byetta and its licensing use with insulin.

[Elixers]

After being given the relevant meds by my local G.P i was also advised to be referred to a diabetic consultant/specialist. Told him my history ( refer to topic on confused Glocophage) and i asked him about Byetta. At the time before loosing the kgs recently i asked if i could use Byetta as i heard it had some effect on loosing weight. he was concerned that i had been on insulin on and off for some years but never the less said we could give it a try. this conversation took place at his diabetic clinic. 1 month later i received a letter from him saying that he felt it not wise to put me on Byetta as it was not licensed to use with insulin and the fact i had been on insulin too long. This was a total contradiction to what he told me verbally, and i now feel so disappointed. is this true about the licensing? Could soe one give me more info on Byetta and how it works on a understandible level than a medial jargon one? a sweet thank you..x

 

[sixfoot]

Elixer, hi byetta is generally used in conjunction with other meds for T2s,There is a posting on here about its use with insulin but the case is very specialised and unique. In my own area there are a lot of T2s transfering from Insulin to Byetta. I started Byetta back in late March this year and find it works for me, It does have side effects namely nausea and the weight loss / appetite suppression. Not everybody gets nausea and exept for a very few it is short lived a matter of week or so. It can also be dependant on which doseage you are on 5mcg or 10mcg.
Initially my GP wanted to move me onto insulin but i was unwilling because of the hypo risk and the implications for my licence and other things like travel etc.

There are any number of Byetta topics in the Discussions thread and a lot of personal experience to help you make up your mind.
You will see postings by Dennis who is particularly up to speed on this treatment.

Hope this helps
Dave P

 

[Dennis]

i received a letter from him saying that he felt it not wise to put me on Byetta as it was not licensed to use with insulin and the fact i had been on insulin too long. This was a total contradiction to what he told me verbally, and i now feel so disappointed. is this true about the licensing? Could soe one give me more info on Byetta and how it works on a understandible level than a medial jargon one? a sweet thank you..x

Hi Elixers,
Unfortunately it is true that Byetta is not licensed anywhere in the world for use with insulin - but this is simply because the manufacturers (Eli Lilly) designed it only for use with Type-2s so never trialled it with insulin patients. Strange that a drug manufacturer would not realise that many type-2s are on insulin! However, despite this, for the last year it has been quite widely prescribed in the US for insulin dependent Type-2s and with no adverse reactions. I have heard of only a few cases in the UK where a diabetician has prescribed a byetta/insulin combination and these are where the patient is unable to tolerate any of the normal oral type-2 meds. I fear that it is very unlikely that you would be prescribed byetta WITH insulin, but of course it could be prescribed INSTEAD OF insulin. This would have to be in conjunction with an oral med, again because it is only licenced in the UK as a secondary treatment - so you must also take an oral med (like metformin) as your primary treatment.

Just for information, byetta works in 5 ways:
- it triggers the pancreas to start producing insulin in response to eating a meal
- it stops the pancreas from releasing glucagon, which in turn stops the liver from producing un-needed glucose
- it slows down the rate at which food is digested, which makes for a slower increase in blood sugar, giving the insulin a better chance of dealing with the "traffic"
- it helps to reduce appetite by sending messages to the brain to say "don't need any more food thanks, I'm full"
- it reduces liver fat content, so reduces the triglycerides that are responsible for leaving deposits in the arteries that lead to heart attacks.

It appears that Symlin (also an Eli Lilly product), as suggested by Sarah, has some of the same properties as byetta and was developed for use with insulin-dependent patients:
- it slows digestion
- it sends messages to the brain to say you are full
- it inhibits glucagon production.
However, I can find absolutely no mention of it (or under its generic name "Pramlintide") in any of the UK medical sites, or on the NICE website, so I can only assume that it is not yet available in the UK.