Byetta & Insulin

[darren10000]

Hi All

I'm a type II and am on 160mg Glicazide, 1000mg Metformin both twice a day and 70units of Glargine. My GP refered me to my local hospital in order to try me on exenatide (Byetta), and said that I would take it along side th above medication, but the Hospital told me to stop the Insulin. According to my GP Practice I shouldn't, and nobody seems to talking to each other.

Anybody here got any ideas,hints &c.

Darren

 

[hanadr]

I would throw a tantrum, however, I think I read somewhere that Byetta isn't licened to be used alongside Insulin. Ask at your pharmacy, their drug interaction software, should throw up a banned drug combination. Your GP should be using it too. You can just check Byetta on the web though.

 

[Dennis]

Hi Darren
I can understand why the hospital would say that. Byetta encourages your pancreas to produce the appropriate amount of insulin to deal with the raise in blood sugar following eating. The important word is APPROPRIATE - in other words you either need Byetta or you need insulin, but taking both would put far too much insulin into your system and simply force a major hypo. Your hospital must be happy that your pancreas is capable of producing insulin or there would be no point in recommending it. It is possible that your pancreas might not be able to produce the full amount of insulin that is needed, in which case topping up with a small quantity of injected insulin might be necessary, but that can only be determined by removing the insulin and seeing what the result of Byetta on its own is.

There is a further consideration that your hospital may be considering, which is that NICE have not approved Byetta to be prescribed in combination with insulin, although several diabetes consultants do prescribe the two in tandem where the insulin is a small quantity to simply augment the pancreas' own production.

I hestitate to mention this because however you say it, it sounds like slagging off the medical profession - but in most cases the diabetes specialists that work in hospitals have forgotten more about diabetes than doctors and nurses in general practice will ever know. I certainly know which one's advice I would be inclined to follow!!

 

[Trinkwasser]

It isn't licenced to be used with insulin, but in the States it is being used that way experimentally. It will need a considerable reduction in insulin probably, but dropping the lantus altogether may leave you running high as the Byetta principally works on the postprandials similar to a bolus insulin.

Likewise you will almost certainly need a reduction in the glicazide. I'd rely on the hospital consultants who've almost certainly got more experience than your GP, but they really need to be more informative and you really need to update and pester them during the changeover.

 

[darren10000]

Thanks everyone for that info. I spoke to my Db nurse at my gp practice today and she wasn't ver impressed!! What I have been advised is to halve the Glicazide and to reduce the Insulin down to 10 units and very closely monitor BM levels.

So far so good...

Darren