Exenatide once weekly in type 2 diabetes.

The difficulties of maintaining long-term glycaemic control with available antidiabetic treatments in patients with type 2 diabetes have led to the need for additional treatments that can replace or be safely combined with existing agents. Patients with type 2 diabetes who have not achieved adequate glucose control at the maximum tolerated doses of their oral therapies have had no alternative other than insulin. However, the best insulin regimen is a matter of controversy because addition of biphasic, prandial, or basal insulin to oral therapy has been proposed. Furthermore, the start of insulin therapy is often delayed. Besides the fear of subcutaneous injections, the two main objections raised by the patient (and often also by the physician) are the risk of hypoglycaemia and weight gain.