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What is a GLP- 1 agonist (Exenatide or Liraglutide)?

Exenatide (Byetta) or Liraglutide (Victoza)

Exenatide (Byetta) and Liraglutide (Victoza) are the first type of medication in a class of drugs called 'incretin mimetics' called GLP-1 agonist.  They are different from diabetes tablets and insulin injections. Although it is taken by injection it is not insulin.

How does it work?

Each GLP-1 agonist is produced synthetically and works in four different ways:

  1. Helps your body produce more insulin when it is needed.
  2. Reduces the amount of glucose being produced by the liver when it is not needed.
  3. Reduces the rate at which your stomach digests foods and empties. This means that the rate at which glucose from your food is released into your blood is reduced.
  4. Reduces appetite and the amount of food you eat.

How do I take it?

Both treatments cannot be taken like a tablet because it is a protein. If it was taken as a tablet it would be digested in your stomach. It comes in a pre-filled injection pen that uses a small needle and contains enough medication for 30 days. 

How much do I take and when do I take it?

You will usually start you off on a small dose taken either once or twice a day for 2 - 3 weeks and then the dose is increased. You will be informed as to how to take the medication with regards time of day and meals.

Are there any side effects?

The most common side effect of this medication is nausea, which tends to go away with time for most people. Taking it may make you feel less hungry and eat less so many people find that they lose weight as a result. If you are trying to lose weight then this may be a welcomed side effect. Weight is a significant factor in helping you control your blood glucose, blood fats and blood pressure levels as well as reducing your risk of heart disease.

Neither treatment will increase the chance of you having hypoglycaemia (low blood glucose levels) unless you are taking sulphonylurea tablets (e.g.Gliclazide). Your healthcare team can tell you more about whether you are at risk of hypos. Other side effects include vomiting, diarrhoea, dizziness, headache, feeling jittery and having an acid stomach. If you experience any side effects discuss them with your diabetes specialist nurse.

Information from Diabetes UK

Starting a GLP - 1 agonist treatment (Exenatide or Liraglutide) in Salford

All patients with a Salford GP who are looking at starting this treatment MUST complete the 6 week X-PERT programme where they will then be taught how to inject themselves and guidance will be given on expected weight loss and reduction in HbA1c and if this is not achieved in 6 months then treatment will be stopped.

If people have unmanagable side effects or the treatment does not improve HbA1c despite weight loss, then the treatment will be stopped and referral should be made to the Diabetes Team for assessment to commence insulin.

The following guidance is provided by Medicines Management for commencing GLP-1 treatment and the treatment pathway is included in the guidance 

Refer for the GLP-1 X-PERT programme of education using the referral forms via Choose and Book stating that the patient is being referred for the GLP-1 start.