Bydureon: A Once-a-Week Injectable Diabetes Medication

Are you someone who has had diabetes for several years and you simply can't control your sugar anymore on oral medicines? Diabetes is a progressive disease and sometimes adjustments in medicine regimens need to be made to help control blood sugar.

Often, people with diabetes can benefit from using an injectable medication (not insulin) in addition to their oral medicines. Non-insulin injectable medicines, referred to as GLP-1 agonists (such as Byetta and Victoza), have been shown to help lower after-meal blood sugars and reduce weight.

Another GLP-1 agonist, Bydureon, is a long-acting form of the medication Byetta that is given once per week. Bydureon is a GLP-1 (glucagon-like peptide 1) agonist that stimulates insulin secretion when it comes into contact with glucose.

It has also been shown to preserve beta cell function (beta cells make insulin) and has been proven to promote weight loss by delaying gastric emptying and increasing feelings of fullness. Studies have shown that people taking Bydureon lose an average of about five pounds by month six of taking the medication and have been shown to keep it off by year three.

New research by AstraZeneca (owners of Bydureon) demonstrates that exenatide once-weekly suspension for autoinjection provided greater mean reductions in HbA1c (-1.4 vs -1.0) than Byetta twice daily injection. Patients in the exenatide autoinjection group and Byetta group had similar reductions in mean body weight (-1.5 kg vs. -1.9 kg, respectively; p-value = 0.4).

Other studies have shown that when compared to insulin, patients using Bydureon lose more weight – an independent determinant of blood sugar control. 

While clinical trials have shown that treatment with Bydureon can help to reduce A1c by about 1.5 percent, Bydureon is not used as a first-line diabetes treatment. Instead, it is typically used as a second or third agent in combination with metformin or a sulfonylurea.

If you are taking a sulfonylurea, your dose may need to be adjusted to reduce the risk of hypoglycemia. Bydureon should be used in combination with diet and exercise and is not meant to be used as a weight loss drug. 

Previously, Bydureon was only available using a syringe that was rather long and thick. Although the injection was only once per week, some people complained of discomfort. However, now Bydureon is available for use via pen. The pen is likely to be more comfortable and easier to use than the syringe. 

Bydureon should be injected subcutaneously into fatty tissue and not into a muscle or vein. You can inject Bydureon in the same places you would insulin—abdomen (two inches away from your belly button), outer thighs, backs of your upper arms. You can use the same area weekly, just try not to use the same exact location.

Sometimes people feel itching or redness at the injection site. Call your healthcare provider right away if you have severe pain, swelling, blisters, an open wound, or a dark scab at your injection site. 

Discuss with your healthcare provider if you are a candidate for Bydureon. Bydureon is not meant to be used as a weight loss drug and is typically used in conjunction with other diabetes medicines. If you are someone with type 2 diabetes whose blood sugars are not at goal and can afford to lose some weight than Bydureon might be an option for you. 

In animal studies, Bydureon caused rats to develop tumors of the thyroid gland. Therefore, Bydureon is contraindicated in patients with a personal or family history of medullary thyroid cancer (MTC) and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). People with sensitivity to exenatide or to any product components should also not take Bydureon.

Before taking Bydureon, you should tell your provider if you have a history of pancreatitis, stones in your gallbladder (gallstones), a history of alcoholism, or high blood triglyceride levels as Bydureon may not be meant for you. When taking Bydureon, if you experience severe stomach pain that does not go away, you should contact your healthcare provider immediately as this may be a sign of pancreatitis. Bydureon is not meant for patients with type 1 diabetes. 

Currently, Bydureon is the only once-weekly injectable medication on the market. But, other companies are working on formulations and are conducting clinical trials. Bydureon is simply the beginning of an expanding diabetes market. 

Because Bydureon delays gastric emptying, the most common side effects include nausea and vomiting. Nausea commonly happens when first starting the medication and decreases over time when the body gets used the medication. Other side effects include headaches, diarrhea, redness at the injection site.