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New kids on the block: continued


One medication that has gotten alot of press is called Byetta(Exenatide) and many of you may have heard of it already. Byetta, unlike Januvia, is an injection but is not insulin. Many people, including doctors, mistake this medication for insulin because it is an injection. But it is NOT INSULIN and works quite differently.{{more}} Byetta works by mimicking some of the “gut hormones” that help regulate how fast our stomach empties, how appropriately our insulin production is going for the food we just ate, controlling the amount of sugar we make on our own and even making us feel fuller so we eat less. Cool, huh? Lots of folks think so, and in fact Byetta is becoming quite popular for two big reasons: It often will not cause low blood sugars, and it has been shown to cause weight loss. Fantastic! You say, start me on it now!!! Hold on there, Vincy, just a few more things to know. First, this medication is new, and that means it is quite expensive. It is also a shot that has to be taken usually twice a day. The most common side effect is mild nausea which can become more significant and result in vomiting. Most patients I know have gotten through this okay but I do have patients who needed to stop it because of the nausea. The most important side effect to note is the risk of an inflammed pancreas which was just noted a few months ago, well after the drug had been on the market.

One quick word about inhaled insulin (I know, I said no talk of insulins just yet but I think this topic belongs here moreso than with the injectable insulins). A number of years ago, this was the great hope for diabetics everywhere, that we have an inhaled form of insulin available. No more injections!!!! Alas, this has not come to be as we had hoped. Inhaled insulin was in use for some time but it never quite took off in terms of popularity. That may surprise you – why wouldn’t anyone want this more than injected insulin? Well, the issue was both with what patients wanted and also what they needed. The device was somewhat cumbersome and had to be taken around with you (it looks like a very big asthma inhaler), and many folks found the size of the device to be a challenge. People complain about hiding their insulin syringes but then realized it is easier to hide a little syringe than this big tube. On the medical side, the tubes for use with the device came in pre-mixed and measured amounts of insulin and this proved difficult to adjust in terms of changing doses, and also a challenge when a high dose of insulin was needed. Of course, there was also higher cost involved. So doctors much preferred to just use the injections where you could adjust even by little amounts quite easily. So, unfortunately, we said adios to inhaled insulin a few months back when the manufacturer stated they would be taking it off the market for the time being It may be back in future, reformulated and repackaged, so don’t give up on the dream yet!

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227