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Exenatide (Byetta) and Weight Loss?

Exenatide (Byetta) and Weight Loss?

Byetta and Weight Loss

Exenatide (Byetta) is an injectable drug used by patients with type 2 diabetes to help control blood sugar levels.  One of the side effects of Exenatide is its effects on weight loss.  For those with type 2 diabetes, lowering their body mass index is one of the objectives to help control their blood pressure, cholesterol levels, and insulin resistance.

A new study published in the American Journal of Medicine, studied the effects of Exenatide plus lifestyle changes vs. lifestyle changes plus placebo on weight loss in overweight or obese patients with type 2 diabetes (apovian et al, 2010).

Study Design:

  • 24-week, multicenter, randomized, double-blind, placebo-controlled study which included 194 patients.
  • lifestyle modification program consisting of a 600 kcal/day caloric deficit combined with at least 2.5 hours per week of physical activity.
  • patients were randomized to receive 5 micrograms Exenatide injection twice daily or placebo.
    • after 4 weeks, this dose was increased to 10 micrograms

Results:

  • Exenatide + lifestyle modification program showed greater change in weight (-6.16 +/- 0.54 kg vs -3.97 +/- 0.52 kg, P = .003)
  • hemoglobin A(1c) (-1.21 +/- 0.09% vs -0.73 +/- 0.09%, P <.0001)
    • [hemogloin A(1c) is a measure of long-term glycemic control.]
  • systolic (-9.44 +/- 1.40 vs -1.97 +/- 1.40 mm Hg, P <.001) and diastolic blood pressure (-2.22 +/- 1.00 vs 0.47 +/- 0.99 mm Hg, P = .04).
  • nausea was reported more as a side effect for Exenatide group than placebo (44.8 vs. 19.4%)

Study Conclusions:

“When combined with lifestyle modification, Exenatide treatment led to significant weight loss, improved glycemic control, and decreased blood pressure compared with lifestyle modification alone in overweight or obese participants with type 2 diabetes on Metformin and/or sulfonylurea treatment.”

Exenatide Side Effects:

Nausea is the most common side effect of Exenatide.  Other previously reported side effects include:

  • hypoglycemia
  • vomiting
  • diarrhea
  • headache
  • decreased appetite
  • acid reflux
  • there have been reports of acute pancreatitis

Reference:

  1. Apovian CM, Bergenstal RM, Cuddihy RM, Qu Y, Lenox S, Lewis MS, Glass LC.  Effects of exenatide combined with lifestyle modification in patients with type 2 diabetes.  Am J Med. 2010 May;123(5):468.e9-17.

5 Comments

  • naveen

    Nice Post. Pancreatitis is the most important side effect to be noted. Indeed FDA has issued a public note on the same for the byetta users.

  • Jarret Morrow, M.D.

    Naveen, thanks for your comment. Yes, pancreatitis can be a potentially very serious side effect from taking Byetta. There have been case reports of in the literature of either hemorrhagic or necrotizing pancreatitis (more severe forms of pancreatitis) with some cases resulting in death. Patients who have a history of pancreatitis should not take Byetta and if it suspected, the drug should be discontinued and not restarted. The FDA has also issued warnings about acute renal failure and insufficiency from patients taking Byetta.

  • naveen

    Thanks for the additional information Dr. Morrow. I have managed a Phase III clinical trial with Byetta as the investigational product, and, it was interesting.

  • PennStateDoc

    I've been on Byetta since I was diagnosed with Type 2 in February (2011). In these few months, I've lost about 20-30lbs. What I would like to note is that the nausea is SERIOUS. I feel sick on the stomach most of the time, which causes me not to eat much. At times, I wonder if I'm actually eating enough. At the time of diagnosis I was 193lbs (but I had started losing 2lbs a day, so I knew something was wrong), after spending 6 days in the hospital, I was released at a whooping 225lbs. Yep, I gained about 30lbs in just SIX days. (I was told that the weight gain was from the insulin-but I have no clue) I'm now down to 198lbs, thanks to Byetta. I hope to be off Byetta by the end of the summer. It's been nice, but I'd love to only have to take a pill. My breakfast and dinner revolve around Byetta. I can't eat within 15 minutes of taking it, but I have to eat within an hour. The timing sucks when you're at the dinner table watching everyone else eat while you're looking at your watch waiting for 15 minutes to pass.

  • kim howard

    my mum has type 2 diabetes she has bin taking byetta for 1 month now and has lost a stone in weight im wondering is this healthy for someone 2 loose so much weight in so little time. would byetta work on someone that hasnt got diabetes ?

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