Januvia vs. Byetta for Diabetes Type 2: Important Differences and Potential Risks.

Key takeaways

Januvia (sitagliptin) and Byetta (exenatide) are both medications used to treat Type 2 diabetes, but they work in different ways and have different forms of administration. Januvia is a dipeptidyl peptidase 4 (DPP-4) inhibitor taken orally once a day, while Byetta is a Glucagon-like Peptide-1 (GLP-1) agonist that you inject under the skin twice a day before meals. Januvia helps control blood sugar by allowing insulin to stay in your body longer and reducing sugar production, whereas Byetta mimics a hormone that triggers insulin release and blocks sugar release from the liver. Byetta also has a long-acting version called Bydureon BCise, which is injected once a week. Januvia is generally weight-neutral, but Byetta might help with weight loss. Both medications can cause pancreatitis, but Byetta has additional risks like thyroid cancer and severe allergic reactions. Januvia is available in a combination form with metformin called Janumet, while Byetta does not have a generic form and can be more expensive.

Januvia

(sitagliptin)

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Exenatide

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Summary for Januvia

Prescription only

Januvia (sitagliptin) is a prescription medication that helps lower blood sugar in adults with Type 2 diabetes. It works best when you also follow a balanced diet and exercise regularly. It belongs to the drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors, or gliptins. Januvia (sitagliptin) comes as a tablet you take by mouth once a day. Side effects include stuffy or runny nose and headache. Januvia (sitagliptin) is a brand-name medication only; the generic version isn't available yet.

Indications for Januvia

Type 2 diabetes in adults

Pros and Cons for Januvia

Pros

Taken once a day
Not likely to affect your body weight

Cons

Not for people with Type 1 diabetes
Possible risk of severe joint pain

Common Side Effects for Januvia

Runny or stuffy nose and other symptoms of the common cold (5%)

Warnings for Januvia

Inflammation of the pancreas (pancreatitis)
Risk of heart failure
Sudden kidney problems
Low blood sugar when taken with other diabetes medications
Serious allergic reactions
Joint pain
Severe skin reactions

Summary for Byetta

Prescription only

Exenatide is an injectable medication used to lower blood sugar in people with type 2 diabetes. It should be used along with an appropriate diet and exercise plan. This medication comes in short-acting (Byetta) and long-acting (Bydureon BCise) versions.

Indications for Byetta

Type 2 diabetes, in combination with diet and exercise (adults) - Byetta only
Type 2 diabetes, in combination with diet and exercise (adults and children age 10 years and older) - Bydureon BCise only

Pros and Cons for Byetta

Pros

Can lower your A1c (average blood sugar over time)
Not as likely to cause very low blood sugar as other diabetes medications
Might help some people with weight loss
Bydureon BCise (once-weekly injections) can be taken any time of day, with or without food

Cons

Slows stomach emptying, which can affect how other medications are absorbed
Short-acting version (Byetta) must be used within 60 minutes before meals
Not safe for people with severe kidney problems
Brand-name only, so it can be expensive

Common Side Effects for Byetta

Nausea (Up to 44%)
Vomiting (Up to 18%)
Diarrhea (Up to 18%)
Headache (Up to 14%)
Injection-site lump (11%)
Constipation (Up to 10%)

Note: These side effects were reported by people taking either exenatide alone or with other diabetes medications. The side effects you experience might differ depending on what other diabetes medications you're taking.