Exenatide Use in the Management of Type 2 Diabetes Mellitus

Abstract

Exenatide is a GLP-1 (glucagon-like peptide-1) agonist that has been approved in the UK for use in the management of Type 2 Diabetes Mellitus (T2DM) since 2006. It acts by increasing glucose-induced insulin release and by reducing glucagon secretion postprandially. It therefore increases insulin secretion and reduces glucose levels, especially postprandially. It also reduces gastric emptying and acts centrally to promote satiety. In clinical practice it reduces HbA1c (range; -0.4% to -1.3%), fasting and postprandial blood glucose levels and is the only antidiabetic agent (together with liraglutide; a human GLP-1 analogue) to promote weight loss (range; -1.5 kg to -5.5 kg). It can be used as monotherapy or in combination with metformin and/or sulphonylureas (SU) and/or thiazolinediones (TZD). When compared with insulin it causes similar reductions in HbA1c and glucose levels, but unlike insulin it has the advantage of inducing weight loss. Its main side effect is gastrointestinal (GI) disturbances; nausea is the commonest GI adverse effect, albeit usually mild and transient. Hypoglycaemia is uncommon, especially when used as monotherapy or in combination with metformin. In this review article we scrutinize the currently available evidence for use of exenatide in the management of T2DM.

Antihyperglycemic, antihyperlipidemic and antioxidant activity of phenolic rich extract of Brassica oleraceae var gongylodes on streptozotocin induced Wistar rats

“…In the last few decades, there has been a tremendous increase in the prevalence of type 2 diabetes internationally, and has been estimated that the number of diabetic patients will be more than 205 million in the next 20 years (Diabetes Atlas and 6th Edition 2014 ). Oral hypoglycemic agents and insulin, generally used to treat Diabetes Mellitus (DM), have number of serious side effects (Kyriacou and Ahmed 2010 ). Hence, interest has increased in finding naturally occurring anti-diabetic therapeutics to replace synthetic drugs (Velioglu et al 1998 ).…”

A fusion protein derived from plants holds promising potential as a new oral therapy for type 2 diabetes

“…Ex-4 increased insulin production by b-cells in response to glucose, promoted b-cell regeneration and protected against apoptosis (Hadjiyanni et al, 2008;Lovshin and Drucker, 2009). The synthetic version of Ex-4, exenatide, was approved by the Food and Drug Administration (FDA) in 2005 for the treatment of T2D and was the first marketed GLP-1 receptor agonist (Kyriacou and Ahmed, 2010;Robles and Singh-Franco, 2009). While exenatide has demonstrated its value in treating patients with T2D, its therapeutic utility is limited due to the frequent injections required (twice daily), thus making it an inconvenient and expensive treatment (Garber, 2011).…”

Hypoglycemic effect of Brassica juncea (seeds) on streptozotocin induced diabetic male albino rat

“…We have recently reviewed the Indian plants that may have an antidiabetic potential [8] . The treatment of DM in clinical practice has been confined to use of oral hypoglycemic agents and insulin, the former being reported to be endowed with characteristic profiles of serious side effects [9] . This leads to increasing demand for herbal products with antidiabetic factor but little side effects.…”