BYETTA

[shavals]

Morning Dennis

thanks for your reassurance. Today all went perfectly, yesterday was a little anxious as it was my first time.

They have cut out the Actos completely and am down to 1 Gliclazide morning and night but still taking 2 Metformin day and night. Going back at end of month for a review, hopefully things will have settled down. Whilst at the Clinic they did a finger test and I was 5.3 great (before lunch) , did one yesterday morning before breakfast 10.2, this is what we are trying to get sorted. I also am suffering from acne rosetia (something like that)which she tells me is a sympton of diabetes, well I will be 62 in April and have never had a spot in my life, you ought to see it now!

Thanks for all your help, will keep in touch.

Pauline

Pauline Jones

 

[Dennis]

Hi Pauline,

I will just beat you to it. I will be 62 in March.

Glad to hear it all went well. Byetta is always given as a second-line treatment with metformin, or as a third-line treatment with metformin and a sulphonylurea (like glicazide). If your morning reading is higher than usual then it could indicate that your sugar levels are dropping quite low during the night, which causes your liver to generate glucose to compensate. Unfortunately once the liver starts doing that it doesn't know when to stop, so will keep producing more until you next eat!

If you find you get a bit nauseous after taking byetta, don't worry - this is a common side effect and usually wears off within a week.

 

[ash]

I'm on 2 500mg of metformin a day. Would it be suitable for me, and what benefit would it bring ?

HBa1C 6.3 T2

 

[Dennis]

Hi Ash,

I can tell you how byetta works. It has 5 actions:

- it encourages the pancreas to produce insulin in response to eating meals. This results in the release of a higher, more appropriate amount of insulin that helps lower the rise in blood sugar from eating. Once blood sugar levels go down closer to normal values, the pancreas will stop producing insulin. This means that you can't go hypo unless you are also taking a supplementary drug that will encourage continuing insulin production even when further insulin is not needed (e.g. a sulphonurea).

- it suppresses pancreatic release of glucagon in response to eating, which helps stop the liver from overproducing sugar when it isn't needed, which prevents hyperglycemia

- it helps slow down gastric emptying and so reduces the rate at which glucose moves from the large intestine into the bloodstream.

- it reduces appetite, so preventing weight gain. Most people on Byetta slowly lose weight, with the greatest weight loss achieved by people who were the most overweight when they started to take it.

- it reduces liver fat content. Fat in the liver or non-alcoholic fatty liver disease (NAFLD) is strongly related with several metabolic disorders, in particular low HDL cholesterol and high triglycerides, especially in patients with type 2 diabetes.

Unfortunately I can't say whether it would be right for you. Only you and your doctor can make that decision. But bear in mond that many PCTs refuse to fund it and more than half of the 80+ people in the UK currently on it have to pay for it privately (retail cost is around £100 per month, but cost to a PCT would be £68).

 

[martinbuchan]

How are you feeling now on Byetta?

Marty B

 

[shavals]

Hi Martin

only started Byetta on Wednesday. Already by levels seem to be going down.10,0 before breakast Wednesday 5.3 before dinner Thursday 5.6 before tea Yesterday, looks promising. No side affecst either at the moment.

thanks for asking

pauline

Pauline Jones

 

[martinbuchan]

I would love to know what effect it has on you post prandial readings. I suspect there might be a significant effect here as well.

I am glad you have noticed improvement already.

Marty B

 

[shavals]

Hi MARTIN

not too sure what you mean by prandial readings, can't remember hearing about those.

well have had a good day today, walked a little over a mile on Salisbury Plain with our 2 corgis, pottered around th garden in the beautiful weather, absolutely shattered off to bed, just taken my last reading of the day 6.2.

pauline

Pauline Jones

 

[martinbuchan]

Post prandial = after meals. recent theory is that it is more related to increased cardiovascular risk. Some advice is that 2 hour PP BS should be <10. One site suggests <8.3 1hour and <6.5 2 hours PP. In type 2 diabetes there are other causes of raised BS other than insulin resistance (such as rapid food absorption and the abnormally raised glucagon.) These factors are also targeted by exenatide. It seems logical that exenatide should keep post prandial BS in the normal range and could therefore give better reduction in cardiovascular complications (especially heart attacks and strokes). Thats why I measure PP BS after the majority of main meals and occasionally after breakfast and lunch. It helps me judge my insulin bolus doses as well.

Diabetologists sometimes describes type 2 diabetes as a condition of early cardiovascular death..........

Marty B

 

[sugarless sue]

Cheers Marty for that uplifting thought!

Knowledge is the key to control

 

[martinbuchan]

great isn't it. These are the same doctors who refer to to type 2 diabetes as a 'lifestyle choice'- my own diabetic consultant does. I don't think it helps their attitude sometimes. (maybe that should be deathstyle choice).

Marty B

 

[ash]

Thanks for the info Dennis 8).

I'm not overweight (5'10" & 11 stone 7 lbs)and have never been above 11 stone 12lbs, so weight has never really been an issue to me.

I think my question would relate more to the other benefits it offers.

If there are only 40 people in the UK on it through the NHS, then I think its a waste of time me even asking


HBa1C 6.3 T2

 

morning martin

will do a couple of after meal readings to get an idea of what is happening, the Clinic told me to do pre-meals only.

Before breakfast this morning 6.8.

Now at work, will see how the stress factor works and will do reading after tea tonight.

Pauline

 

[Dennis]

Hi Ash,

In terms of benefits, I personally believe that it is great because it acts in a natural way. Sulphonylurea drugs just stimulate your pancreas to produce more and more insulin, and will continue to do so until the sulphonylurea dose has worn off, regardless of whether more insulin is actually needed. Hence the possibility of hypos.

Byetta mimics the action of the incretin GLP-1, which is the substance that tells your pancreas that food is on its way, so start generating insulin. Effectively it wakes up your pancreas to the presence of food so that the pancreas can naturally produce an appropriate level of insulin in response. When the insulin has done its job and sugar levels have dropped, then the pancreas is allowed to naturally shut off insulin production. Hence no hypos.

What Byetta doesn't do is to help the insulin to metabolise the glucose into energy stored within the body cells. If your particular problem is cellular resistance then this is where a biguanide drug like metformin comes in that helps make the cell walls more receptive to glucose.

Having just re-read all that it sounds like I'm a salesman for Eli Lily, which I promise you I am not! (but if you want a pension then drop me a line!! - moderators just joking, I am not touting for business!). Why not discuss it with your GP or consultant. At worst they will say no, its not what you need. Bear in mind that this drug has only been available in the UK for 9 months, and more people are currently getting it on the NHS than are having to go private, but unfortunately it is still a postcode lottery.

 

[ash]

My PCT took on the debts of a porely performing neighbour, so the money is thin on the ground now

HBa1C 6.3 T2

 

[Dennis]

Pauline,

I have found it helps to do some after meal (postprandial) readings as well, especially after a meal containing pasta, rice, or a jacket potato. I have found that somehow the byetta has changed my reaction to several high-carb foods. I find that any kind of rice sends my sugar levels soaring, pasta similar but not as severe, jacket potato hardly at all but bread seems to have no effect on me! This is the opposite of what I was like before byetta. A bit worrying as my favourite foods are Indian and Italian!

 

[shavals]

Hi Dennis and Marty

just checked myself after tea and i was 6.3. I had tuna and wholewheat pasta today.

will see what happens next time.

Pauline Jones

 

[martinbuchan]

I wonder what it would have been before you started Byetta.

Marty B

 

[shavals]

Hi Marty

it probably would have been around 15. I was always too high which is why we are trying Byetta. Yesterday before lunch I was 5.5, this is great. Symptoms wearing off now also, lets hope some weight does.

hope alls well.

Pauline

Pauline Jones

 

[Dennis]

Hi Pauline,

Don't worry, the weight will come off. I experienced an initial rapid loss for a couple of months, then it stopped for about 6 weeks, then it started to come off again but slower. Many in the States have experienced little or no loss for the first month, then suddenly it starts. What nearly all the long-termers in the States have reported is that the weight loss stops completely after around 21 months, then suddely starts again after another 3-4 months.