New drug helps control type 2 diabetes

Long-term use of exenatide, an experimental diabetes drug derived from lizard saliva, reduces blood glucose levels in people with type 2 diabetes who don't do well with sulfonylurea-type drugs, investigators report.

Furthermore, treatment with the new drug leads to sustained weight loss.

Exenatide (also called Exendin-4) is made by Amylin Pharmaceuticals and is awaiting U.S. FDA approval.

It's the first compound in a new class of drugs called incretin mimetics, which mimic hormones released in the intestinal tract that help regulate glucose levels.

Dr. John B. Buse from the University of North Carolina School of Medicine in Chapel Hill and colleagues studied 377 adults with type 2 diabetes that wasn't being controlled sufficiently with sulfonylurea drugs such as glipizide or chlorpropamide.

The participants were randomly assigned to twice-daily injections of exenatide at fixed doses of 5 micrograms or 10 micrograms or matching placebo injections. The subjects self-administered the injections subcutaneously in the abdomen within 15 minutes before meals in the morning and evening.

Overall glucose levels declined with both doses of exenatide during the first 12 weeks of the study, in contrast to relatively little change with placebo injections, the team reports report in the medical journal Diabetes Care. Similar results were seen after 30 weeks.

Treatment with exenatide led to dose-related progressive weight loss, "consistent with the known ability of exenatide to reduce food intake." By 30 weeks, people on 10-microgram exenatide had lost about 1.6 kilograms, or 3-1/2 pounds.

Overall, exenatide was generally well tolerated. There were no severe episodes of excessively low blood sugar. Nausea, the most common side effect with exenatide, was "mostly mild or moderate" in intensity, was most notable at the start of treatment, and lessened with time.

The researchers conclude that fixed-dose subcutaneous exenatide injections "have potential for the treatment of patients with type 2 diabetes not adequately controlled with sulfonylurea agents."

SOURCE: Diabetes Care, November 2004.