Online Professional Education
View professional education presentations discussing type 2 diabetes and BYETTA treatment.
Current Offerings
Title: A Partner for Insulin Glargine in the Treatment of Type 2 Diabetes
Format: On-demand web presentation
Description: Dr. Patrick J. Boyle (University of New Mexico) introduces a complementary approach to glycemic control for type 2 diabetes patients not at goal on insulin glargine.
Title: Making an Impact on Type 2 Diabetes
Format: On-demand web presentation
Description: In this 3-part series, Dr. Linda Gaudiani (University of California, San Francisco) reviews current guidelines in managing diabetes treatment goals through Medical Nutrition Therapy, its practical application, and the use of incretin-class drugs.
Part 1: Importance of Medical Nutrition Therapy (MNT) and Lifestyle Management
The first presentation of the series helps identify the struggles patients face regarding lifestyle management. Dr. Gaudiani offers healthcare practitioners strategies to successfully address them.
Part 2: Practical Application of Medical Nutrition Therapy (MNT)
Listen as Dr. Gaudiani addresses common nutrition myths, reviews nutritional guidelines, and provides practical tips for helping patients manage type 2 diabetes with medical nutrition therapy.
Part 3: The Helper Hormone
Dr. Gaudiani highlights the potential benefits of an incretin-class treatment when Medical Nutrition Therapy (MNT) is not sufficient.
Title: Managing Type 2 Diabetes Mellitus: A Closer Look
Format: On-demand web presentation
Description: This program explores the clinical use of an incretin-based therapy for the management of patients with type 2 diabetes mellitus. Dr. Patrick J. Boyle (University of New Mexico) explores the use of insulin glargine in combination with this incretin-based therapy.
Indication and Usage
BYETTA is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
- Not a substitute for insulin and should not be used in patients with type 1 diabetes or diabetic ketoacidosis.
- Concurrent use with prandial insulin cannot be recommended.
- Has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk for pancreatitis while using BYETTA; consider other antidiabetic therapies for these patients.
Important Safety Information for BYETTA® (exenatide) injection
Contraindications
- BYETTA is contraindicated in patients with prior severe hypersensitivity reactions to exenatide or to any of the product components.
Warnings and Precautions
- Based on postmarketing data BYETTA has been associated with acute pancreatitis, including fatal and non-fatal hemorrhagic or necrotizing pancreatitis. After initiation and dose increases of BYETTA, observe patients carefully for pancreatitis (persistent severe abdominal pain, sometimes radiating to the back, with or without vomiting). If pancreatitis is suspected, BYETTA should be discontinued promptly. BYETTA should not be restarted if pancreatitis is confirmed.
- Increased risk of hypoglycemia when used in combination with glucose-independent insulin secretagogues (eg, sulfonylureas); reduction of the sulfonylurea dose may be needed. When used with insulin, evaluate and consider reducing the insulin dose in patients at increased risk of hypoglycemia.
- Postmarketing reports of altered renal function, including increased serum creatinine, renal impairment, worsened chronic renal failure, and acute renal failure, sometimes requiring hemodialysis and kidney transplantation. BYETTA should not be used in patients with severe renal impairment or end-stage renal disease. Use with caution in patients with renal transplantation or when initiating or escalating the dose in patients with moderate renal failure.
- Not recommended in patients with severe gastrointestinal disease (eg, gastroparesis).
- Patients may develop antibodies to exenatide. In 3 registration trials, antibody levels were measured in 90% of patients, with up to 4% of patients having high-titer antibodies and attenuated glycemic response. If worsening of or failure to achieve adequate glycemic control occurs, consider alternative antidiabetic therapy.
- Postmarketing reports of serious hypersensitivity reactions (eg, anaphylaxis and angioedema). If this occurs, patients should discontinue BYETTA and other suspect medications and promptly seek medical advice.
- No clinical studies establishing conclusive evidence of macrovascular risk reduction with BYETTA or any other antidiabetic drug.
Adverse Reactions
- Most common adverse reactions in registration trials associated with BYETTA vs placebo (PBO): nausea (44% vs 18%), vomiting (13% vs 4%), and diarrhea (13% vs 6%). Other adverse reactions ≥5% and more than PBO: feeling jittery, dizziness, headache, and dyspepsia. With a thiazolidinedione (TZD), adverse reactions were similar; as monotherapy, most common was nausea (8% vs 0%). With insulin glargine: nausea (41% vs 8%), vomiting (18% vs 4%), diarrhea (18% vs 8%), headache (14% vs 4%), constipation (10% vs 2%), dyspepsia (7% vs 2%), asthenia (5% vs 1%).
- Hypoglycemia incidence, BYETTA vs PBO, with metformin (MET): 5.3% (10 mcg) and 4.5% (5 mcg) vs 5.3%; with SFU, 35.7% (10 mcg) and 14.4% (5 mcg) vs 3.3%; with MET + SFU, 27.8% (10 mcg) and 19.2% (5 mcg) vs 12.6%; with TZD, 10.7% (10 mcg) vs 7.1%; as monotherapy, 3.8% (10 mcg) and 5.2% (5 mcg) vs 1.3%; with insulin glargine, 24.8% (10 mcg) vs 29.5%.
- Withdrawals: as monotherapy, 2 of 155 BYETTA patients withdrew due to headache and nausea vs 0 PBO; with MET and/or SFU vs PBO, nausea (3% vs <1%) and vomiting (1% vs 0); with TZD ± MET, nausea (9%) and vomiting (5%), with <1% of PBO patients withdrawing due to nausea; with insulin glargine vs PBO, nausea (5.1% vs 0), vomiting (2.9% vs 0).
Drug Interactions
- BYETTA slows gastric emptying and can reduce the extent and rate of absorption of orally administered drugs. Use with caution with medications that have a narrow therapeutic index or require rapid gastrointestinal absorption. Medications dependent on threshold concentrations for efficacy should be taken at least 1 hour before BYETTA.
- Postmarketing reports of increased international normalized ratio (INR) sometimes associated with bleeding with concomitant use of warfarin. Monitor INR frequently until stable upon initiation or alteration of BYETTA.
Use in Specific Populations
- Based on animal data, BYETTA may cause fetal harm and should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- Caution should be exercised when administered to a nursing woman.
- Safety and effectiveness have not been established in pediatric patients.
For complete safety profile and other important prescribing considerations, see the Prescribing Information and Medication Guide.
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