Exenatide: clinical aspects of the first incretin-mimetic for the treatment of type 2 diabetes mellitus.
BACKGROUND
Exenatide is the first-in-class incretin mimetic for the treatment of type 2 diabetes.


OBJECTIVE
To assess exenatide's mechanism of action, therapeutic and adverse effects.


METHODS
Pharmacokinetics and pharmacodynamics of exenatide were reviewed, as well Phase I, II and III clinical trials, and postmarket reports.


CONCLUSIONS
Exenatide improves fasting plasma glucose and HbA1c in type 2 diabetic patients not controlled on other antidiabetic drugs, due to its effects on glucose-dependent stimulation on insulin secretion, suppression elevated glucagon secretion, slowing the accelerated rate of gastric emptying, reduction of food intake and possible beta-cell preservation. Nausea and vomiting were the most common and dose-related side effects. Rare reports of acute pancreatitis do not appear greater than the rate in the general population of patients with type 2 diabetes.
Wajcberg
Estela
E
Seton Hall University, Trinitas Hospital, Internal Medicine Department, 330 West Jersey Street ap. 7-O, 07202, Elizabeth, NJ, USA. ewajcberg@yahoo.com
Tavaria
Ashdin
A
D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D000077270:Exenatide; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D054795:Incretins / Q000378:metabolism*; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D010455:Peptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D014688:Venoms / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D054795:Incretins; D007328:Insulin; D010455:Peptides; D014688:Venoms; D000077270:Exenatide