Stimulate insulin secretion, inhibit glucagon secretion, and suppress appetite.
Exanatide and sitagliptin use have been associated with acute
pancreatitis in case reports
- A synthetic analogue of human amylin, a hormone secreted by pancreatic beta cells which prevents postprandial rise of glucagon; also may reduce appetite.
- An injectable treatment intended as an adjunct to insulin, when optimized insulin dosing fails to control glucose in type 1 or type 2 diabetics
- Can increase risk of hypoglycemia
- When starting, reduce insulin dose by 50%
- In type 2 DM, initiate at 60ug SQ immediately prior to meals, can increase to 120mcg as tolerated
- A synthetic analogue of human incretin, which increases glucose-dependent insulin secretion
- An injectable treatment intended as an adjunct to metformin and/or sulfonylureas when they aren't controlling type 2 DM
- 5 mcg SQ BID, 60min before breakfast & supper; may increase to 10 mcg after 1mo
- May increase the risk of hypoglycemia if used with a sulfonylurea so consider reducing sulfonylurea dose when starting treatment
- Exenatide has been successfully combined with insulin in at least one clinical trial (Ann. Int. Med. 154:103, 2011-JW)
- Not intended for use in type 1 DM