Sooner or later most type 2s face the choice of whether they should begin using insulin. As the effectiveness of metformin or sulfonylureas fades, physicians often look to insulin as the safest, most effective means of asserting control over blood sugar levels.
However, a British study shows that patients may want to consider using exenatide (brand names Byetta and Bydureon) instead.
Researchers at the University of Leicester tracked 216 type 2 patients whom they divided into two groups. Over a 26-week period, 111 patients injected exenatide once a week while 106 patients injected themselves twice daily with insulin detemir, a long-lasting insulin analog.
By the end of the study, 44.1 percent of the patients using exenatide had dropped their A1c’s to 7% or less compared with 11.4 percent of the insulin-injecting patients. The exenatide group reduced its average A1c by 1.3% while the insulin group reduced its average by .88%.
Weight loss between the two groups was also significantly different. The exenatide-taking group lost an average of about 6 pound while the insulin-taking group gained an average of 1.8 pounds.
Both groups had fairly low percentages of hypoglycemic episodes: 6 percent of the exenatide group; 7 percent of the insulin detemir users.
Although the performance differences were notable, exenatide’s drawbacks included more reports of gastrointestinal distress and injection site problems.
Researchers concluded that exenatide is a viable alternative to insulin detemir when a type 2 patient reaches the point where metformin no longer offers adequate blood sugar control.
Amylin Pharmaceuticals, which manufactures Byetta, the twice-daily form of exenatide, and Bydureon, the once-weekly form tested by the researchers, sponsored the study. An abstract is available online.