Amylin Pharmaceuticals and Eli Lilly released Byetta, a prescription drug, in June 2005. The use of Byetta for diabetes is limited to type 2 and should not be used for type 1 patients who require insulin therapy. Byetta is normally prescribed to type 2 patients who are unable to control their blood sugar with metformin. The active ingredient in Byetta is the synthetic protein exenatide, which encourages digestion and the production of insulin by mimicking the natural hormone GLP-1. The patient administers doses of Byetta, at home, twice daily, injecting into the skin of the arm, belly or thigh. Byetta should never be injected after a meal. Initial doses are 5 mcg with the possibility of increasing the dose to 10 mcg after one month of treatment.
Byetta for Diabetes – Weight Loss
One of the unexpected side effects of Byetta is significant weight loss, an attractive idea for many diabetics who are over weight or obese. A New York Times article describes Byetta’s ability to shed weight leading to speculation of its use as a weight loss drug. In a clinical trial of Byetta versus insulin on 537 patients found the Byetta patients lost an average of five or six pounds after six months while insulin patients gained four. In another clinical trial Byetta patients lost an average of 12 pounds after two years on the drug with weight loss increasing the longer they were on the drug. The reasons for the weight loss are unclear though Byetta slows the movement of food from the stomach to the small intestine creating a feeling of “fullness”.
Diabetes – Byetta and Kidney Failure
In 2009 the FDA approved revisions of the labeling of Byetta for diabetes to include altered kidney function, including acute renal failure and insufficiency. The decision was based on the reporting of 78 cases of altered kidney function in patients from 2005 – 2008. A portion of the 78 cases had reported common side effects of the drug such as nausea, vomiting, and diarrhea. These side effects may in fact cause kidney failure if a patient becomes dehydrated due to vomiting. In total, 91% required hospitalization, 18% needed dialysis, two had kidney transplants, and four died. After hospitalization 80% of the 78 stopped taking Byetta for diabetes with half reporting improved kidney function after stopping the drug. All diabetic patients should be aware of the signs and symptoms of decreased kidney function and should be tested by their doctor before taking Byetta. A rare problem is pancreatitis. In 2008 there were 30 reports of acute pancreatitis and six hospitalizations due to hemorrhagic pancreatitis or necrotizing pancreatitis brought on by use of Byetta.
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