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Type 2 Diabetes Treatments – Byetta, Victoza and Bydureon

We’ve come a long way since Dr. Frederick Banting’s discovery of insulin. Nowadays, there are a few injectable options available for people with type 2 diabetes, and many, many insulin choices and strengths. Some injectables are not even made of insulin.

Incretin mimetics

In the past, we have mentioned how our bodies communicate the need to produce insulin by making a certain hormone known as an incretin – which then directs the pancreas to make more insulin as a response to blood glucose levels. Many persons with type 2 diabetes do not make enough incretins, and various strategies have been developed (like with DPP4-inhibitors) to address this deficiency.

A new class of injectible medications known as incretin mimetics, work by mimicking the action of incretins, and thus prompting the pancreas to produce more insulin when there are higher levels of glucose in the system.  The medications also prevent the pancreas from producing too much glucagon – a hormone which prompts the liver to release stored glucose into the bloodstream, and by slowing down the rate at which the stomach empties after eating.  This extra effect may help a person feel fuller after eating, and more satisfied, helping patients avoid overeating and lose weight.

Incretin mimetics may be used on their own, or in combination with other oral agents or insulin. Their most common side effects include mild nausea, diarrhea, and heartburn during the first few weeks of use. People with gastrointestinal problems or kidney disease are not usually good candidates.  And there might be a slight association with pancreatitis and thyroid cancer.

Incretin mimetics are extremely convenient, as they only need to be injected once or twice a day, and with some kinds, even once a week. Their biggest drawback? Their cost. Some of them go for $300-$400 a month!

Here’s a quick look at the most common incretin mimetics, and their benefits:1

  • Exenatide, more commonly known as Byetta (FDA approved as of 2005): May lead to an average weight loss of 6 lbs, and an average reduction of 0.8% in A1C. Needs to be administered with daily, before meals.
  • Liraglutide, more commonly known as Victoza (FDA approved as of 2010): May lead to an average weight loss of 7 to 8 lbs, with an average reduction of 1.1-1.5% in A1C. Needs to be administered once daily.
  • Long acting exenetid, more commonly known as

As previously noted above, when incretins are not enough, incretins are medications that may be used in conjunction with insulin. We will discuss insulin more in depth as a treatment for people with type 2 diabetes in a future blog post.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1.  The Lancet, published online June 8, 2009; presentation by John Buse, MD, PhD, at the European Association for the Study of Diabetes 2011 annual meeting