Diabetes

Question 1

Incretin Mimetics

Answer 1

Glucagon-like peptide-1 receptor agonist - exenatide - a synthetic GLP-1 analog.
Improve glycemic control in DM-2 with existing oral hypoglycemic medication (if struggling with glycemic control)

Question 2

Incretin mimetics / glucagon-like peptide-1 receptor agonist (GLP-1 RA) / exenatide / semaglutide

Answer 2

SubQ.
Rapid onset, excreted in urine, crosses placenta = caution with pregnancy.
Natural helper hormone that stimulates the pancreas to secrete the right amount of insulin based on recently eaten meal. Halts gluconeogenesis (liver). Slows gastric emptying, enhances satiety > less eating = potential weight loss.

Question 3

Incretin mimetics / glucagon-like peptide-1 receptor agonist (GLP-1 RA) / exenatide / semaglutide

Answer 3

If oral medications, diet, and exercise are not meeting A1c goals. Exenatide can be taken with sulfonylureas, metformin, and/or thiazolidinediones.
Can be a monotherapy with diet and exercise for newly diagnosed DM-2.

Question 4

Incretin mimetics / glucagon-like peptide-1 receptor agonist (GLP-1 RA) / exenatide / semaglutide

Answer 4

Major ADEs are hypoglycemia, GI distress, and nausea. A rare serious side effect is acute pancreatitis.
Do not combine with statins if liver disease or elevated liver enzymes.
Black Box Warning - C-cell thyroid cancer > monitor for thyroid nodules. Contraindicated for family history of endocrine cancer.

Question 5

Incretin mimetics / glucagon-like peptide-1 receptor agonist (GLP-1 RA) / exenatide / semaglutide

Answer 5

My reduce absorption of other meds due to slowed gastric emptying.
SubQ twice a day within 1 HOUR of morning and evening meals. NO adjustment for food or blood glucose.
Assess fasting, preprandial, and postprandial blood glucose. Assess for A1c improvement.