Injectable medicines are not what they used to be in the management of diabetes, with new formulations and devices providing more convenient and appealing ways to manage medication administration.

Learning objectives

After reading this article, pharmacists should be able to:

  • Summarise the new injectable therapies in type 2 diabetes
  • Discuss the advantages and disadvantages of injectable therapies in type 2 diabetes
  • Explain the differences within the classes of glucagon-like peptide (GLP-1) analogues and newer insulin formulations.

Competencies (2016): 1.1, 1.4, 1.5, 1.6, 3.5,

Accreditation number: CAP1908CDMNR

Over the past five years a number of new injectable medicines have been registered and PBS subsidised in Australia for the management of type 2 diabetes. They include a new injectable glucagonlike peptide-1 (GLP-1) analogue, an ultra-long-acting insulin, a newly formulated long-acting exenatide, and a higher concentration insulin glargine. The practical advantages and disadvantages of these injectable therapies must be considered in conjunction with the evidence for their impact on both surrogate and longer term outcomes.

Glucagon-like peptide (GLP-1) analogues

GLP-1 analogues offer a number of advantages to the diabetic patient, including positive metabolic effects, cardiovascular safety, and in some cases, weekly administration.1

GLP-1 analogues stimulate insulin release and reduce glucagon secretion in a glucose-dependent manner.2

The resulting decreased hepatic production of glucose and fasting blood glucose levels create a reduction in HbA1c by approximately 1%.1 In addition to their anti-glycaemic effects, GLP-1 analogues have also been shown to positively impact weight, blood pressure and lipids.3 Differences in their structure, formulation and dosing may impact glucose-lowering efficacy, weight loss and adverse effects.4

Test your knowledge on this article’s assessment questions here to earn up to 1.5 Group 2 CPD credits.