Exenatide is a synthetic biological compound that has been found to boost the number of insulin-producing cells in the pancreas in animal tests, and to enhance insulin output as glucose levels rise, the authors explain.

"Exenatide is a novel first-in-class therapeutic that addresses a large unmet need for patients with type 2 diabetes," Dr. Alain D. Baron explained to Reuters Health. "It is unique as the only anti-diabetic with glucose-lowering potential close to that of insulin with far less risk of hypoglycemia."

Dr. Baron and colleagues from Amylin Pharmaceuticals, Inc. in San Diego, California tested exenatide given by subcutaneous injections in over 100 patients whose type 2 diabetes was inadequately controlled with diet and an oral anti-diabetes drug.

Exenatide reduced blood levels of fructosamine, a measure of intermediate (2 weeks) glucose control, and hemoglobin A1c (HbA1C), a measure of longer-term (3 months) glucose control, the scientists report.

After 28 days of exenatide treatment, average glucose levels after a meal declined the researchers note, but average glucose levels while fasting did not change. Low blood sugar levels occurred only in those patients who were also treated with one particular type of oral drug (a sulfonylurea), the report indicates

Adding to the benefits, exenatide had no effect on body weight, fasting triglycerides, or any of the cholesterol measurements.

On the down side, nearly one in five patients given exenatide developed anti-exenatide antibodies (although there was no sign that this interfered with the effectiveness of treatment), and nausea was common, especially at the beginning of treatment.

"Nausea is largely centrally mediated, mild-to-moderate, and usually transient," Dr. Baron told Reuters Health. He said this problem can be eased by slowly increasing the dose of exenatide.

The study was funded by Amylin Pharmaceuticals, Inc.

Source: Yahoo News: Reuters Health: Diabetes Care, August 2003.