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What is All are true about Exenatide except aEUR' and explain in detail?
Used in type I diabetes mellitus Exenatide belongs to class of drugs called "incretins". Incretins are insulin stimulation hypoglycemic factor found in the duodenum. - Incretin hormones are produced in the gastrointestinal tract in response to nutrient entry. Incretins, in turn, stimulate insulin, secretion. - Glucagon like polypeptide (GLP-1) and gastric inhibitory polypeptide (GIP) are two examples of incretins. Glucagon like peptide (GLP-1) is a naturally occurring peptide that enhances insulin secretion in response to raised plasma glucose concentrations. It can lower blood glucose level by other methods too. It does so by: ? - Increasing the secretion of insulin from the pancreas. - Slows absorption of glucose from the gut. - Reduces the action of glucagon (Glucagon increases glucose production by liver). These actions of GLP-1 lead to lowering of blood sugar levels. Thus, the compound has unique propeies to reduce postprandial glucose level. But these propeies are offset by very impoant adverse effect. - GLP-1 is rapidly (1-2 minutes) deactivated by the dipeptidyl peptidase IV DPP (IV) enzyme. Thus GLP-1 must be infused continuously to have therapeutic benefits. Consequently, considerable work has been performed to produce GLP- 1 receptor agonist that maintain the physiological effects of native incretin but are resistant to the action of DPP IV. Exenatide is a synthetic GLP-1 receptor agonist that is resistant to DPP-IV and has full agonistic activity for GLP-1 receptors. Exenatide is approved only for use as an adjunctive therapy to improve glycemic control in patients with type 2 diabetes mellitus who are taking metformin, sulfonylurea or a combination of both hut have not achieved adequate glycemic control. -This drug is effective in lowering glycosylated hemoglobin concentration and promotes weight loss in type 2 diabetes mellitus. Exenatide is injected "subcutaneously" within 60 minutes before meal. - When exenatide is added to preexisting sulfottylurea therapy the oral hypoglycemic dosage should be reduced to prevent hypoglycemia.