However, new research suggests another answer may be a hormone called glucagon-like peptide 1 (GLP-1).
Eli Lilly is also developing another GLP-1 that is distinct from the Amylin products.
It does so by biting off bits of the glucagon-like peptide-1 or GLP-1 hormone.
GLP-1 was discovered in monkfish in the 1970s by a Harvard professor named Joel Habener.
Roche is developing a similar, long-acting GLP-1 drug, and it might face similar problems.
Patients who took part in a pilot study showed marked signs of improvement after taking GLP-1.
People who took GLP-1 showed signs that their B-cells were starting to work more effectively.
GLP-1 is secreted in the intestine after a meal prompting beta cells in the pancreas to produce insulin.
But GLP-1 turned out to be an impractical medicine, as it degrades quickly once injected into the body.
The 20 participants, who all had type 2 diabetes, were given either GLP-1 or saline for six weeks continuously.
Another GLP-1 analog is liraglutide, sold by Nova Nordisk (NYSE:NVO) as Victoza.
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DPP-4 regulates hundreds of hormones in the body, not just GLP-1, and blocking it can have unintended effects on others.
Yes, this is the same issue that, over the past few years, has plagued drugs that increase the GLP-1 hormone.
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The drug is a synthetic form of GLP-1 and was originally derived from the venomous saliva of the Gila monster.
In the late 1970s Harvard Medical School researcher Joel Habener serendipitously discovered a hormone in monkfish called GLP-1 (glucagon-like peptide).
They picked a hormone called glucagon-like peptide-1 (GLP-1) that is made by intestinal cells in response to sugar and fat.
ECONOMIST: Hormones influence how sensitive taste buds are to sugar
GLP-1 also plays a role in insulin production - and is present in lower concentrations in people with type 2 diabetes.
To investigate GLP-1's role in taste, the team used a strain of mice that were genetically engineered to lack GLP-1 receptors.
ECONOMIST: Hormones influence how sensitive taste buds are to sugar
GlaxoSmithKline has its own GLP-1 drug in late-stage trials, and Sanofi-Aventis has one that it plans to pair with its insulin pens.
Ginger Graham , Amylin's chief executive, says that by educating doctors about GLP-1, she thinks Merck and Novartis might actually benefit Byetta.
But making a pill form of GLP-1 has so far proved impossible.
Aside from giving Victoza a running start, the FDA scrutiny could contribute to the idea that Byetta or other GLP-1 drugs are not safe.
At about the same time, endocrinologist Jens Juul Holst of the University of Copenhagen figured out why GLP-1 dissolved so quickly in the body.
But GLP-1 degrades quickly once you inject it into the body.
Previous studies have shown that GLP-1 stimulates B-cell growth in animals.
Bydureon is a longer-acting version of Byetta, the first GLP-1 drug, which was based on a chemical in Gila monster spit that is similar to GLP-1.
He says Montreal-based ConjuChem (trades as CJC in the TSE) is a good buy, following positive phase II results for its type II diabetes drug DAC:GLP-1.
And they noted there are nine ongoing, prospective, controlled trials of GLP-1 based therapies with more than 65, 000 subjects, which should hopefully shed light on safety issues.
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Drug companies, including insulin maker Eli Lilly, thought so, too, but GLP-1 turned out to be an impractical medicine: Once injected into the body, it degrades quickly.
Dr Munger, though, found that both GLP-1 and the receptor molecule that picks it up and thus allows it to act are found in taste buds too.
ECONOMIST: Hormones influence how sensitive taste buds are to sugar
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