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Johns Hopkins Health Alert

Should You Add Byetta or Victoza to Your Diabetes Regimen?

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If you have type 2 diabetes and your oral medication is not enough to control blood glucose levels, your doctor may prescribe an injected medication other than insulin. Known as incretin mimetics, drugs in this new class of type 2 diabetes medications mimic the action of glucagon-like peptide-1 (GLP-1), an incretin hormone that triggers insulin production after a meal.

Exenatide (Byetta) was the first GLP-1 to hit the market; liraglutide (Victoza) was approved by the FDA in 2010. Byetta and Victoza act only when blood glucose levels are high, so they should not cause hypoglycemia (low blood sugar). As blood glucose decreases, these medications stop stimulating insulin release. 

GLP-1 medications are synthetic versions of a protein derived from the saliva of a venomous lizard known as the Gila monster. They are injected medications that are taken in addition to oral medications. Both drugs can cause significant weight loss through decreasing appetite. 

GLP-1 drugs are not recommended for people with type 1 diabetes, severe kidney disease or severe gastrointestinal disease. Nausea is the most common side effect. Vomiting and diarrhea may also occur. Because Byetta slows the absorption of oral drugs, you may need to take certain medications at least one hour before an injection of Byetta. There is some concern that Victoza may increase the risk of pancreatitis and thyroid cancer. Because these are new drugs, their long-term effects are still unknown. 

In summary, Byetta and Victoza are injectable drugs that work by a new mechanism of action, unlike insulin. A main advantage is that they promote weight loss in many people. 

Posted in Diabetes on April 12, 2012


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