Other Injected Therapies - Treatment For Type 2 Diabetes: Diabetes A Plan For Living

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Other injected therapies

Two injectable treatments for type 2 diabetes were approved by the FDA in 2005. Both should be injected with meals, and both are only approved for use in people whose blood sugar levels are not being adequately controlled with other medications. Both drugs also have the same primary side effect, nausea, which tends to get better with time.

Exenatide (Byetta). Exenatideis the first in a new class of drugs called incretin mimetics. It lowers blood sugar by increasing insulin production by the pancreas and decreasing glucose production by the liver. An important benefit of exenatide is that it only affects insulin levels when blood glucose levels are elevated, so it does not increase the risk of hypoglycemia on its own. However, when it is taken with a sulfonylurea, hypoglycemia can occur. Exenatide has been approved for people with type 2 diabetes whose blood glucose levels have not been well-controlled using metformin, a sulfonylurea, or a combination of metformin and a sulfonylurea. It comes in a prefilled "pen" injector.

Pramlintide (Symlin). Pramlintide is a synthetic version of a hormone that is secreted by the pancreas along with insulin. The newly approved injectable drug appears to work by slowing the absorption of food from the intestines, thereby lowering the rise in blood sugar after meals. Like exenatide, it is associated with nausea and vomiting.

Pramlintide and insulin must be injected separately—they cannot be combined in the same vial or syringe. Pramlintide is approved for people with type 2 diabetes who are taking insulin but whose blood sugar levels are still not well-managed. It is also approved for people with type 1 diabetes whose blood sugar levels are not well-managed. Pramlintide will not replace your need for insulin treatment, but it may alter the dose you need. It can cause hypoglycemia; working with your doctor to alter your insulin dose can prevent this problem.

Last updated:	January 23, 2007