Incretin Mimetics (GLP-1 Agonists)

An injectable drug for patients unable to control diabetes with tablet medication
An injectable drug for patients unable to control diabetes with tablet medication

Incretin mimetics are a relatively new group of injectable drugs for treatment of type 2 diabetes.

The drugs, also commonly known as glucagon-like peptide 1 (GLP-1) receptor agonists or GLP-1 analogues, are normally prescribed for patients who have not been able to control their condition with tablet medication.

Drugs in this class

In the UK, the following incretin mimetics are available for type 2 diabetic patients - (trade name first, generic name in brackets):

  • Bydureon (Exenatide) - taken once weekly
  • Byetta (Exenatide) - taken twice daily
  • Lyxumia (lixisenatide) - taken once daily
  • Trulicity (Dulaglutide) - taken once weekly
  • Victoza (Liraglutide) - taken once daily

Byetta and Bydureon are the same medical drug. The only difference is that Bydureon is long-lasting, requiring only one injection per week, whereas Byetta is taken twice-daily due to its much shorter-term effects.

How do they work?

They work by copying, or mimicking, the functions of the natural incretin hormones in your body that help lower post-meal blood sugar levels. These functions include:

  • Stimulating the release of insulin by the pancreas after eating, even before blood sugars start to rise.
  • Inhibiting the release of glucagon by the pancreas. Glucagon is a hormone that causes the liver to release its stored sugar into the bloodstream.
  • Slowing glucose absorption into the bloodstream by reducing the speed at which the stomach empties after eating, thus making you feel more satisfied after a meal.

These effects are in direct response to the presence of carbohydrate in the gut and therefore the chance of significant hypoglycemia occurring is unlikely, unless used in combination with other hypoglycemic drugs.

Benefits of incretin mimetics

By increasing insulin secretion and inhibiting glucagon release, incretin mimetics have blood glucose-lowering effects which help to reduce your HbA1c.

They have also been shown in clinical research studies to be beneficial in losing weight, compared with a placebo, when used in combination with diet and exercise.

Side effects

Possible side effects of incretin mimetics include:

  • diarrhoea
  • nausea
  • vomiting
  • headaches
  • dizziness
  • increased sweating
  • indigestion
  • constipation
  • loss of appetite
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