Exenatide and Rare Adverse Events

Abstract

Seven years after receiving a kidney transplant, a 44-year old woman with a 31-year history of type 1 diabetes mellitus and long-term complications (retinopathy, neuropathy, and end-stage renal disease) underwent an allogeneic islet-after-kidney transplantation with the use of a modified Edmonton protocol.¹ Islet-graft dysfunction with preserved C-peptide levels was observed after approximately 1 year. After the patient had provided written informed consent, off-label use of exenatide (Byetta, Amylin Pharmaceuticals) (≤10 μg, administered subcutaneously twice daily) was initiated 19 months after the islet transplantation in order to improve glucose control (ClinicalTrials.gov number, NCT00315588).² Exenatide treatment resulted in insulin independence and normalization of glycated hemoglobin levels.