Incretin Related Drugs and Diabetes
Victoza and Byetta have a similar mechanism of action, and actually we can compare these to the DDP-4 inhibitors as well. These drugs are GLP-1 analogs which is similar to an incretin hormone in the body. Per Lexi-comp, incretin increases glucose-dependent insulin release, decreases glucagon secretion, increases B-cell growth and replication, slows gastric emptying, and decreases food intake (i.e. promotes being full). The difference between the DPP-4 inhibitors and GLP-1 analogs is that DDP-4 inhibitors actually help preserve the body’s own incretin hormones while the GLP-1 analogs are actually supplemental incretin type hormones. There are some special storage requirements for the GLP-1 analogs so we need to remember to look at this. Both Victoza and Byetta are very expensive so they will not be the first drugs used for diabetes management and another thing discouraging use is that they are an injection. One advantage of Victoza over Byetta is that it is a once daily drug vs. a twice daily drug. I don’t recall that I’ve ever seen Bydureon utilized so far (once weekly injection). This is only speculation, but the long acting nature of the drug while may be advantageous as far as less frequent dosing, may scare some providers off – i.e. if side effects encountered, the drug will be in the system for at least a week.