The concept of incretin mimetics is a new approach in the treatment of DM2 patients who don't achieve adequate glucose control with sulphonylurea and metformin.
Exenatide is the first approved drug that imitates the incretin GLP-1. It is able to bind the GLP-1 receptor and to activate signal transduction via cAMP (1), resulting in an increased release of insulin. Exenatide decreases food intake by reducing appetite (5) and delaying gastric emptying (4). It also improves β-cell function as shown by restored insulin secretion after intravenous glucose injections in treated patients.
Thus, adding exenatide to existing therapy with oral blood sugar lowering agents results in decreased body weight and also decreased HbA1c levels. Exenatide is administered 1 hour before the meal by a subcutanous injection.
Nausea is the most common side effect, but this can be avoided by starting a low dose and slowly increase the dose after a month. In combination with a sulphonylureum derivate, hypoglycemia can occur, especially in elderly patients.
EPAR of exenatide.