What is Bydureon™?
Bydureon is a member of the GLP-1 agonist family of medicines. Bydureon works in several places in the body and addresses four different defects. It works by supporting a system of hormones in the gut called the incretin system. These gut hormones in the normal functioning pancreas are able to detect rises in blood sugar due to food intake and they go to work telling the pancreas to squirt out insulin. At the same time they tell the liver NOT to release stored glucose. They act sort of like a thermostat in that when the blood sugar goes up they turn up the insulin and when it goes down they turn down the insulin. In a person with type 2 diabetes this incretin system does not function properly and needs some help. Bydureon has the following actions in the body:
• Stimulates the pancreas to produce insulin when the blood sugar goes up due to food intake.
• Keeps the pancreas from telling the liver to squirt out stored insulin after a meal when it is not needed.
• Slows the stomach emptying time. Having type 2 diabetes seems to make the food clear the stomach quicker than normal which in turn causes a rapid spike in blood sugar. The rapid spike is hard for the body to handle but a slower entry of the sugar into the system is easier to handle.
• Stimulates the satiety center in the brain. The satiety center or the "I've had enough to eat" center in the brain tells you that are ready to push away from the plate of food.
• Causes weight loss. Many people will lose weight when they take these medicines and that in turn usually translates to better blood sugar control.
Who can take Bydureon?
Selected adults with type 2 diabetes can take Bydureon. You would usually have already tried diet and exercise and another diabetes medicine before starting Bydureon.
Who should not take Bydureon?
• People with type 1 diabetes or diabetic ketoacidosis (DKA)
• Pregnant women
• Individuals who are breast-feeding
• Individuals with a history of thyroid cancer or pancreatitis
• People with severe kidney problems
• People with a GI disease called gastroparesis
When used alone Bydureon is unlikely to cause low blood sugar and the possibility of weight loss is always a benefit for overweight people with type 2 diabetes. The once weekly dose and the flexibility in timing of the dose are also positive features of Bydureon.
It must be given by injection. The medication must be mixed using the kit which is included with each dose and requires some preparation time although a Bydureon Pen was recently approved for use. The side effects of nausea and injection site reactions such as raised spots at the site can be a problem but are not usually cause for stopping the medication.
What dosage can I take and how often/when should I take it?
The dose is the same for everyone and is 2 mg weekly. It can be given anytime during the day without regard to meals. The dosing day can be changed or a makeup dose given if one is missed and those instructions are included with the medicine. Bydureon should be injected directly into the skin of the abdomen, back of the arm or thigh. The injection site should be moved with every new injection to prevent the development of scar tissue. Bydureon should be injected immediately after it is mixed to get the full effect of the medicine.
What are the common side effects?
• Nausea may occur early on but usually begins to go away after two weeks. Techniques to prevent or lessen the nausea are to try eating much slower and stop before you feel full. Another trick is to try a ginger in some form such as ginger ale, ginger, or a ginger supplement.
• Redness or itching at the injection site
• Raised bumps at the injection site that usually go away after a few weeks and are not considered dangerous
What else should you know about Bydureon before you start?
There are warnings about certain types of cancer including thyroid cancer that appeared in animals during testing of Bydureon. There are also warnings about possible pancreatitis issues. Please consult the accompanying FDA approved Medication Guide for further information.
Reviewed by James A. Bennett 5/14
- Bydureon.com. Bydureon™ (Exenatide Extended-Release for Injectable Suspension), http://www.bydureon.com/ (Accessed 2/3/2012.)
- Drugs.com. Bydureon Information, http://www.drugs.com/bydureon.html (Accessed 2/3/2012.)
- RxList.com. Bydureon (Exenatide) Drug - Overdosage and Contraindications, http://www.rxlist.com/bydureon-drug/overdosage-contraindications.htm (Accessed 2/3/2012.)
As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...