byetta

[sixfoot]

Some Good News,

Had my 3rd Monthly Byetta review today. Spec nurse looked at the diary and said well done you are losing weight and the BS are down regularly in 5/6`s. How about we reduce your Gliclazide to 1 twice a day and see how that goes. So am trying for a month to see what happens fingers crossed.

Dave P

 

[Dennis]

Hi Dave,

Sounds like you are taking the same route as me. When I started on byetta I was on 4mg Amaryl (which is very similar to gliclazide), then dropped to 2mg, then 1mg, now on 0.5mg and hoping to be able to drop it completely within the next month.

I think the secret for me was not just the byetta but, after reading Dr Bernsteins books, also embarking on a lower intake of carbs. I can't manage the Bernstein low carb diet, but 80-100g per day suits me perfectly. I was previously on the UK recommended 180g per day and struggling with weight and BS control.

 

[sixfoot]

Indeed, the group thing was liberally sprinkled with statements and comments about cost and event limiting testing. Many in the group were obviously people you would call very obese and struggling with BS up in the 16-20 range. We did the go round the room and tell us your experiences routine. But when it got to me I mentioned that i had looked on the internet spoken to other Byetta users etc and was experimenting with low Carb and GI etc even Cinnamon. I was challenged by the nurse. My reply was that Balanced diet is ok if the system is ok but for most diabetics there is an imbalance which must be addressed. Carb reduction is being shown to be effective. When i finished my little piece i was instantly bombarded with questions from the other patients. Most were saying that they had been to dieticiens. It seems to me the Health service could save a fortune by changing their advice on Nutrition and actually benefit a lot of People. The Cynic might say theres a lot of money to be made out of sick people. As yet i am still not confident in my new found Knowledge other than it seems to be working and that is one of the best reasons i know for contiuing.

ps going back to bed now
Dave P

 

[sussex]

Could you please, explain a little more about byetta. I am on novamix twice a day and inject 140 units each time. No other diabetes medication used, my weight has escalated and my waist and stomach is huge. My BS averages 9 and the nurse wants it lower, I don't want to increase the insulin and am unable to do much exercise due to arthritis. :?

 

[sixfoot]

Hi Sussex you dont say whether you are type 1 or 2 the point being that Byetta is for Type 2 diabetics.

 

[Dennis]

Hi Sussex, I see from your profile that you are type 2, so here is the lowdown on the treatment. It is fairly new, having only been approved in the UK in May 2007. It has to be injected twice a day, before breakfast and evening meal (or before lunch and evening meal provided the injections are a minimum of 6 hours apart). It works in 5 different ways, as follows:

- Byetta (Exenatide) increases insulin secretion by the pancreas in response to eating meals; the result is the release of a higher, more appropriate amount of insulin that helps lower the rise in blood sugar from eating. Once blood sugar levels decrease closer to normal values, the pancreas response to produce insulin is reduced. By comparison injected insulin is effective at lowering blood sugar, but can "overshoot" the target and cause blood sugar to become too low, resulting in hypoglycemia.

- Byetta suppresses pancreatic release of glucagon in response to eating, which helps stop the liver from overproducing sugar when it is unneeded, which prevents hyperglycemia (high blood sugar levels).

- Byetta helps slow down gastric emptying and so decreases the rate at which meal-derived glucose appears in the bloodstream.

- Byetta reduces appetite and thus may prevent weight gain. Most people using Byetta slowly lose weight, and generally the greatest weight loss is achieved by people who are the most overweight at the beginning of therapy. Clinical trials have demonstrated that the weight reducing effect continues at the same rate through 2.25 years of continued use.

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

Side effects are nausea (57.1% of patients), vomiting (17.4%) and diarrhea (8.5%). For most patients, the nausea is mild to moderate and goes away entirely after a few days.

It can only be used for treatment of Type 2 diabetes and should not be used in conjunction with injected insulin (as there has been no published research on the safety of this). In the UK it cannot be used as a stand-alone medication. It has to be used as a secondary treatment, generally with metformin, or a glitazone, or a sulphonylurea as the primary treatment.

I think that covers most of it but if you have any other questions, please fire away.

 

[GillC]

Hi Dave P
I have had exactly the same response when I have challenged a nurse's advice to eat plenty of carbohydrates. That's not good advice for us type 2's, as my food/BM diary can demonstrate. I would advise anyone to keep a food diary with their blood results and see for themselves. The literature always talks about the importance of self-management, but some of the professionals treat you like an idiot. Hard evidence is always good to have.

Well. I've just got home from hospital after switching to Byetta, They kept me in for 2 days to monitor me, but apart from slight nausea after meals (which might just have been in response to the hospital food, which was awful) I have been feeling fine. My bloods are high (16-20) but apparently this is to be expected at first. They said that they would probably start treating patients who switch as outpatients, as the 40 or so that have switched in Gateshead have had very few problems.

Gill

 

[Dennis]

Hi Gill and welcome to the strange world of the lizard spit! If you have experienced a little nausea I would recommend
(a) don't have the injection too soon before you eat. You can inject up to an hour before food, but many people find that makes the nauseous feeling worse. Taking it 5 to 10 minutes before you eat seems to help most people.
(b) avoid anything greasy or spicy for the first week.

I presume you have started on the 5mcg pen, but you will probably experience the same slight nausea when you move up to the 10mcg pen. The nausea generally only lasts for a few days.

 

[sixfoot]

Hi Gill thanks for the response, Good luck with the "Spit". Do persevere with it. I was very fortunate in that i havnt suffered the effects that a lot have. Having said that it does seem to subside quite quickly. There is a whole load of experience on this site which should help with any side effects should you have them. I am about to finish my first 10 pen this week and my gliclazide has been halved as a look see. Considering that they wanted to put me on insulin before i asked about Byetta i am more than pleased with how it has gone ( at least so far)

As you may have gathered already Dennis is a treasure trove of info on the Subject.

 

[sussex]

Would you please explain some of the expressions you use like lizard spit. :lol: :roll:

 

[sixfoot]

If you " Google " BYETTA or EXENATIDE you will come to information about how they discovered this medicine. In short there is something in the saliva of the Gilla Monster of the USA that works the magic with blood sugars and other parts of the system. I believe Dennis has posted this info somewhere previous on this thread. The Americans have had this for a few years now and have dubbed it lizard spit - 8) the name seems to have stuck over here as well.

Hope this dosnt put the benefits in a poor light

Dave P

 

[Dennis]

Hi Sussex,

As Dave has said, exenatide is a synthetic version of a hormone that was originally found in the saliva of the Gila Monster, a poisonous lizard found in the south-west of N America. Hence the name lizard-spit. Now to get technical!

This hormone (exendin-4) is almost identical to the GLP-1 incretin that is produced in the human body. GLP-1 is produced in the intestine when food is detected in the stomach and is what signals the pancreas to start producing insulin. In many cases of type 2 diabetes GLP-1 either doesn't get produced, or its message just doesn't reach the pancreas, so this is where the exenatide takes over and triggers the pancreas to get going. Byetta is simply the trade name for exenatide.

Hope that helps.

 

[sussex]

Thank you, its a bit of a learning curve.

 

[sixfoot]

Sussex the learning curve is there whether you have been diagnosed 10 days or 10 years. For a real learning curve you might have a peak at the "Carbs" thread. Dont get involved in the tangles, but it will illustrate how pretty entrenched views are changing. The conventional medical view versus what people are finding out for themselves and in many cases benefiting from.

Its a very informative thread just follow it and ask questions as they come to you

Dave P

 

[siddywest]

Hi one and all,

Just wanted to update you. Have now been on the 5mcg byetta for 2 1/2 weeks, had slight nausea and one or two incidents of vomiting (this seemed to be when I had eaten a lot and it was almost like my body telling me I had eaten too much and didn't need it - great news for me). This all passed after the first week. It is really making me not feel hungry at all and I just don't fancy greasy food, which is weird for me. Took the kids to McDonald's the other day and would normally have wanted a large something or other but couldn't face it so had a salad and couldn't manage it all. This is all very positive for me and I have lost 5 1/2 pounds since starting it.

My BS is not quite as good as I would like, was getting slightly better results when I was on insulin but am hoping they will only improve when I switch to the 10mcg pen in 2 weeks. My average BS is between 8 - 10 at the moment but working on it.

Still really chuffed they agreed to let me try this stuff and feeling really positive about it. Thanks for all your continued advice and support.

Michelle.

 

[Dennis]

Hi Michelle, Your switching from insulin to byetta is very interesting. I have a theory that when you inject the right amount of insulin to deal with the carbohydrates you have eaten, then your pancreas doesn't need to produce any more insulin, so therefore it won't. Over a period of time your pancreas will have become used to not needing to respond to the rise in blood sugar. Then when you come off insulin, your pancreas needs to learn all over again what it is supposed to do.

There is a US byetta group that I keep in touch with and what you have described about your BS not initially reducing is in line with what they have found. But eventually the pancreas seems to get its act together and the BS starts to come down. This would seem to support my theory, but I have no evidence other that anecdotal information from people like yourself.

 

[sixfoot]

Dennis you may have missed it but a thread called Returning to Byetta bbsued might benefit from your depth of knowledge

Dave P

 

[Fuggsy]

Well I now have it in writing As soon as my pct agree to funding I'll be moved onto byetta.
Have been put back onto Gliclazide -80mg twice a day so it looks like things are moving.
I'm currently on 150 humalog 5 times a day and 250 lantus twice a day so the byetta is going to be a huge change for me.
I will have much more room in my fridge for starters.
Don't know what to expect when I stop taking the insulin but I'm really hoping to get my bg down to my target of 15.
Hope the funding comes through soon

 

[Dennis]

Hi Fuggsy,

If you are taking gliclazide as well as insulin injections you will need to watch carefully for hypos. Gliclazide forces your pancreas to produce insulin (regardless of whether more insulin is actually needed) so, unless your humalog and lantus intake has been reduced from what it was before you were started on gliclazide, you will effectively be getting a double hit of insulin.

 

[siddywest]

Advice please.

Byetta going great however have terrible yellow bruises all over my belly and it is painful injecting. I have tried in my thigh so will give that a go for a while. It also says you can inject in your arm, do you still need to pinch skin together or not when it is your arm, seems impossible to do and also do the injection. Can you just put it in your arm without pinching do you think???

Also, I am injecting and then eating almost within the first minute or so of injecting, should I be leaving it longer between injecting and actually eating do you think?

Michelle.