Am I a candidate for Byetta?

[toastlover]

I will try and keep my story short but there's a lot to it ...

I was diagnosed as T2 in 1995 and after years of little success with Metformin was moved onto Insulin in 2003, a combination of long lasting (Insulatard) and fast acting (Novorapid). In my first 18 months on insulin I gained 5 stone in weight and have been the same weight ever since. :cry:

I used to take Insulatard at night and Novorapid with food and my HBa1c was around 8. I was taking approximately 30 units of Insulatard and around 70 of Novorapid during the day. I have been struggling to lose weight so a year ago I was advised to change to two Insulatard injections a day (morning and evening) and Novorapid with food but significantly less - I currently take 2 x 26 Insulatard and around 10-15 Novorapid with each meal.

Since switching to this regime my BG has risen and I struggle to get it below 10. My recent HBa1c is 10.4 which is very concerning. My kidneys have started to leak a little protein so yesterdasy the GP prescribed me Ramipril.

I used to go to the hospital but didn't find that a positive experience - consultant too pushy towards gastric band surgery and not really interested in much else. I don't really want to go down that route because in my heart I know that insulin is the reason for the 5 stone weight gain that I haven't been able to shift.

At the end of this month my GP is enlstign the services of a specialist dioabetic nurse and I have an appointment to see her to discuss my options. However, looking at other people's experiences I'd like a good idea of my options before I see her.

Am I a candidate for Byetta to help with reducing insulin, BG and weight? Is there anything else I can suggest to her for consideration?

I am a 34 year old female who eats sensibly, exercises 3 times a week and apart from the above otherwise good health. We plan to start a family in around 2-3 years time - I really want to get my BG and weight under control to help with that.

Sorry for the long post and thanks for any info

Tina

 

[cugila]

Am I a candidate for Byetta to help with reducing insulin, BG and weight? Is there anything else I can suggest to her for consideration?

I am a 34 year old female who eats sensibly, exercises 3 times a week and apart from the above otherwise good health. We plan to start a family in around 2-3 years time - I really want to get my BG and weight under control to help with that.

Sorry for the long post and thanks for any info

Tina

I digress from your main question a little.......
I noted from one of your previous posts that you were considering low carbing, there was no reply from you. Did you go down that route ? At that time you did appear to be consuming quite alot of carbs. The reason I ask is that your diet can have a big impact on weight, Bg levels and many other things. You say you eat 'sensibly'.......not sure what that actually means. We have found many times here that one persons 'sensible' diet can in fact be the cause of many of the problems, so we need to see just what it is.

As for Byetta and whether you would be suitable.....there is a strict criteria used when prescribing. You have to have been on max meds, Biguanides and Sulphonylureas and have poor blood glucose control. Your BMI should be more than 35. However, having said that many Consultant's routinely ignore those guidelines when it suits.

Ken

 

[toastlover]

I would say I follow a moderately low carb diet but maybe I have got it wrong?
For example, yesterday's food was as follows:

Breakfast - One slice of wholemeal toast & butter. I find I struggle with headaches/fatigue if I don't have carbs for breakfast, and it has to be something I can eat on the run.

Lunch - salad with chicken, small dollop of coleslaw. Apple.

Dinner - Beef stir fry (vegetables only, no noodles)

Snacks - handful of nuts, small bowl of mixed berries (strawberries, blueberries and blackberries), 2 chunks of dark chocolate.

Drinks - 2 cups of tea, one cup of coffee, 1 can of diet coke, sugar free squash, water.

My BG is relatively stable during the day at around 10 and is usually within 2 mmol of my pre meal levels 2 hours after eating. I can only test this in the evening however as it's too difficult at work.

My fasting BG in the morning is always high - around 12-15. I wonder if the Insulatard is wearing off during the night and I need to take it later perhaps? I usually take it with my evening meal.

 

[hanadr]

toastlover
You may be like me and need to cut the carbs right down. Did your care team teach you to match your insulin to your meals, or to eat up to your insulin? The latter would definitely make you gain weight.
the third part of the equation is exercise. How much do you do?
exercise doesn't usually make you lose wweightt, but it seems to prevent gain.
Hana

 

[toastlover]

I had one session with a diabetic nurse at the hospital who gave me a scruffy leaflet that described carbohydrate portions. That was pretty much about it really. I tend to take 1.5 units of insulin for every cp. Maybe I need to increase that.

Exercise - I go to the gym 3 times a week and do 45 minutes of cardio exercise - i vary between exercise bike, treadmill (jog-walk) and cross trainer, followed by weights to try and build up my muscle mass in the hope it speeds up my metabolism generally. I can't go any more than 3 times a week due to other commitments.

I'm really at my wits end with it and would really like some ideas I can suggest to the nurse in case she is very old school. The last time I saw the GP nurse she tried to convince me to base my diet around starch and was anti low carb. I'm hoping this new nurse will be a little more progressive.

Any ideas people on what I can suggest?

 

[cugila]

I had one session with a diabetic nurse at the hospital who gave me a scruffy leaflet that described carbohydrate portions. That was pretty much about it really. I tend to take 1.5 units of insulin for every cp. Maybe I need to increase that.
As stated before and elsewhere....instead of increasing Insulin, cut the carbs down instead.

Exercise - I go to the gym 3 times a week and do 45 minutes of cardio exercise - i vary between exercise bike, treadmill (jog-walk) and cross trainer, followed by weights to try and build up my muscle mass in the hope it speeds up my metabolism generally. I can't go any more than 3 times a week due to other commitments.
All sounds good, however you can add say 30 mins per day at home, just getting the old heart poundin in two 15 min sessions will help.
I'm really at my wits end with it and would really like some ideas I can suggest to the nurse in case she is very old school. The last time I saw the GP nurse she tried to convince me to base my diet around starch and was anti low carb. I'm hoping this new nurse will be a little more progressive.

You just need to tell her what you are doing already and that you are being more pro-active but need something else to help you along. Byetta or Victoza are options. One thing I would suggest you DON'T mention is low carbing....they immediately think you mean Atkin's. Tell her you have REDUCED your carbs and are reducing your portion sizes, that seems to go down much better. :wink: If you also say you are using low GI/GL methods.....she should be eating out if your hand !! But, it all boils down to if you are suitable or not, if the Practice or PCT will pay for it and whether the Nurse knows anything about it. One other minor problem is that neither Byatta or Victaza are recommended for concommittant use with Insulin. I know in my area it is used together, but the Diabetes Clinic I go to is very forward looking and not afraid to try new things out.

Best of luck, stay calm and factual about what you do, what you want, and let us know how you get on.

Any ideas people on what I can suggest?

Ken.

 

[hanadr]

toastlover
Do you have a dog? or a neighbour who might lend you one?
I've infcreased my walking loads, with my dogs.We do a 2.75mile loop every evening and include some time in the park too. It's doing us all good.
Hana
Ps it's very hilly round here too.

 

[toastlover]

I would love a dog but hubby won't let me! :twisted:

 

[jpg]

Tina,

My BMI was borderline at 35 for Byetta, and I had been on insulin, putting on weight much as you have done. My BGs however were very good, and I seem to have found a sympathetic DSN who seemingly considers the weight reducing properties of Byetta more important that its anti-diabetic properties.

To go around with BGs of 10 all day is not good, I'm surprised that you have not experimented with increasing doses of insulin to bring these down - maybe you're concerned that more insulin would make you more hungry and you will put on even more weight?

There does seem to be a bit of a postcode lottery regarding attitudes to the new medications, probably due to their high cost. This is a short-sighted attitude as diabetes can become very expensive indeed in later years if the more drastic complication kick in, such as blindness, kidney failure, heart disease and amputations. Compare the cost of twice weekly dialysis with a month's supply of Byetta!

jpg

 

[sue32]

I have to say Byetta changed my life!! No, seriously. I had insulin resistance, was injecting massive amounts of insulin just to keep my BM's within acceptable ranges, and put on 3 stone in 5 years. Since starting on Byetta last December I have stopped taking Novorapid - still take Glargine at night, but half of what I used to inject, have decreased my portion size by at least a third, and have followed the GL diet plan. So, yes, I would advocate Byetta, but then I'm biased and it won't work for everyone.