Table 2. Patient Selection Considerations6,23
ConsiderationsComments
Objective criteria
    Diagnosis of type 2 diabetes mellitusFDA indication
    Triglycerides <500 mg/dLReduce risk for pancreatitis
    No history of or current issues with alcoholismReduce risk for pancreatitis
    Amylase WNLReduce risk for pancreatitis
    Lipase WNLReduce risk for pancreatitis
    No history of current or recurrent pancreatitisReduce risk for pancreatitis
    No history of current or recurrent gallstonesReduce risk for pancreatitis
    Normal or mild renal impairment (CrCL >60 mL/min)Caution with CrCL 30–60 mL/min; avoid in those with CrCL <30 mL/min or ESRD
    Normal hepatic functionCaution in acute or chronic hepatic impairment; effects are unknown
Others
    Concurrently taking a sulfonylurea agentHalve the sulfonylurea agent dose to reduce risk of hypoglycemia; educate patient on signs/symptoms of hypoglycemia and appropriate treatment
    DexterityDrug requires self-reconstitution and injection
    Digit manipulation issues: arthritis, rheumatoid arthritisDrug requires self-reconstitution and injection
    AdherenceRemembering weekly drug administration
    TolerabilityConsider using in patients who have tolerated exenatide twice daily
  • CrCL, creatinine clearance; FDA, U.S. Food and Drug Administration; ESRD, end-stage renal disease; WNL, within normal limits.