Who Cares About Gila Monster Spit?
  Contributed by: Matt Groh, Pharm.D. Candidate
                        UMKC School of Pharmacy

All Type 2 diabetics should pay close attention to gila monster spit.  Byetta (exenatide injection) is a medication commonly used by Type 2 diabetics.  This drugs was originally identified from saliva of gila monsters.  Byetta is now a man-made protein drug that helps Type 2 diabetics control their blood sugar levels.

What is diabetes?
Diabetes is a disease of either insufficient insulin production from the pancreas or the body has diminished capacity to use insulin the pancreas produces.  Insulin is vital for controlling blood sugar in our bodies.  Over time abnormally high blood sugar levels can lead to heart attack, stroke, blindness, kidney failure, or limb amputation.

How does Byetta help control blood sugar?
Byetta enhances glucose-dependent insulin secretion from the pancreas.  Byetta helps suppress the bodies normal rise in blood sugar by decreasing glucagon secretion and slows the time food stays in the digestive tract, meaning we feel hungry less often.  This helps improve glycemic control by reducing fasting and after meal blood sugar levels.

How is Byetta administered?
Byetta is supplied as a subcutaneous injection in a sterile glass cartridge that is assembled into a pen-injector.  Byetta is administered in the same manner as injectable insulin.  Each prefilled pen deliver 60 doses to provide 30 days of twice daily administration.  It should be administered in the thigh, abdomen, or upper arm at any time within the 60-minute period before the morning and evening meals (or before the two main meals of the day, approximately 6 hours or more apart).  Byetta should not be administered after a meal.  If a dose is missed, do not double up on the dose or give an extra shot, resume with the normal schedule before the next meal.

Can Byetta be taken with other diabetic medications?
Byetta is indicated as add-on therapy to improve glycemic control in the patients who are already taking metformin, a sulfonylurea (ex, glipizide, glimiperide, or glyburide), a thiazolidinedione (ex, Actos (pioglitazone) or Avandia (rosiglitazone), and any combination of metformin with any of the previously listed drugs.  Byetta could be added if the combination therapy was not achieving established glycemic goals.

Who should not receive Byetta?
Patients with Type I diabetes, end-stage renal disease, or severe digestive tract problems should not receive Byetta.  Byetta in combination with metformin did not increase the number of hypoglycemic events.  However, patients using Byetta and the other anti-diabetic agents listed previously should be aware of the potential for hypoglycemic events.  Therefore patients need to be able to recognize and treat hypoglycemia if they are on Byetta.

For additional information talk with your pharmacist or physician or visit www.byetta.com.