Exenatide for diabetes

About exenatide

L'insulina è un ormone prodotto naturalmente nel tuo corpo, nel pancreas. Aiuta a controllare i livelli di zucchero (glucosio) nel sangue. Se il tuo corpo non produce abbastanza insulina, o se non utilizza efficacemente l'insulina che produce, questo porta alla condizione chiamata diabete (diabete mellito).

People with diabetes need treatment to control the amount of sugar in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat but, for other people, medicines are given alongside the changes in diet. Exenatide is one of the medicines that are prescribed for people with diabete di tipo 2.

Exenatide works in three ways. It increases the amount of insulin produced by your body which then reduces the level of sugar in your blood. It also reduces the amount of a substance called glucagon being produced by your pancreas. Glucagon causes your liver to produce more sugar, so by reducing the amount of glucagon in your body, this also helps to reduce the levels of sugar in your blood. Exenatide also works on your stomach so that food passes more slowly through it. This means that the sugar from your meals takes longer to get into your blood.

Exenatide is given as an injection just under the surface of the skin. It is administered using a syringe and needle or by using an injection device called a pre-filled pen. It is used in addition to other antidiabetic medicines. There are two types of exenatide injection available. There is a standard-release injection (brand name Byetta®) which is given twice daily, and there is a prolonged-release injection (brand name Bydureon®) which is given once a week.

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using exenatide it is important that your doctor knows:

• Se sei incinta, stai cercando di avere un bambino o stai allattando.

• If you have a problem with your stomach or digestive system.

• If you have ever had an inflamed pancreas (pancreatitis).

• Se hai problemi con il funzionamento dei tuoi reni.

• Se stai assumendo altri medicinali. Questo include qualsiasi medicinale che stai assumendo e che è disponibile per l'acquisto senza prescrizione medica, così come i medicinali a base di erbe e complementari.

• Se hai mai avuto una reazione allergica a un medicinale.

• Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack as well as any information you are given by your doctor or diabetes clinic. The manufacturer's leaflet will provide you with a full list of the side-effects which you may experience.

• Use exenatide exactly as your doctor tells you to. Your doctor or diabetes nurse will show you how to inject yourself. Exenatide should be injected into the skin on your upper arms, thigh, or tummy (abdomen). Try to choose a slightly different injection site for each of your injections as this will help to prevent skin problems and difficulties in injecting.

• If you are using Byetta®, you will be advised to inject two doses a day. You should have each injection within the 60-minute period before a main meal, and the two doses should be at least six hours apart. The best way to achieve this is to have your first injection during the hour before your first meal of the day, and the second injection during the hour before your evening meal.

• If you forget to use exenatide before a meal, do not inject it after you have eaten, but instead just wait until your next dose is due.

• If you are using Bydureon®, you will be advised to inject one dose a week, on the same day of each week. Each pre-filled pen provides a single dose. The injection can be given at any time of the day, and it can be given either before or after a meal. If you forget to use the injection on your usual day, use it as soon as you remember and keep to your normal weekly schedule. However, if your next scheduled dose is due within three days, miss out the forgotten dose and take your next dose when it is due.

• È importante che mantieni i tuoi appuntamenti regolari con il medico e la clinica. Questo è necessario affinché i tuoi progressi possano essere monitorati. Avrai bisogno di controlli regolari presso una clinica oculistica e una clinica podologica, oltre che con il tuo medico e la clinica per il diabete.

• Il tuo medico potrebbe raccomandarti di controllare regolarmente il livello di zucchero (glucosio) nel sangue o nelle urine per verificare che il tuo diabete sia sotto controllo. Il tuo medico o l'infermiere specializzato in diabete ti mostrerà come fare.

• Se il tuo medico ti ha dato consigli su cambiamenti nella tua dieta, smettere di fumare o fare esercizio fisico regolare, è importante che segui i consigli che ti sono stati dati.

• Each time you collect a prescription, check that you have been given the brand and strength of exenatide that you are expecting. If anything looks different from what you have had before, ask your pharmacist to check the prescription for you.

• Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia, or a 'hypo'. Although exenatide is unlikely to cause low blood sugar, other medicines that you are taking for diabetes alongside it may. The first signs of hypoglycaemia are feeling shaky or anxious, sweating, looking pale, feeling hungry, having a feeling that your heart is pounding (palpitations), and feeling dizzy. If this happens, eat something containing sugar, such as dextrose tablets, jelly babies or a sugary drink (non-diet), and then follow this up with a snack such as a sandwich or a banana.

• Se sei un conducente, dovresti prestare particolare attenzione, poiché la tua capacità di concentrazione potrebbe essere compromessa se il tuo diabete non è ben controllato. Potresti essere consigliato di controllare i livelli di zucchero nel sangue prima di viaggiare e di avere uno spuntino con te durante i lunghi viaggi.

• Non bere alcolici, poiché possono influire sul controllo della glicemia. Chiedi al tuo medico se hai bisogno di ulteriori consigli su questo.

• Se avverti una sete insolita, urini più frequentemente del normale o ti senti molto stanco, dovresti informare il tuo medico. Questi sono segni che c'è troppo zucchero nel sangue e il tuo trattamento potrebbe necessitare di un aggiustamento.

• Consulta il tuo medico prima di iniziare qualsiasi nuovo esercizio fisico, poiché questo avrà un effetto sui tuoi livelli di zucchero nel sangue e potresti dover controllare i livelli di sangue o urina più regolarmente.

• If you are due to have an operation or dental treatment, you should tell the person carrying out the treatment that you have diabetes and give them a list of the medicines you are taking.

• This medicine should not be used during pregnancy. Women and girls of childbearing potential must use effective contraception during treatment and for two months after stopping.

• If you buy any medicines, always check with a pharmacist that they are suitable for you to take. Exenatide can interfere with the way some other medicines are absorbed. Because of this, some medicines should not be taken during the hour before exenatide is given, or during the four hours after it has been given.

• Treatment for diabetes is usually lifelong. Continue with exenatide unless you are told otherwise by your doctor.

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with exenatide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

If you experience any other symptoms which you think may be due to the injections, speak with your doctor or pharmacist for further advice.

• Tenere tutti i medicinali fuori dalla portata e dalla vista dei bambini.

• Exenatide can be kept for four weeks at room temperature as long as this is below 25°C and it is kept away from direct heat and sunlight. It is, however, best to store unopened packs in a refrigerator. Do not freeze exenatide.

• Byetta® pens must be discarded 30 days after being first used.

• Bydureon® pens are for single use only and should be discarded after first use.