NICE recommends prolonged-release exenatide injections, in combination with other drugs (given as tablets), as a possible treatment for some people with type 2 diabetes (see below).

Who can have prolonged-release exenatide injections?

You should be able to have prolonged-release exenatide given with two other drugs (that is, with a drug called metformin and either a type of drug known as a sulphonylurea or a thiazolidinedione) if your blood glucose levels are not under control, and:

  • you have a body mass index (BMI) of 35 or above and have health problems associated with this, or
  • you have a BMI of less than 35, and treatment with insulin would make it much more difficult for you to do your job or other significant health problems would be helped by weight loss.

You should be able to have prolonged-release exenatide when given with one other drug (either metformin or a sulphonylurea) only if:

  • you are not able to take either metformin or a sulphonylurea, and
  • you are not able to take thiazolidinediones and dipeptidyl peptidase-4 (DPP-4) inhibitors.

You should be able to keep having injections of prolonged-release exenatide after 6 months only if tests show it is working well enough.


Units for reporting HbA1c have changed from % to mmol/mol since this guidance was published. The NICE Pathway on diabetes has been changed to reflect this. The guidance is being updated and the new recommendations (to be published in 2015) will use only mmol/mol.

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