Persistent injection site nodules from exenatide: Successful treatment with intralesional triamcinolone

Exenatide extended release is a once-weekly injectable medication used for the treatment of type II diabetes mellitus. The long-acting formulation consists of the original twice-daily formulation encapsulated in 0.06-mm-diameter microspheres.1 The subcutaneously injected exenatide microspheres then diffuse the medication slowly over time, reaching therapeutic range by 2 weeks and steady state by 6 to 7 weeks.1 Pharmacologically, it acts as an incretin analogue that activates glucagonlike peptide 1 receptors causing a glucose-dependent insulin secretion.