Trulicity vs. Byetta for Diabetes Type 2 and Management with Incretin-based Therapies: Important Differences and Potential Risks.

Trulicity

(dulaglutide)

Exenatide

Summary for Trulicity

Prescription only

Trulicity (dulaglutide) is a glucagon-like peptide-1 (GLP-1) agonist that helps control blood sugar in people 10 years and older with Type 2 diabetes. It's also approved to lower the risk of heart problems like heart attacks, strokes, and heart-related death in certain adults with Type 2 diabetes. The medication is injected under the skin once a week. Common side effects include nausea, vomiting, diarrhea, and stomach pain. When taken with certain diabetes medications like insulin, there's a higher risk of low blood sugar (hypoglycemia).

Indications for Trulicity

Manage Type 2 diabetes in people 10 years and older, along with diet and exercise
Lower the risk of heart problems like heart attack, stroke, or death in adults with Type 2 diabetes who have heart disease or heart-related risk factors

Pros and Cons for Trulicity

Pros

Works well at lowering A1C
Comes as a ready-to-use injectable pen
Only used once a week
Helps with weight loss

Cons

Commonly causes nausea, vomiting, diarrhea, and stomach pain
Potential risk for thyroid tumors
Can cause problems in the pancreas, kidney, and gallbladder
Not recommended for people with stomach problems

Common Side Effects for Trulicity

Nausea (12-21%)
Diarrhea (7-13%)
Vomiting (6-13%)
Stomach pain (7-9%)
Low appetite (5-9%)
Fatigue (4-6%)
Indigestion (3-6%)

Warnings for Trulicity

Thyroid cancer
Inflammation of the pancreas (pancreatitis)
Low blood sugar when used with certain diabetes medications
Severe allergic reactions
Kidney damage
Severe stomach-related side effects
Worsening eye problems in people with diabetic retinopathy
Gallbladder problems
Breathing fluid into your lungs during anesthesia or deep sedation

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.