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Two Type 2 Diabetes Drugs Compared, How Did They Do?

Two type 2 diabetes drugs

If you have type 2 diabetes, there are many drug treatment options at your disposal, and the numbers continue to grow. Two of the newer type 2 diabetes drugs, exenatide (Bydureon) and liraglutide (Victoza) were recently compared in a head-to-head study, so how did they do?

More type 2 diabetes drugs are available

If you and your doctor decide you need to take medications to help control blood sugar and other factors associated with type 2 diabetes, the number of available drugs keeps changing. This means you and your healthcare provider may need to review those options periodically, along with your diet and exercise program, to determine what approach is best for you.

Results of a 26-week direct comparison between exenatide and liraglutide were recently published in The Lancet, and the findings offer both pros and cons of each of the medications. For those unfamiliar with these drugs, here's a quick explanation.

Bydureon (exenatide) is an injectable drug and an extended-release form of exenatide, which is also available under the trade name Byetta. Exenatide helps control blood glucose levels and can be used along with other antidiabetes medications.

Victoza (liraglutide) also is an injectable medication, but it is administered daily. It quickly helps lower blood glucose levels and, like Bydureon, can be used along with other antidiabetes drugs. Both drugs are in a class known as glucagon-like peptide-1 receptor agonists.

A brief rundown of the study
The international study included 912 patients from 19 countries who were randomly assigned to receive injections of either liraglutide (once daily) or exenatide (once weekly) for 26 weeks. Researchers were looking for the overall reduction in hemoglobin A1c (HbA1c) levels from baseline.

By the end of the 26 weeks, 60 percent of the patients who had taken liraglutide and 53 percent of those who took exenatide achieved an HbA1c level of less than 7 percent. For individuals with type 2 diabetes, an HbA1c level of less than 7 percent is desirable, as the higher the percentage, the greater the risk of developing diabetes complications.

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Both drugs also helped participants lose body weight, which is a significant benefit for many people who are battling type 2 diabetes. Patients who took liraglutide lost about 2 pounds more than those who used exenatide.

When it came to side effects, patients who used exenatide reported fewer problems. Overall, 21 percent of liraglude users reported nausea versus 9 percent in the exenatide group. Liraglude users also were more likely to experience diarrhea (13% vs 6%) and vomiting (11% vs. 4%). Fortunately, the occurrence of side effects tended to reduce over time.

John B. Buse, MD, PhD, the study's first author and division chief of endocrinology and metabolism in the University of North Carolina School of Medicine, explained that these results can help physicians and patients when selecting antidiabetes medications. He called both agents "really good blood sugar-lowering drugs," and said that while liraglutide provided a weight loss advantage that could make this drug more favorable for some patients, exenatide has a "more favorable side effect profile."

Other type 2 diabetes treatment options
People who have type 2 diabetes can help manage their disease and potential complications with medications, lifestyle (diet, exercise, and weight control), and natural approaches. In this latter category, the list of possibilities keeps growing. One of those options is turmeric, which has been shown to reduce blood glucose levels.

Another possibility is cinnamon, which has demonstrated an ability to reduce levels of both blood glucose and triglycerides. Yet another natural supplement to explore may be bitter melon.

Type 2 diabetes patients have a wealth of treatment options, and for those who may require medication, the results of the latest comparison study of two type 2 diabetes drugs provide important information to consider.

Buse JB et al. Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes (DURATION-6): a randomised, open-label study. The Lancet 2012 Nov 7. DOI:10.1016/S0140-6736(12)61267-7

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