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

Key takeaways

Glipizide / metformin and exenatide (Byetta) are both medications used to treat Type 2 diabetes, but they belong to different medication classes. Glipizide / metformin is a combination of a sulfonylurea and a biguanide, while exenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist. Glipizide / metformin is taken orally, typically once or twice a day with meals, and is available as a generic, making it a more cost-effective option. Exenatide is an injectable medication available that also has a lower-cost generic available. Byetta is the short-acting form of exenatide (injected twice daily) and Bydureon BCise is the long-acting form (injected once weekly). Common side effects of glipizide / metformin include diarrhea, headache, and low blood sugar, while exenatide can cause nausea, vomiting, and diarrhea. Both medications can lead to low blood sugar, especially when combined with other diabetes medications. However, exenatide has additional risks, such as potential thyroid cancer and pancreatitis.

Glipizide/metformin

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Exenatide

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Summary for Metaglip

Prescription only

Glipizide/metformin combines two diabetes medications into one tablet: glipizide (a sulfonylurea) and metformin (a biguanide). It's approved to treat Type 2 diabetes in adults along with diet and exercise. This medication is typically taken by mouth once or twice a day. Some common side effects of glipizide/metformin can include diarrhea and headache; it isn't likely to cause weight gain or weight loss.

Indications for Metaglip

Type 2 diabetes

Pros and Cons for Metaglip

Pros

Taken by mouth
Combination medication, so more convenient to take
Available as a lower-cost generic

Cons

Need to take with meals
Can't take during pregnancy
Not an option for children

Common Side Effects for Metaglip

Diarrhea (18%)
Headache (13%)
Cold or flu infection (10%)
Low blood sugar levels (9%)
Muscle pain (8%)
Nausea, vomiting (8%)
Stomach pain (6%)
Dizziness (5%)

Warnings for Metaglip

Lactic acidosis
Possible risk of serious heart problems
Low blood sugar levels
Low vitamin B12 levels

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.