ACP Journal Club
- ACP Medicine
| ACP Medicine (as of 12/2006): |
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From: II Type 2 Diabetes Mellitus 
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Authors: Riddle MC and Genuth S |
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"The best way to use injections of pramlintide or exenatide is not yet well defined. Pramlintide may help some patients who are taking both basal and mealtime insulin but who cannot obtain good postprandial glycemic control without gaining too much weight. Exenatide may postpone the need for insulin in some patients for whom oral agents are no longer effective, and it has the advantage of causing weight loss rather than weight gain. Whether exenatide will prove psychologically more acceptable as injection therapy than insulin in general use remains to be seen. Moreover, the long-term balance between the desired effects and the unwanted effects of these agents is not fully tested. The potential safety and effectiveness of combining exenatide with a TZD or insulin is also not established."
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- MKSAP
| MKSAP 14 (as of 12/2006): |
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From: Diabetes Mellitus: Therapy: Emerging Therapies
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"The first glucagon-like peptide-1 (GLP-1) agonist, exenatide, is now available for patients with type 2 diabetes not achieving adequate glycemic control despite the use of metformin and/or a sulfonylurea. This injectable product reduces hemoglobin A1c by an absolute amount of approximately 1% and also results in weight loss"
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- PIER
| PIER (as of 3/26/2007): |
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From: Diabetes Mellitus, Type 2: Drug Therapy
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Authors: Vijan S |
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Consider adding exenatide to oral agents in patients who have not achieved adequate glycemic control on metformin, a sulfonylurea, or both.
- Begin exenatide, 5 µg sc bid within 60 minutes before the morning and evening meal
- Decrease the dose of the sulfonylurea agent to reduce the risk of hypoglycemia; a dose reduction for metformin is usually not needed
- After 1 month of therapy, increase the dose of exenatide to 10 µg sc bid
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- UpToDate
| UpToDate (as of 1/2007): |
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From: Amylin and GLP-1-based therapies for the treatment of diabetes
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Authors: Dungan K and Buse JB |
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"Exenatide could be considered as an add-on drug for patients with type 2 diabetes who are poorly controlled on one or two oral agents. With long-term use, weight loss can be substantial and associated with other metabolic benefits."
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Patient information
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