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Exenatide is a 39–amino acid peptide approved for the adjunctive treatment of type 2 diabetes. It is an incretin mimetic agent that is consistent in activity with the actions of glucagon-like peptide 1. Proposed mechanisms of action include enhanced glucose-dependent insulin secretion from pancreatic β-cells, restoration of first-phase insulin response, suppression of glucagon secretion, and delay of gastric emptying. Kendall et al. (1) found no evidence of cardiovascular, pulmonary, hepatic, or renal toxicities with exenatide. Nausea (39–48%) and hypoglycemia (19–27%) were the most common side effects reported. A 69-year-old man with type 2 diabetes of 15 years’ duration presented for follow-up. He had known diabetic neuropathy and retinopathy. His medical history was remarkable for coronary artery disease, gastroesophageal reflux disease, rheumatoid arthritis, and …
Denker et al. (Wed,) studied this question.