Updated March 17, 2015.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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 ~5lbs by month 6 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.

 

Bydureon and Blood Sugar Control: 

While clinical trials have shown that treatment with Bydureon can help to reduce A1c by about 1.5%, 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 sulfanylurea. If you are taking a sulfanylurea, 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. 

How Do You Take Bydureon: 

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 (2 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.

To view a video on how to use the new pen device go here: http://www.bydureon.com/?

Side Effects of Bydureon: 

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. 

Who is a Candidate for Bydureon? 

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. 

Who Should Not Take Bydureon? 

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). Persons with sensitivity to exenatide or to any product components should also not take Bydureon. Lastly, 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 health care provider immediately as this maybe a sign of pancreatitis. Bydureon is not meant for patients with Type 1 diabetes. 

Is This the Only Once Weekly Injectable Medication? 

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. 

Resources: 

Wysham, Carol, et. al. DURATION-NEO-1: greater HbA1c reductions with exenatide suspension once weekly by autoinjector pen vs exenatide twice daily in inadequately controlled type 2 diabetes || Oral Presentation #244 Accessed on-line. September 29, 2014: http://www.easdvirtualmeeting.org/resources/19012

AstraZeneca .The Official Patient Website: Bydureon. Accessed on-line. September 28, 2014: http://www.bydureon.com/?utm_source=google&utm_medium=cpc&utm_campaign=brandedgeneral&utm_term=bydureon&utm_content=core_textad_Home_text

Ahren, B & Schmitz, O. GLP-1 receptor agonists and DPP-4 inhibitors in the treatment of type 2 diabetes. Horm Metab Res. 2004 Nov-Dec;36(11-12):867-76. Accessed on-line. September 24, 2014: http://www.ncbi.nlm.nih.gov/pubmed/15655721

Reid, Timothy, MD. Choosing GLP-1 receptor agonists or DPP-4 inhibitors: weighing the clinical evidence. American Diabetes Association. Accessed on-line. September 25, 2014: http://clinical.diabetesjournals.org/content/30/1/3.full

Food and Drug Administration. Bydureon - Medication Guide. Accessed on-line. September 25, 2014: http://www.fda.gov/downloads/Drugs/DrugSafety/UCM289869.pdf

Drugs.com. BYDUREON improved A1C, fasting glucose, pulse pressure and weight regardless of baseline body weight in patients with type 2 diabetes. Accessed on-line. September 27, 2014: http://www.drugs.com/clinical_trials/bydureon-improved-a1c-fasting-glucose-pulse-pressure-weight-regardless-baseline-body-weight-13825.html

Cliff, David. Clock is ticking for AstraZeneca. Forbes. Accessed on-line. September 27, 2014: http://www.forbes.com/sites/greatspeculations/2014/02/25/clock-is-ticking-for-astrazeneca/