Once-weekly diabetes treatment?   (June 17, 2008)

[Editor's Note: Once-weekly exenatide (brand name Bydureon) was approved by the FDA in January 2012. See FDA Approves BYDUREON™ -- The First and Only Once-Weekly Treatment for Type 2 Diabetes]

For most patients with diabetes, treatment is something you do not just every day, but multiple times daily: you have to think about the effects on your blood sugar of every meal you eat, it's recommended to check blood glucose tests several times daily, and most folks with diabetes take pills or shots once or more daily. So the possibility of a once-a-week medication for type 2 diabetes is intriguing. And it's just possible that it will be available in the foreseeable future: Amylin and Lilly have just announced the results of a one-year study of a long-acting version of their drug Byetta (exenatide): After One Year, Type 2 Diabetes Patients Taking Exenatide Once Weekly Sustained Improvements in Glycemic Control and Weight; DURATION-1 Presented at ADA 2008. The study showed that exenatide, injected once weekly in a long-acting release formulation, could maintain control of blood glucose levels, and sustain the weight loss that frequently accompanies Byetta treatment. No new safety issues were uncovered using this formulation: in fact, the nausea which is the most frustrating side effect for many patients, occurred less frequently in exenatide once weekly patients. It's being speculated that once-weekly Byetta may be on the market sometime next year if additional studies continue to show its efficacy and safety.

Will once-weekly shots of a diabetes medication prove to be a winner for Byetta? Based on lots of wishful thinking I've read from twice-daily Byetta users and bloggers, I suspect the answer will be a definite yes from those folks: and the study showed transitioning from daily to weekly Byetta works just fine.

But will other patients with type 2 diabetes be tempted to give up their every-day pills or every-day insulin shots to try once-weekly therapy? Only time will tell. Other medications have been developed with extended duration of action: the drugs for osteoporosis prevention come in once daily, once weekly, and even once monthly versions. Will that be the model for future therapy for type 2 diabetes also?

Maybe someday one injection (or even better, one pill) will control blood glucose for a week or even longer... wouldn't that be nice?