Byetta

The drug Byetta (exenatide) mimics the hormone GLP-1 (glucagonlike peptide-1). Byetta is made by Amylin Pharmaceuticals and is generally prescribed for twice daily injection for type 2 diabetes. In a recent study, Byetta achieved reduction in A1c levels of over 1% which is comparable to results observed with insulin therapy in combination with sulfonylurea and metformin.

To diabetics who must self-inject twice per day, a once daily dosing schedule can be a huge benefit. Several drug companies are at work on once daily insulin dosing schedules, so be on the lookout for updates on this topic.

Januvia and Janumet

The drug Januvia (Sitagliptin) is a relatively new DPP-IV inhibitor by OSI Pharmaceuticals that is approved for once-daily dosing. Januvia has been shown to reduce A1c levels up to 1% and to reduce fasting plasma glucose levels (FPG) by about 15 mg/dL. Unlike insulin therapy, DPP-4 inhibitors work by enhancing the body's natural ability to lower blood sugar levels.

Combined sales of Januvia and Janumet for diabetes run about $3 billion per year for Merck who markets these drugs (2010).

Liraglutide

Liraglutide is another GLP-1 analog under development for type 2 diabetes by Novo Nordisk. As of September 2008, liraglutide is in phase 3 development for a once-daily dosing schedule.

Dapagliflozin

Dapagliflozin is an SGLT2 inhibitor that stimulates the kidneys to eliminate more glucose from the body via urine. In a 2010 study of 534 adult patients with type 2 diabetes who were already taking metformin, the 10 mg dapagliflozin daily was associated with a 0.84 percent decrease in Hb A1c levels. Bristol-Myers Squibb and AstraZeneca are developing dapagliflozin together.

Canagliflozin

Canagliflozin inhibits SGLT2, a sodium-glucose co-transporter molecule and is being developed by Johnson & Johnson.

Pramlintide

Amylin analogues like pramlintide act like amylin to suppress glucagon by slowing the rate of gastric emptying. A1c levels may be reduced up to a full percentage point with use of this injected drug.