The amino acid sequence of exenatide partially overlaps with that of human GLP-1. Exenatide has been shown to bind to and activate known human GLP-1 receptors in vitro. This implies an increase in glucose-dependent insulin synthesis and insulin secretion in the body by islet beta cells, including cAMP and/or other intracellular signaling mechanisms. In the presence of elevated glucose concentrations, exenatide promotes the release of insulin from beta cells. Exenatide, when administered in vivo, mimics the action of GLP-1 as an antihyperglycemic agent.
Exenatide injection improves blood glucose control in patients with type 2 diabetes by reducing fasting and postprandial blood glucose concentrations through the following effects:
Exenatide injection has an acute effect on the glucose response of pancreatic beta cells, causing insulin release only in the presence of elevated glucose concentrations. When blood sugar levels drop and approach normal levels, insulin secretion drops.