What are some non-insulin injectable drugs to treat diabetes, and how do they work?

Exenatide (Byetta®)

How it works:

  • Keeps food in the stomach longer, increases insulin when you eat, and lowers the amount of glucose released by the liver.

Side effects:

  • Nausea
  • Vomiting
  • Decreased appetite

Comments/special instructions:

  • Byetta® is taken twice a day, within one hour before the two largest meals of the day.
  • Byetta® can be used in combination with a sulfonylurea, metformin, thiazolidinediones, or Lantus.
  • Byetta® helps with weight loss.
  • The risk of hypoglycemia (low blood sugar) is greater if Byetta® is used with insulin or a sulfonylurea.
  • Byetta® should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Exenatide Extended Release (Bydureon®)

Bydureon is an extended-release form of exenatide and is injected once every seven days.

Comments/special instructions:

  • Bydureon® cannot be used when taking Byetta.
  • Bydureon® can be used in combination with a sulfonylurea, metformin, or thiazolidienediones.
  • The risk of hypoglycemia is greater if Bydureon® is used with sulfonylurea. Bydureon® should not be used in combination with insulin.
  • Bydureon should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Liraglutide (Victoza®)

How it works:

  • Keeps food in the stomach longer, increases insulin when you eat, and lowers the amount of glucose released by the liver.

Side effects:

Comments/special instructions:

  • Victoza® is taken once a day at any time, regardless of meal times.
  • Victoza® can be used in combination with sulfonylureas, metformin, or thiazolidinediones.
  • Victoza® helps with weight loss.
  • The risk of hypoglycemia is greater if Victoza® is used with insulin or a sulfonylurea.
  • Victoza® should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Dulaglutide (Trulicity®)

How it works:

  • Keeps food in the stomach longer, increases insulin when you eat, and lowers the amount of glucose released by the liver.

Side effects:

  • Nausea
  • Vomiting
  • Diarrhea
  • Decreased appetite

Comments/special instructions:

  • Trulicity® should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Albiglutide (Tanzeum®)

How it works:

  • Keeps food in the stomach longer, increases insulin when you eat, and lowers the amount of glucose released by the liver.

Side effects:

  • Nausea
  • Diarrhea

Comments/special instructions:

  • Tanzeum® comes as a powder and a liquid that are mixed together before the injection is given.
  • Tanzeum® should not be taken if there is a personal or family history of medullary thyroid carcinoma (MTC) and by patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Pramlintide (Symlin®)

How it works:

  • Symlin® is a synthetic (man-made) version of amylin, a peptide that is released along with insulin when a person eats. Amylin helps the person feel full by delaying emptying of the stomach. It also lowers the amount of glucose released by the liver.

Side effects:

  • Nausea
  • Vomiting
  • Decreased appetite

Comments/special instructions:

  • Symlin® is for patients who have Type 1 diabetes and for those who have Type 2 diabetes and need insulin.
  • Symlin® is given before meals, usually at the same time as insulin.
  • NOTE: Symlin® and insulin must be given as separate injections.
  • Symlin® helps with weight loss.

Last reviewed by a Cleveland Clinic medical professional on 06/20/2016.

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