Replacing Novorapid with Bydureon

[Jung the foreman]

I have been refered by my GP's DB clinic to a specialist diabetes centre at my local hospital. The reason being my increasing Hb1AC readings (currently 9.5) despite taking 200 units of Levimir and and average of 50 units a day of Novorapid.

The DB nurse suggested that that there was just too much insulin my bloodstream and that with my apparent insulin resistance, it was having little effect. It was decided to one decrease my intake Levimir to 100 units (50% reduction) aqnd keep the novorapid the same befor food with and extra shot before bed if I was reading 10+. The months avaerage readings using this dosage prior to changing to Bydureongave an average of 11.1

The first week I was on Bydureon with 100 units of levemir my average had risen to 13.6 The nurse saw this as good progress as my average reading had only increased by 2 (I didnt see it that way). However this past week, my morning readings have all been in the 14.1 to 14.9 range and before food readings hitting 18+. The lowest reading all week was 13.3.

After reviewing this with the DB nuse and was told to stick with it and if the readings are high before bed, to coninue to take 10 units of Novorapid. I did this the other night and felt distinctly awful the next day, so I wont be mixing bydureon and Novorapid again. In fact I feel awful most of the time now. I do suffer form Sleep aponea but recently I've been waking getting to urinate about 4 times a night, so my sleep hygeine is worse than my "normal".

Anyway sorry about the long-winded post but I would like to hear fron anyone else's experience with Bydureon.

Regards

 

[hanadr]

Jung
it sounds like you are using LOADS of medication.I have noticed that some T2s need Insulin by the bucketload. Insulin resistance won't improve on that kind of regime. Have you looked into what you are eating? if you try a truly low carb diet, You have some chance of improving the siuation;e.g.a reduced need for medication and a reductrion in insulin resistance.
There's loads of information n this forum about low carb diets. I prefer to think of it as CONTROLLED carb diet. combined with a CONTROLLED portion size diet, it tends to work well.
Hana

 

[Daibell]

Hi I agree with Hanadr. I notice that you didn't mention diet and weight in your post and I wonder if you realise diet and weight reduction where needed is the number one priority for T2s. If you haven't already done so you need to set yourself a daily carb target of, say, 150mg and perhaps less. Have you been given any dietary advice? If you can get any excess weight down then the insulin resistance should fade and lower injection levels should be adequate. Its possible any sleep apnoea may also reduce but that does depend on the cause.

 

[sw11bloke]

i dont understand... are you a type 2 and taking insulin?
I thought type 2's only took pills and perhaps a single injection a day.

I agree with the two replies. Have you read Dr Bernsteins 'Diabetes Solution'? That might be a good start especially if you follow the advice about going low carb.
Perhaps also look at using coconut oil and cinamon in your daily diet along with cardio vascular excersise. 30 minutes jogging or cycling each day will definately help you.

 

[Jung the foreman]

Hi all, and many thanks your replies and questions:

In a nutshell, I was diagnosed in 2008 (although it's now suspected I was undaignosed for "several" years). After trying metformin, and other oral meds I was put on Levemir in early 2010 initially at 4u a day and in 2011 I was put on a Novorapid initially at 5u or dose prior to main meals. I immediately put on over half a stone.

In terms of diet yes I am a carb watcher and I have read the good Doctor's book. I eat no breakfast cereal have cut back on, potates, rice and pasta and drink no fruit juice or eat fruit (although I tried cranberry juice recently and that made my bg soar as well). A good breakfast in terms of BG control for me is an omelette or bacon and eggs and tea with no sugar. I suppose many would ay my diet is bland i.e. meat or fish and piles of veg. I admit my weakness is ice cream.

I've seem two dieticians, the first told me to eart more carbs (this was when I was first dianosed :shock: )he second who was very patient and listened to my history of devouring food even when I was at primary school and thin as a stick. In the end after weeks of food diaries etc, she admitted she was stumped and agreed with me that there was no pattern to my BG levels vs food intake and therefore she could not recommend any further dietary advice although she put me on Januvia which helped reduce hypos.

I must add that I am on a daily concoction of oral drugs for various things (about 12 tabs a day).

In summary I would say that standard T2 medication doesn't work for me and believe me, when I say I've tried all sorts of injection units/routines and diets.

Re the question about T2 and insulin I would respond by saying that we are all different with some of us being able to control BG with diet and exercise, some with those plus oral meds and some needing insulin.

As my BG readings get higher the older I get, I do wonder if my pancreas is simply packing up.

Regards
Mark

PS I'm 6ft weigh 16st 3lb and my BMI is/was 31. I am 56 married and we have a lovely 10 year old daughter.
PPS Also, my diabetes.co.uk signature seems to have lost the history of my HB1ac readings for the past few years.

 

[alaska]

Hi Mark

I just wonder whether one or more of your non-diabetes medications may need reviewing because of the constant hyperglycemia you're having to deal with?

Some of the medications which are known to often lead to hyperglycemia include certain blood pressure medications (beta blockers), steroid medications, antidepressants and certain anti-cancer drugs.

It may be worth asking whether any of the non-diabetes medication you are taking needs some kind of an in depth review. I understand it can be difficult for doctors to strike the right balance when taking quite a high number of medications as there are many interactions and side effects that all need to be taken into account.

Ed

 

[Jung the foreman]

Hi Ed,

I had ny meds checked with a pharmacist lasy year, but imo all the side effects for most meds seem to be the same, ie. tireness nausea, dry mouth etc. so there's not a lot I can do as I would say that my weds have been effective.

Re ongoing Bydureon trial, my BG levels are a nightmare averaging around 17 and I'm now into my 3rd week. To say I feel rough is an understatement (although on the bright side I've lost 5.5 pounds in weight)

Mark

 

[alaska]

Dry mouth and tiredness are sometimes, if not always, linked with higher sugar levels.

Statins can raise sugar levels but I believe it's usually a relatively small effect.

Hyperglycemia doesn't seem to be a common symptom of citalopram but it has been listed as a possible side effect in post-marketing studies (ie studies carried out after the drug has met regulator's approval):
http://sideeffects.embl.de/spl/20100319_23ff2d62-b5ff-4837-8b54-439a65609d90/C0020456/

I wouldn't jump to any conclusions but it may be worth discussing if you're looking to nail down what might be the cause.

Ed

 

[kellibabi]

Hello all,

I am currently on Bydureon (been approx 8 weeks-ish now).
My BG is down slightly (according to self testing) BUT I have been advised it can take 3-4 months to see any REAL improvement.
I had a blood test 2 weeks after starting & my DN told me that it hadn't given much indication re: Bydureon effect.

Will be going for another test in December to see if the Bydureon has 'kicked in'.

Looking at your diet might be a good idea - you may be eating hidden sugar without realising it.
I found in the past that THAT was making me get up 2/3 times in the night for a wee (SO ladylike!).

Check the labels on stuff in your cupboards (just in case).

Don't lose heart - my meds have all been 'trial & error' - Byduren is on that list at the moment.

 

[Jung the foreman]

Hello all, just a quick update.

Since I've been on Bydureon I've lost nearly 1 and half stone! (I'm now 15st 2 lbs ) my appetite is reduced and so I haven't been eating as much + I feel full when eating much more quickly. Unfortunatley, by BG levels are worse and out of control a recent Hb1ac was 90 increasing from 70. My Levemir was reduced to 60 units a day with small shots (5-10 units) of novorapid (as advised by the hospital DB team), but this has made no change to my persistently high BG levels.

I seem to be baffling the DB team and, after a case conference, they want me to switch form Levemir to Lantus, so maybe this will help

Best

 

[lizbet9]

i dont understand... are you a type 2 and taking insulin?
I thought type 2's only took pills and perhaps a single injection a day.

I agree with the two replies. Have you read Dr Bernsteins 'Diabetes Solution'? That might be a good start especially if you follow the advice about going low carb.
Perhaps also look at using coconut oil and cinamon in your daily diet along with cardio vascular excersise. 30 minutes jogging or cycling each day will definately help you.

I'm type two and take novo rapid depending on my carb intake and levemir 44 units and 4 metformin to control my blood sugars!

 

[Daibell]

Hi. You seem to be doing all the right things and sadly it isn't working. Have you Google'd the web for all of your meds yourself to see if any affect blood sugar? Steroids for example are notorious. It sounds like your carbs are under good control; do you know what your average daily intake is? Hopefully as your weight continues to go down so will any insulin resistance. This will enable the Levemir and NovoRapid to be more effective and with lower doses. Good luck.

 

[Jung the foreman]

Hi Daibell and thanks for your reply.

I've been on Lantus since 23/12/13 with no change to my BG levels. My recent Hb1AC was 90 - it seems my diabetes is baffling the medics. Just to mention I'm not on steroids. I do limit my carbs but do not count them anymore.

Regards
Mark