Newbie to Byetta ... am I normal???

[kimmy]

Hi All!
I wonder if someone can help ... I am a 50 year old, type 2, very overweight, diagnosed since 2004. Caused through fifteen years of living in hotels, travelling 1000 miles a week, being a career girl, until April 2004 when everything seemed to collapse a bit! Have been on oral medication since, and until about six months ago, my blood sugars were usually around the 7's. Have never been good at looking after myself ... and hate to admit I have something wrong with me. "After all diabetes is common and lots of people have it ... " Sorry guys, believe me, I empathise with everyone else, just prefer to be there for others rather than sharing too much about me!!! :? Yes, I heard you ... yet another complex female!!

Anyway, about six months ago my BS started going up and down ... mostly up, and the doc and nurse started talking about insulin, as I was already on Metformin with Roziglitazone plus Gliclazide twice a day. However, last Thursday started Byetta 5mg plus 4 x 500mg Metformin once a day. BS on Thursday ranged from 24 to 19 ... Friday 18 to 15 ... Saturday 17, 18 & 19 ... yesterday 16, 19 and 15 ... this morning 17, lunchtime 19. Have not eaten a lot at all. Mornings bowl of melon and fat free yogurt, lunch a wholemeal pitta with tuna ... or a bowl of soup and a pitta ... evenings a chop or something like, veg and a couple of new potatoes. No snacks ... not feeling hungry at all ... gone down from 17st 1lb Thursday to 16st 10lb this morning. Saturday spent the day at a working test with dog ... plenty of exercise ... really struggled. Really feeling exhausted continuously, but since Friday have had little sleep due to feeling agitated, butterflies in tummy, brain going from one thing to another, but not being able to remember one word from another!!! Only slight nausea ... that I can handle ... not feeling hungry (Great!).

Now because I often appear as if I am quite intelligent, and tend to bluff things out, I don't want to appear stupid and waste my nurse's time for any stupid little thing that really is probably common when first on Byetta ... can anyone with experience, please tell me if this is all pretty much as it should be?

Please bear with me ... first experience of discussion forums, too!

Thanks

Kim

 

[Jacqhar]

Hi Kim

This is my third month on Byetta; like you my levels kept going up and up but within 2 days were averaging at about 7 and by the end of the last month were at 6 and now are frequently at 4.7 (fasting). I have had a slight blip this week when I started with a mild cold but still only went up to 7.7 which panicked me slightly but was still no where near the 15 I would have been previously.

I've also read all the low carb threads on this site and thought I would give it a try, can't go as low as some but I have cut down a lot and am sure this has helped with my bs levels and believe it or not my energy levels!!!!

Your levels are still very high so I would contact my DSN as soon as possible I'm sure she won't consider it a waste of time.

Good Luck and let us know how you get on

Jacqueline

 

[kimmy]

Thanks, Jacqueline

Well, this morning, although down to 15.6 I thought I would ring the DSN, and she has put me back on Gliclazide (half twice a day) as well as the 2000 mg Metformin. She is going to ring me on Friday and see where we are then. She is very helpful, and I shouldn't have worried about contacting her.

I have to say that the side effects seem to have calmed down a little ... although I was sick this afternoon, which is the first. To start with I really didn't feel hungry at all, and although I haven't wanted as much as usual, unfortunately it is more than when I started last week.

With regard to the low carb that I have been reading the comments about on here, I have never looked at that before, so I will have to do some research. I have never been good at monitoring what goes into my mouth, I am afraid. I have always tried to have seed bread, brown rice and pasta ... because I have known how poorly I have felt when having white. And although the morning always start well with melon, grapes and fat free yogurt, probably about 11 I would go for a couple of slices of brown toast. Sandwich at lunch time ... then it would all go down hill from there!! Its always the chocolate and sweets and biscuits that always do the big damage!!!

Thanks, Jacqueline, again. Its actually quite nice to talk to someone else in the same situation.

Kindest regards

Kim

 

[Dennis]

Hi Kim,
If its any consolation, the butterflies in the stomach feeling is a known side effect of byetta, although not that common. The feeling of nausea is very common, but it usually wears off after a week to 10 days.

Your blood sugar levels are very high, more than double what they should be, and from the little you have said about what you eat your diet isn't helping at all - most of what you have mentioned is very high in sugar and/or carbohydrate. Can I suggest that you buy yourself a Collins Little Gem Carb Counter book. This lists the carb content of pretty much anything you could possibly eat and will give you a good idea of just how much carbohydrate you are taking on board each day.

What you should try to aim for is no more than 120g of carbs per day. Try that as a starting point and see how you get on. You can always adjust the carbs up or down as needed.

 

[kimmy]

Thanks, Dennis ... I will certainly review my diet. Having looked at some of the comments that are around on this site, is the feeling that a diet similar to Atkins, high protein, high fat, low carb is the way to go?

Side effects seem to be ok now, however I am still tired due to the high blood sugar levels, and it would be good to get on top of them.

Kindest regards

Kim

 

[Dennis]

Hi Kim,
A lower carb diet is certainly good for most diabetics, both type-1 and type-2, but it doesn't necessarily have to be as low as Atkins, which is (IMHO) at the more extreme end of low-carb. Personally I find that I have very good control at a carb level of around 120 to 150g per day, some people find that they need to go as low as 30g a day, but others find that just a small reduction does the trick. We are all different, have different metabolisms, different lifestyles, different degrees of insulin resistance. So, not surprisingly there is no one-size-fits-all solution. Its very much a case of experimenting to see what works for you.

Can I suggest that you try a few experiments, like substituting the pittas and sandwich bread with a low-carb bread like Weightwatchers. This is only around 9g per slice instead of "normal" bread's 16g. Instead of the fruit and low-fat yogurt for breakfast have scrambled eggs on a slice of low carb toast (probably a third of the carbs your present breakfast gives you).

What has been suggested, and it has worked for some, is for a week cut out all starches from your diet (i.e. no cereals, bread, pasta, rice or potatoes). In that time your BS will plummet (so watch out for hypos). Then gradually reintroduce small portions of each into your diet and see which ones have what effect. This is another way in which we all differ. In my case bread has very little effect on me (but strangely cereal breakfasts do), potatoes have a moderate effect, but rice and pasta send my BS sky-high.

 

[bretaneby]

I am interested in trying Byetta - GP didn't know what I was talking about.
Consultant wasn't keen.
Does anyone know how widely used it is here?

 

[Dennis]

Hi Bretaneby,
Sorry I missed your question, but better late than never.

Byetta has only been available in the UK for a little over a year so is not yet widely prescribed. Many GPs will not have heard of it unless they have a particular interest in diabetes and are keeping up with the latest developments. Consultants are generally up to speed with it and are probably responsible for modt of the Byetta prescriptions. However, one reason why it is not widely prescribed is the cost. It is more expensive than insulin of any of the other diabetes medications, so PCTs are reluctant to let GPs prescribe it.

This is changing, but very slowly.

 

[bretaneby]

I posted back in September re Byetta.
Still keen to try - I have put on a lot of weight with insulin - Byetta is attractive as it often helps with the weight issues.
Mentioned it again to another GP in m practice - didn't know anything about it again but offered to talk to someone on some panel or another who would know.
But I guess they won't be too keen on account of the cost.
Anyone got any ideas how I can persuade them to prescribe it to me.

 

[Dennis]

Hi Bretaneby,

Have just got back from holiday today so wasn't able to answer your question earlier. It is very common for a GP to have not heard of Byetta (I have actually come across one who had not even heard of metformin - but that's another story). GPs are generalists and not specialists in diabetes treatment. Your best route would be to ask your GP for a referral to a diabetes consultant - consultants are specialists and will have forgotten more about diabetes than your GP will ever learn, and will certainly be fully clued up on all the latest treatments, including Byetta.

 

[hanadr]

Byetta is expensive. As much, I suspect, because of the delivery system as anything. For that reason GP practices rarely prescribe it.
I think it should be used more often, because putting T2s with weight issues,onto insulin, simply makes them worse.
Still spending a little more now, to save on complications later, is not the way of the NHS