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BYETTA

Discussion in 'Incretin Mimetics' started by Dennis, Aug 22, 2007.

  1. fiona35

    fiona35 Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Well my pen lasted all of a day before it started playing up again, so I'm returning it back to Eli Lily and I've had another pen issued which does actually work!!

    Still constipated but I'm now going to star munching some Diabetic Chocolate, failing that I guess another visit to my GP will be in order!!
     
  2. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Fiona,
    I guess I've been quite fortunate in that I have only ever had one bad pen in 19 months on Byetta. Although the plunger seemed to be working it wasn't delivering any Byetta. I phoned the Eli Lilly help desk for advice and they took the details of the chemist I got it from, phoned them and arranged for the chemist to issue a replacement, collect the bad pen and send it to them for tests. At that time I was getting it on private prescriptions at around £100 per pen, so I was quite relieved that Lilly issued the replacement free.

    Enjoy the chocolate - after all it is for medicinal purposes!
     
  3. ascetic_rose

    ascetic_rose · Newbie

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    Re: Anyone use Byetta?

    Hi
    I have been using Byetta for the last 4 months and its true i do feel nausea but only on some particular days when i leave my meal later than half hour after injecting myself,
    As for my weight i feel i have kind of shriveled ( as my family says) my dresses have loosen slightly i am not complaining :D but i have not lost any weight,
    I used to keep a diary of my blood glucose but now i check sometimes and it seems my sugar levels are controlled. But i have one problem that is i crave for sugary things esp chocolates I have never been a mad chocolate eater as much as i am now, My consultant told me to re- train my brain by drinking water when i crave for chocolates but that is not helping at all :| any advice or tips anyone?
     
  4. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Rose,
    A reduction in blood sugar generally comes alongside a reduction in carbohydrates and it is very common for this to result in cravings for sweet things, even some things that you did not previously eat, like chocolate. I remember a comment not long ago saying that this person was suddenly getting cravings for chocolate when he had never eaten much of it before.

    The reason for this is that sugar, whether eaten directly as sugar or indirectly as another form of carbohydrate, encourages the production of seratonin in the brain. Seratonin is a neurotransmitter that is responsible for calming, relaxing and general wellbeing, and is often referred to as the "feel good" transmitter. The brain becomes accustomed to a regular level of seratonin and when this is reduced, the brain suffers withdrawal symptoms and sends messages demanding that you eat more sweet things. After a while the brain becomes accustomed to a lower level of seratonin and the cravings stop.

    For those of us who have switched to a low or just a reduced carb diet, or as in the case of Byetta maybe not a deliberate reduction in carbs but simply a reduced food intake, we have probably all experienced this to a greater or lesser degree. Don't worry, its just your body adjusting itself to living with less seratonin and it does pass.
     
  5. goji

    goji · Well-Known Member

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    Re: Anyone use Byetta?

    Is Byetta suitable for badly controlled Type 2s who are already on insulin?

    I'm just wondering as my dad has had Type 2 for about 9 years. Until his 40s, he was very skinny but now is very overweight (well only his stomach as the rest of him is thin - his fat distribution seems odd to me) and he did not have good control even with ever-increasing combinations of tablets.

    He was put on basal/bolus insulin (with metformin) earlier this year and seems to need fairly high doses (levemir about 38 units) but after 6 months his control is still really bad (hba1c = 11.2). I've tried talking to him about low carbing and regular testing but he seems totally immune to it all and says that his doctor is handling his diabetes for him so I don't need to be involved etc. When he ocassionaly goes to the shops, he always comes home with big white baguettes and he eats masses and masses of fruit etc. He does go to the gym about twice a week but this hasn't made any difference to his weight, otherwise he has quite a sedentary office-based job/homelife.

    I don't really think the doctor has even explained how to adjust carbs and has just given my dad a set unit dosage to take with each meal. I think the doctor's approach to the control issue is just to keep increasing the insulin but I'm sure that is making my dad get fatter and fatter which must in turn promote further insulin resistance.

    Would Byetta be of any use in this situation?
     
  6. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Goji,
    Although Byetta is technically not approved for use with insulin, there is an increasing number of people who are being put on it by endocrinologists and diabetologists. Unfortunately not by GPs because they generally stick to the NICE guidelines that say not approved with insulin. Of course he could come off the insulin in order to take Byetta - he would have to reduce his insulin while on Byetta in any case. But it sounds like his GP is of the old school - "only one way to treat diabetes and that's with insulin and as many carbs as you can eat".

    As you have already tried to persuade him to consider low carb, you are obviously well aware yourself of the difference this makes. His reliance on his GP's advice is literally killing him. I am afraid that if he doesn't change his diet then he is heading rapidly for an early grave, aided and abetted by his GP. Is there any chance you could persuade him to join this forum, or at least to have a look at it? Maybe someone outside of the family, like us, might be able to educate him as to what high carbs are doing to him.
     
  7. lizlow

    lizlow · Newbie

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    Re: Anyone use Byetta?

    Hi
    I have been on Byetta since July of thsi year. So far the the results have been good, i say the consultant in Sept and everything is good. I have very little appitite for food but the good side of that is that i have lost 20lbs
    My only problem is the continuing Nausea, it appears to have been worse since i started my new pen a couple of weeks ago. I was violently sick one night :mrgreen: andthe nausea has been bad since that night.
    I never feel like eating and find even cooking can make me feel sick so i have become very limited in what i am able to eat.
    Has anyone experienced the same or similar? or any advice for me?
    PS: I am only taking Byetta for my Diabetes nothing else

    Liz
     
  8. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Liz,
    Is your new pen the same dose as the previous pen? If you have changed dose from 5mcg to 10mcg then you will experience a second bout of nausea until your body becomes accustomed to the higher dose.

    If you haven't changed dose then about all I can suggest to reduce the nausea is
    - inject immediately before you eat - the longer the gap between injection and eating then the worse the nausea
    - if you also take metformin then take these with some water in the middle of your food, not before or after the meal
    - don't eat anything greasy or spicy
    - try having a very diluted ginger drink with your meal (e.g. Bottlegreen's ginger and lemongrass).

    The only other thing that does often work is to switch back to the lower 5mcg dose for a month, then go back to the 10mcg. The body seems to be better able to accept the 10mcg dose the second time around, but nobody knows why!

    However, if your dose hasn't changed, and you weren't getting nausea before, then you shouldn't suddenly start getting it now. That could indicate that there is a problem with the dose level in your pen so I would report it to your doctor and see if you can get a prescription for a replacement pen.
     
  9. jansouth

    jansouth Type 2 · Member

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    Re: Anyone use Byetta?

    Dear All
    Can I ask how long one should wait to eat after injecting byetta? My diabetic nurse says one hour, but I find I do feel nauseaous if I leave it that long. Can one inject immediately before eating? I have had quite a bit of nausea over the weekend. Personally, I attribute a lot of my gastric upset to Metformin. I have been on it 4 months now, and I am constantly having diarrhoea and upset stomach. ( Even on the slow release)

    Since starting byetta almost 3 weeks ago, my blood glucose readings are excellent, 5 in a morning, so I have decided to try one week without metformin just to see if my stomach settles .
    Byetta certainly reduces the amount of food I want to eat, but it would be nice if I could enjoy the little I am eating !

    Advice from experienced users on injection times might help the problem

    As always, thanks for your good advice

    Janet x :)
     
  10. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Janet,
    I'm afraid your nurse hasn't read the instructions properly. One hour is the absolute maximum time you can leave between injection and eating, not the amount of time that you must wait for. As I covered in my response to Liz, the longer you leave it before you eat then the greater is the chance (and severity) of nausea. Unfortunately your nurse is not the only one who has misunderstood (or not read) the manufacturer's instructions. We had a member last year who had been told that the medicine is supposed to make you feel sick, that's how it works - that way you don't eat so much so it makes you lose weight!

    This is a link to the Eli Lilly instructions for health professionsls.
    http://pi.lilly.com/us/byetta-pi.pdf
    The section that covers when it should be taken is on page 13. You might want to print the page and show it to your nurse when you next see her.
     
  11. lizlow

    lizlow · Newbie

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    Re: Anyone use Byetta?

    Hi Dennis
    Thanks for replying
    I have been on the 10mcg since August so maybe trying the lower dose for a month would help, I don't take anything else, only Byetta. I do inject just before I eat but it doesn't really help the nausea. I will try the drinks
    Most of the time i don't feel like eating at all, but i have to have someting with the injection.
    i have ordered a new pen, as you say maybe there is someting wrong with the dosage in the pen cause i only had a tiny bit of nausea before starting this pen.
    I will let you know how i get on.
    thanks for the advice
    Liz :)
     
  12. jansouth

    jansouth Type 2 · Member

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    Re: Anyone use Byetta?

    Dear Dennis
    As always, thank you so much. Have now read (and printed ) the professionals page. Will take it with me when I go for my appointment Thurs 18th Dec, when I am to go on the 10mg dose.

    Thank goodness I found this forum.

    My best wishes to you all

    Janet x :)
     
  13. chips n egg

    chips n egg · Member

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    Re: Anyone use Byetta?

    Hi all,

    I was only diagnosed as Type 2 in late September, had 9 days in hospital being tested for Cushings and i am now 3 weeks in to my first lot of Byetta, so still on 5mg taken with 2mg of Glimipride. I don't take Metformin as it is supposed to be bad for my poorly heart.

    I have had none of the side effects, good or bad, i am still as hungry as ever and my blood glucose is averaging out at 11. In short, it seems to make no differance at all. Is this normal?

    Another thing, i normally inject into my arms as i do not like injecting my stomach, so i inject into the flabby bits at the outside of the top of my arm - i have had very basic instruction, my consultant is fantastic, but my nurse should be paid in bottle tops.
    Over the weekend, the inside of my left bicep and the inside of my left forearm started hurting like hell, as if i have pulled a muscle. Today, they have turned into really big, Black bruises. My right inner forearm has also started to go the same way.

    Should i be concerned??

    C
     
  14. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hello C,
    Unfortunately it sounds like you are getting scarring under the skin from the injections, which leads to bruising, and when you inject into the area not only does it hurt like hell but the injection is often ineffective. The problems you are experiencing with your forearms are well away from the injection sites so you need to see your doctor to find out what could be causing this.

    The makers recommend that you inject into the stomach, or failing that into the thighs, or (3rd choice) into the upper arms. The problem with the arms is that they have a much smaller area than either of the others so you are constantly re-using the same injection sites. Is there some reason why you can't inject into your stomach, because that is by far the best target area? On your stomach, even if not overly large, you can go for weeks without re-using the same injection site.

    You don't mention what your typical diet is, but if you are constantly hungry then it sounds like it could be rather high in starchy carbohydrates and low in fibre and protein. That would account for what is a dangerously high blood sugar level and the hunger pangs. One of the big problems with high carb foods is the "chinese meal" syndrome - an hour after youv'e eaten one you feel hungry again!

    If you can give us an idea of what your typical day's meals would comprise, we might be able to give you some pointers to getting your BS back into the safe zone.
     
  15. babbettes

    babbettes · Member

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    Re: Anyone use Byetta?

    i have been on byetta 5 for 3 weeks and going up to 10 at the weekend as im on insulin as well i inject into the top of my leg with a smaller needle it dosent hurt but ive had several bad hypos and lowering my insulin doses.
    The specialist put me on Byetta with the insulin to see if my readings will come down and they have im just hoping i dont get any side effects with the 10 as i was fine on the lower dose .
    Make sure you leave the injection in for the count of 5 or 6 and have it at least an hour before food .
     
  16. chips n egg

    chips n egg · Member

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    Re: Anyone use Byetta?


    Thanks for taking time to reply Dennis,

    I think I had decided to go to the Doctors tomorrow anyway. The only problem is that I tend to get the apprentice, and that can be no fun at all.

    There is certainly plenty of room to inject in my stomach; I just find it uncomfortable, as I do with my thighs. I do try to use my thighs at home and my arms at work though.

    Is 11 dangerously high? Education, it seems, is very hit and miss. I went to the Dietician and he asked me what I wanted from him. Absolutely no use at all. I had just been told I may need Brain Surgery (they thought I had Cushings) the week before, so it was all a bit surreal. I suppose I should give him another go really.

    It seems strange that there seems to be so much “Carbohydrates Bad” talked about here, as I had been told that I should have some with every meal.

    As for my preferred diet, the name should give you a clue!

    Thanks again

    Chips
     
  17. sugarless sue

    sugarless sue · Master

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    Re: Anyone use Byetta?

    C,if we can help you lose some weight it may very well help not only your diabetes but also take some of the strain off your heart.
     
  18. chips n egg

    chips n egg · Member

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    Re: Anyone use Byetta?

    I have been fighting that particular battle for 2 years, with absolutely no sucsess whatsoever.

    The day i packed up smoking i started to expand! :shock:
     
  19. sugarless sue

    sugarless sue · Master

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    Re: Anyone use Byetta?

    Small steps at a time,C. Give us some idea of an average days food intake.
     
  20. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Babbettes,
    As your specialist will no doubt have already told you, you will need to keep a very careful watch for hypos because Byetta encourages your pancreas to produce insulin, so you should need a lot less injected insulin. If you had no side effects with the 5mcg dose then it is unlikely that you will get them with the 10mcg.

    I'm a bit concerned by your comment about injecting "at least an hour before food". The one hour figure is the absolute maximum time, not the least time. Have a look at the patient information in this link (on page 2)
    http://pi.lilly.com/us/byetta-ppi.pdf
    You will see that the instructions are very clear that you must eat WITHIN 60 minutes of injecting. The reason for this is because when we eat our body's insulin production comes in two phases. When we start to eat the stomach produces substances called incretins that tell the pancreas to start producing insulin. This is first phase insulin production.

    Then as we digest the food, and the blood sugar goes up, the pancreas recognises the increase and starts to produce more insulin to deal with it. This is second phase production. Many type-2s don't have the first phase production, so the pancreas is very late in producing insulin in response to food, and often won't produce the appropriate amount. The result is blood sugar levels that just won't come down. This is where Byetta comes in. Byetta contains an incretin that is just like the ones produced by our bodies, and so the injection kicks off first phase production. The first phase production doesn't last very long and If you don't eat within that hour then the first phase production will have stopped and second phase won't be able to deal properly with whatever you eat.

    When I was first put on Byetta 17 months ago I wanted to learn all I could about it and how it worked and I had some very long email and phone conversations with Eli Lilly staff both in the UK and their US head office. They were quite surprised that someone should take such an interest and were extremely helpful and encouraging. I learned a great deal from them, including lots of hints and tips that they don't include in the instruction leaflets, and am pleased to now be able to pass on that knowledge to the many new "lizard spit" users in the UK.

    However, it does concern me that so many "specialists" are giving their patients information that simply shows that they haven't read either the patient information or, more importantly, the instructions for health professionals on what this drug does and how it should be used.

    Just one other point that you may want to bring up with your specialist - if your BS levels are coming down and you are already experiencing hypos on the 5mcg dose then why on earth would you need to have the dose doubled!?! Again, the (apparently unread) instructions to health professionals are that the dose can be increased to 10mcg, but only where the patient needs the higher dose.
     
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