New drug formulation brings hope of weekly jab for diabetics

Researchers from the University of Toronto have developed a new long-acting formulation of the incretin mimetic exenatide (Byetta®), which appears to offer better control of blood glucose levels than the current regimen of twice-daily injections. Thus, suggesting that it may soon be possible to control type 2 diabetes with a once-weekly injection.

The 295 study participants were given either a once-weekly injection of the long-acting form of exenatide or were asked to continue with their twice-a-day injection for 30-weeks. The researchers looked at hemoglobin A1c (HbA1c) levels, which gives an indication of average plasma glucose concentration over prolonged periods of time, to determine the effectiveness of both methods of treatment. Lower levels of HbA1c are desirable as they suggest that blood glucose levels are being controlled effectively.

Results showed that there was a bigger average drop in HbA1c levels in participants given the once-a-week injection than in those who continued with their normal management routine of twice-daily injections. A higher proportion of the participants given the once-a-week injection also achieved target HbA1c levels of 7.0% or less. Furthermore, the once-a-week injection was associated with fewer side effects.

The authors conclude: "Exenatide once weekly resulted in significantly greater improvements in glycemic control than exenatide given twice a day, with no increased risk of hypoglycaemia and similar reductions in bodyweight."

Drucker DJ, Buse JB, Taylor K, Kendall DM, Trautmann, Zhuang D PhD, Porter L, for the DURATION-1 Study Group. Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non-inferiority study. The Lancet Early Online Publication, 8 September 2008. DOI:10.1016/S0140-6736(08)61206-4.