Beta cells??????

[Angela72]

Hi there,
A few weeks ago I posted asking about Byetta and after discussing it with my Diabetic Nurse and GP I decided I would like to give it a try. I was under the impression I was quite lucky to be offered Byetta as my BMI was only 33 (35 is NICE criteria) but because my BS was always high and I seem to be unable to get it down no matter what I try ,seemed the way to go. I had to have a test for beta cell function first and today got the results. I've been told byetta will be of no benefit as (DN words) "my betta cell function is practically non existant at less than 10%" What does this mean?? I've been feeling really unwell lately and have been off work for a few weeks as BS so high. I've now today changed the insulin I was on to a faster acting one but will this make any difference????. Does the fact that I have hardly any beta cell function mean that I am insulin resistant and therefore the insulin wont work. I just dont understand and I'm trying to make sense of what the DN has said. Please help!!!!!!
thanks
Angela

 

[Dennis]

Hi Angela,

The beta cells are the part of your pancreas that produce insulin in response to food. Byetta works by encouraging your beta cells to produce the right amount of insulin to deal with the rise in blood sugar caused by what you are eating. If your beta cells aren't working (or are only working at 10%) then no amount of Byetta or any other type 2 medication that stimulates pancreas response will be of any use. Think of it like driving a car that has no petrol in the tank - no matter how hard you press the accelerator you won't go any faster.

If you do have some insulin resistance then you may be prescribed metformin to help reduce this, but it rather sounds like your high BS is not caused by insulin resistance but by your pancreas not being able to produce enough insulin. That means your medication will have to continue to be insulin injections.

 

[Angela72]

Thanks Dennis.

I was on 3x 500gm metformin before going onto insulin along with a mixture of other things(rozigilazone, giclizide) but could not tolerate this which I think I mentioned before. I now still take 1 x 500gm metformin which is all I can just about tolerate. The new insulin is humalog mix 50 instead of novomix 30, will this be better? This might be a stupid question but does this mean I may be type 1 instead of type 2 and why do the beta cells stop functioning. I had gestational diabetes and pre-eclampsia while pregnant and hospitalised for 10 weeks but that was in 1990 and I wasnt diagnosed with diabetes unil jan 2005. I cant help thinking that I had diabetes all this time in between and because untreated this has killed the beta cells. All sorts are going through my mind at the moment. Probably all nonsense though :?

angela

 

[Dennis]

Hi again Angela,

I was on 3x 500gm metformin before going onto insulin along with a mixture of other things(rozigilazone, giclizide) but could not tolerate this which I think I mentioned before. I now still take 1 x 500gm metformin which is all I can just about tolerate.

Rosiglitazone is similar to metformin, and does much the same things, but is more powerful. Unfortunately it also has a long list of side effects so some GPs are reluctant to prescribe it. Gliclazide is a sulphonylurea treatment and is designed to force your pancreas to produce more insulin. Of course the pancreas can only do this if it is still capable of working at 100%. Even at full capacity yours can produce only 10% of what it should do, so none of the sulphonylureas will work for you. I remember you saying that you had problems with metformin, but did you try the slow-release version (metformin SR or Glucophage SR)? These are supposed to be much easier to tolerate.

The new insulin is humalog mix 50 instead of novomix 30, will this be better?

Unfortunately I'm not very clued up on insulin but perhaps one of our type 1s may be able to help?

This might be a stupid question but does this mean I may be type 1 instead of type 2 and why do the beta cells stop functioning.

It sounds like your failing pancreas is converting you from a type 2 to a type 1 (or more accurately LADA, as I know you are not teens/twenties). Of course it is possible that you have gradually been becoming a type 1 all along and it is only now that your pancreas' functioning is so reduced that it has become apparent. The cause of type 1 is that the body's autoimmune system starts to kill off the beta cells. No one knows exactly why this should happen. It might be triggered by a virus or other autoimmune diseases, or it may be due to inheriting certain genes.

I cant help thinking that I had diabetes all this time in between and because untreated this has killed the beta cells.

One possibility for a cause is that the beta cells have become burned out by being forced to produce too much insulin over too long a period. This is one of the criticisms sometimes aimed at sulphonylureas drugs - that over-use can cause pancreas burn-out. But in your case it sounds unlikely because you weren't on them for a long enough period. In your case it does seem more likely that your autoimmune system will be the culprit.

 

[Angela72]

Thanks Dennis (once again)

I think its making a it more sense now and giving me a bit more understanding of why I seem to have found it hard to control my BS over the past few years. Answer to your question about metformin, I did try the Glucophage SR but found it worse at the time and switched back to metformin. This was pre insulin but the last few months I've noticed that the metformin has mysteriously changed into glucophage SR again without any notification from the doctor?????? So currently taking this instead of metformin and no i'm not in my teens or twenties, i'm 37 , recently feeling 57 though :lol:
Angela