The type 2 diabetes medication exenatide (Byetta) has won an expanded role in treatment of the disease while also being linked in some cases to kidney disease.

The Food and Drug Administration (FDA) has announced that Byetta, which was first approved in 2005, is now permitted to be used as a stand-alone medication-along with diet and exercise-for people with type 2. Byetta had previously been designated for use only in conjunction with other diabetes medications.

Separately, the FDA has also warned that Byetta has been linked in 78 cases (out of some 7 million prescriptions written for the medication) to deteriorating kidney function. The regulatory agency has approved language to be included with the medicine's packaging detailing the potential connection between Byetta use and kidney problems.

The FDA is recommending that people with severe kidney disease not take Byetta and that caution be used in prescribing Byetta, or in increasing its dosage for those with even moderate kidney impairment who are already on the medication. The packaging insert will also suggest that everyone using Byetta be closely monitored for and educated about kidney disease.

Byetta has been shown to lower blood glucose levels and spur weight loss. It works by mimicking natural hormones in the body called incretins, which increase insulin production by the pancreas.