Glucagon-like peptide-1 receptor agonists glucagon (GLP-1). There are currently two drugs in this class, exenatide (Byetta, Bydurian) and liraglutide (Victoza) (LexiComp, 2014). These drugs mimic the actions of endogenous GLP-1. Endogenous GLP-1 is secreted by L cells of the colon and ileum in response to nutrient ingestion (Ryan, Foster, & Jobe, 2011, p. 794). GLP-1 has a half-life of 2 minutes due to the action of DPP-4 enzymes. GLP-1 agonists overcome this problem by having a modified structure that makes them less sensitive to enzymatic degradation of DPP-4, thus prolonging the effects of GLP-1 (ADA, 2014, p. 621). The first glucagon-like peptide 1 agonist to be developed was exenatide. Exenatide was approved for use in the United States in 2005. It is a synthetic form of an exendin-4 molecule. Interestingly, this compound was discovered in the saliva of the Gila monster, a reptile found in the desert of southwestern North America. This compound was found to be 53% identical to human GLP-1 and mimics GLP-1 on human receptors with greater stability than native human GLP-1 hormone. (Furman, 2012, p. 464) In January 2010, the Food and Drug Administration approved the use of liraglutide in the treatment of type 2 diabetes in the United States. Liraglutide is a synthetic form of the human hormone GLP-1 with a modified molecular structure. Alterations increase drug aggregation, decrease albumin binding, and are more resistant to degradation by DPP-4 enzymes (Ryan et al., 2011, p. 795). These properties increase bioava...... middle of paper ...... 2 Diabetes mellitus. Case Reports in Pediatrics, 2013. Retrieved from http://www.hindawi.com/journals/cripe/2013/703925/Novo Nordisk Inc. (2013). Victoza liraglutide injection (rDNA origin). Retrieved from http://www.novo-pi.com/victoza.pdf Robinson, M. and Wynne, AL (2012). Drugs affecting the endocrine system. In Pharmacotherapeutics for Nurse Practitioner Prescribers (3rd ed., pp. 587-644). Philadelphia, PA: FA Davis. Ryan, GJ, Foster, KT, & Jobe, LJ (2011). Review of the therapeutic uses of liraglutide. Clinical Therapeutics, 33(7), 793-811. Tierney, K. (2012). Therapeutic choices and the role of the nurse practitioner in type 2 diabetes when metformin is no longer sufficient. Journal of the American Academy of Nurse Practitioners, 24, 234-248.VictozaPro.com. (2014). http://www.victozapro.com/practical-resources/access-and-affordability.html