In this episode of The Deep Dive, we explore the remarkable journey of exenatide, a diabetes medication that began in an unlikely place—Gila monster saliva. As the first GLP-1 receptor agonist approved for type 2 diabetes, exenatide paved the way for an entirely new class of blood sugar–lowering treatments. We trace its evolution from the twice-daily Byetta to the once-weekly Bydureon, highlighting the innovations in drug delivery—like microsphere formulations and prefilled pens—that made it more patient-friendly. Listeners will gain a clear understanding of how exenatide works in the body, including its glucose-dependent insulin stimulation, suppression of glucagon, delayed gastric emptying, and modest weight loss effects. Clinical trial data and real-world outcomes und ...