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BYETTA

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

  1. sixfoot

    sixfoot · Well-Known Member

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    Re: Anyone use Byetta?

    Dear Candy Apart from its action on Insulin production the other feature of Byetta is that it delays the transit of food through the system leading for a lot of patients to much desired wieght loss. Eating a snack after injection and then a full meal at some point down the line would defeat the point of the medication.

    I might suggest if you dont already, a glimpse at the low carb threads. The reason being that almost everyone who has tried it says that they eat as much as they want and dont feel hungry.
    The additional bonuses of wieght loss - improved lipid profile - and better blood sugars mean it is at least worth a look

    From personal experience its the route i follow and wouldnt go back if they offered to pay me

    I`m sure dennis will be able to add more on the actual action of Byetta

    Good luck
    Dave P
     
  2. fiona35

    fiona35 Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Does anyone know if although my HBA1C reduces but my weight only goes down a little will they still let me carry on with Byetta or will they withdraw it?
    My HBA1C was 8.2 and is 6.8 at the moment but I was curious as nothing has occured in the weight loss dept!!

    I guess I am starting to worry if nothing occurs will they take me off it and try something else instead :(
     
  3. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Candy,

    I can't really add anything to Dave's excellent response. Thanks Dave.
     
  4. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Fiona,

    The main purpose of Byetta is blood sugar control. Weight loss is only a secondary benefit. So long as your figures show that Byetta is enabling you to maintain BS control then they would have no grounds for withdrawing it.
     
  5. HLW

    HLW Type 1 · Well-Known Member

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    Re: Anyone use Byetta?

    Thanks for the link Dennis, that was exactly what I was looking for.

    I notice on that link it says glitazones should only be used if sulphonylureas can't be, but I've only ever been prescribed metformin and pioglitazone, they never tried anything else. Wonder why.

    If the NHS won't pay for Byetta, how does one go about getting a private prescription?
     
  6. nativenewyorker

    nativenewyorker · Member

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    Re: Anyone use Byetta?

    Hi
    Just been for my review and my GP wants me to consider Byetta. HbA1C 6.3%, U&E's, LFT's and lipid profile normal, however my weight is 100kg. Currently take Metformin, plus Lantus 55units and Apidra with my main meal.
    After reading this thread, I am quite keen to try it, but a little bit of me thinks if my blood glucose control is good then don't start messing with treatment. Also I was a bit concerned when she said I would not need to test my blood sugars, but instead test my urine for ketones once a day.
    Just need that little shove to push me into giving it a go - can anyone help! :roll:
     
  7. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi HLW and Nativenewyorker,

    HLW, the NICE guideline is actually rather weird because glitazones and sulphonylureas do totally different things and should therefore be used in different circumstances. One is not a replacement for the other. Glitazones bind to receptors in a body's cells in order to reduce insulin resistance, so they are more akin to a much stronger version of metformin. Sulphonylureas (like gliclazide, glyburide and glimepiride) force the pancreas to produce more insulin. So logically a sulphonylurea should be used where it is believed that a patient's pancreas can't produce enough insulin without extra encouragement. There is an increasing number of doctors (and particularly consultants) who now believe that use of a sulphonylurea to force the pancreas into producing more insulin can burn out the pancreas' beta cells, resulting in the patient being forced onto insulin much earlier than is really necessary.

    It is possible to get Byetta on private prescription. Any doctor or consultant should be able to issue you with a private prescription. All chemists are happy to handle private 'scripts because they make a good profit from them. Byetta costs the NHS around £63 per month's treatment, but on private prescription most chemists will charge around £104. The cheapest I was able to find when I initially had to pay for it privately was Boots at £92 a go (I now get it free on the NHS).

    Nativenewyorker, I suspect that you probably don't qualify under the NICE guidelines, but that won't stop your GP prescribing it if s/he feels it is right for you. The reason I say that is because your HBA1C is not unduly high (although there is room for some reduction), and Byetta is not licenced for use with insulin and is not supposed to be used with insulin unless there are circumstances that make it impossible to use anything else. On the weight side you probably do qualify, and Byetta would certainly help you there. One thing that seems to be common with most Byetta patients is that the weight loss starts immediately on the lower 5μg dose, whereas the greater BS reduction seems to occur on the 10μg dose. The normal progression (for those that need it) is to take the 5μg dose for one month and then move up to the 10μg dose. You could always ask your GP to keep you on the 5μg dose which would give you the benefits of weight loss but the lower dose would give you a smaller reduction in BS levels. Just a suggestion!

    Incidentally it is perfectly normal for there to be ketones in your urine, and testing for them won't give any indication of your blood sugar levels! Ketosis is a perfectly natural body function that occurs whenever you burn off any fat, and the by-product of ketosis is ketones that are flushed out through your urine. I would be inclined to ask your GP why he/she is going against NICE guidelines and the new government Framework for Diabetes guidelines in trying to discourage you from testing.
     
  8. Sammybee

    Sammybee · Member

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    Re: Anyone use Byetta?

    Hi,

    I need HELP! My medical history is I am type 2 diabetic and currently on Novorapid 30 about 50-60 units a day. I have high cholesterol (guess - can't spell) and I'm on simvastatin for that which i hate as I have to take it Suspension rather that tablet form. I had a Gastric Band 2 years ago and lost 3 1/2 stone. The op kept me off insulin for 18 months but the diabetes broke through and I had to go back on it. Since going back on it I have stoppped losing weight.

    My doctor mentioned Byetta to me and said he would find out if I was suitable for it BUT he has not come back to me even after my chasing him (maybe he has realised the cost!).

    After reading my history can anyone see any major reason that I would not be able to start Byetta, I need some come back when the doctor tries to tell me no.

    Please HELP!

    Many thanks,

    Sammy
     
  9. babbettes

    babbettes · Member

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    Re: Anyone use Byetta?

    i dont see any reason why you cant go on byetta im on insulin novorapid and mine has dropped from 30-30 30 units 3 times a day to 24-24-10 units which is good for me .
    keep the presure on your doctor because it does stop you eating so much and im now on byetta 10
     
  10. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Sammy,

    From what you have told us you do seem to fit the NICE guidelines for benefitting from Byetta. As you say your GP is probably concerned by the cost, but as you fit the prescribing guidelines his PCT have no grounds to challenge it if it was prescribed. As Babbettes said, keep pressurising him.

    I'm no insulin expert but you do seem to be on a pretty high dose and, as insulin encourages weight gain, it is doing you absolutely no favours in that department. One thing that you might consider is reducing your intake of carbohydrates, particularly the starchy carbs that do nothing for you apart from fill you up! These are wheat products (cake, bread, cereals), pasta, rice and potatoes. I'm assuming that you have already cut out sugar from your diet, although sugar actually does you less harm than the starchy carbs. A reduction in your carbs will do a number of things:
    - will help you to lose weight (permanently, not like Weightwatchers and similar diets where it all piles back on as soon as you come off the diet)
    - will lower your blood sugar and allow you to keep good control over your BS levels
    - Will drastically reduce your need for so much insulin
    - will make to feel far fitter and have more energy
    - will reduce your cholesterol.
    On the minus side - it needs you to think more about your food and understand what you can and can't eat based on what effect different foods have on you. By my book that's not much of a price to pay for feeling and looking good!!

    Whether you are allowed Byetta or not, a reduction in your carbs would still do you a power of good. If you would like more information on this then have a look at the low-carb or success stories threads.
     
  11. Sammybee

    Sammybee · Member

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    Re: Anyone use Byetta?

    Hi

    Thank you so much for your help, I will now put the pressure on!

    My weight is an issue with me but my diet is very good. This has been forced as with my gastric band it doesnt allow me to eat starchy carbs as they come straight back up. I eat very small quantities of food (healthy balance of food).

    I only stopped losing weight with my band when I started back on insulin. Which is why Byetta seems so appealing to me. Anything to help improve my health and weight! I also think Byetta would be good with my band as I can only eat very small quantities, so no over eating effects!!

    Many thanks again for your help and I will keep you informed on the progress!
     
  12. sixfoot

    sixfoot · Well-Known Member

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    Re: Anyone use Byetta?

    Sammy if it is an option for you go for it. Ive been on Byetta since April last year and recently passed the 3 stone lost marker which leaves me just a few pounds to get to my target. I could go lower to what they say is my BMI but I would look like a matchstick. Its already going to cost a bomb for some new clobber shortly as my trousers and jeans dont fit. I also lo Carb and agree wholeheartedly with Dennis.

    Good luck to you
    Dave P
     
  13. philipc

    philipc · Member

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    Re: Anyone use Byetta?

    Hey All - N00b here!

    Am starting using byetta on 11th March - NICE guidelines or not, my consultant put me on it...

    I am very wary about it to be honest - what should I expect?? - and is a 90 min group session at the hospital normal for getting started - or is my PCT just being extra careful!!

    Ooooh FTR I am on :

    4 x 30mg Glyclazide (spelling!!)
    3 x 850mg Metformin
    112 Units of Lantus - 1x daily
    10mg Ramipril
    30mg Pioglitozone
    30mg of some other blood pressure medicine I cant remember!!
    1000mg Omacor
    1 x Prozac 20mg for depression
    3 x 120mg Xenical for weight loss ( Been on them 4weeks - lost 4lb... now *only* 19st 3.4lbs)
    80mg Atorvastatin
    400mg Bezalip.

    (and yes, i do rattle when I walk lol :D :D )

    30 yr old male weighing as above. HBA1C at 9% - Triglycerides down from 41.2 (no joke) to 17. Cholesterol number at 7....

    Would i be right in thinking as well that the xenical and the byetta will work together in losing the weight?!

    Phil
     
  14. mikeydon

    mikeydon · Newbie

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    Re: Anyone use Byetta?

    i have just been prescribed byetta by my dr, i am so scared i have been on metformin for 1 year now, i think its the ostrich syndrome i thought this would go away through diet and excercise, i am overwhelmed by all this info !!!!!
     
  15. sixfoot

    sixfoot · Well-Known Member

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    Re: Anyone use Byetta?

    Phil - Mike hi and welcome, first well done for getting BYETTA. it is a good move unless you dont actually want to get bs under control or likely lose some weight.

    it does quite simply what it says on the tin. True some experience a kind of Nausea which generally goes after a while, but equally others me included dont.

    Rather than rewrite screeds of stuff check through the postings on this thread . Im sure most of your questions will already have been asked and answered. Im sure dennis will be along in a mo If / when you have more detailed requests.

    OH before i forget in all probability you will lose weight as a consequence of the way Byetta works.
    My general advice - take it easy, look at what you eat now , if you havnt got one get a test meter - Follow the injection instructions and prepare to get a whole lot better.
    Good luck
    Dave P
     
  16. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Phil,

    That's quite a cocktail you are on at the moment! Your doctor seems to have looked up every anti-diabetes and anti-cholesterol medicine currently produced and prescribed all of them!

    You really don't need to worry about going onto Byetta. It is one of the newest diabetes drugs available and has been proved to be enormously successful. Unlike most diabetes drugs which do only one thing, Byetta provides 5 benefits:
    - it triggers your pancreas into producing insulin in response to a meal
    - it stops the liver from producing unwanted glucose
    - it slows down the rate at which food is converted to blood sugar by slowing the digestive system
    - it reduces appetite
    - it reduces liver fat content (which encourages greater HDL (good cholesterol) and reduced triglycerides (bad cholesterol))

    What I would warn about though is that the manufacturers say you should not take Byetta with the combination of gliclazide, pioglitazone and Lantus that you are currently on. If you do then you could end up with a massive hypo. You will need your doses of Lantus, pioglitazone and gliclazide reduced considerably.

    One other thing is that the manufacturers say that Byetta should not be used in combination with other weight-reducing medication, which means either Byetta or Xenical, but not both. Also it is not recommended to use Byetta with ACE inhibitors (like Ramipril) because it reduces their effectiveness.

    What you will find, as Dave has already mentioned, is that Byetta is great at stabilising blood sugars, great for weight loss, and can also help with your high cholesterol levels. So go for it - and keep us informed of how you get on.

    Just realised, I should have mentioned that it is absolutely vital that you test your BS every day (and at least twice a day) especially while you are also taking other meds that cause hypos when used with Byetta.
     
  17. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Mikey and welcome to the forum,

    When my consultant first suggested Byetta I have to admit I was absolutely petrified. That wore off a bit when he explained all that it does, but I was still scared stiff of having to inject, because I have always had a needle phobia (I had actually been known to pass out on seeing an injection). But I was amazed at how quickly I got used to it and, after 18 months on Byetta, 3 stone lighter and blood sugars in the normal non-diabetic range, I thank God every day that I happened on a consultant who is a huge advocate of Byetta.

    Have a good read back through this thread and if you stall have any concerns then please ask away.
     
  18. fiona35

    fiona35 Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hey Everyone

    Have been advised by my clinic to now take Byetta 45mins to an hour before eating in order to not eat much but I've noticed that since doing this I suffer terrible heartburn, does anyone else have this problem or is it just a coincidence that its started at the same time when my foods haven't really changed.

    Cheers
     
  19. Dennis

    Dennis Type 2 · Well-Known Member

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    Re: Anyone use Byetta?

    Hi Fiona,

    I'm not sure where this idea came from that the longer you leave it between injection and eating then the more effective it will be - certainly not from the manufacturers because they have never claimed this. It is not mentioned in either their patient or practitioner literature. The only thing they do say is that the longer the gap then the more likely you are to experience the side effects - as you are now finding.

    The idea of Byetta is that it sets off first phase insulin production by your pancreas. In a non-diabetic person first phase is triggered by the stomach recognising that food has arrived and sending messages to the pancreas to get started. The pancreas starts insulin production within a few minutes of the first food arriving, before the food has even been converted into glucose. Depending on what type of carbohydrate is in the food, the conversion of carbs into glucose can take anything from a couple of minutes to more than an hour. This would indicate that logically, the ideal time to take Byetta for it to have maximum effect would be around 15-30 minutes before eating. That would get the pancreas getting its first phase production nicely into gear just in time for the first increases in blood sugar. And also avoids side effects.
     
  20. babbettes

    babbettes · Member

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    Re: Anyone use Byetta?

    i too have noticed i have been suffering from heart burn since starting byetta itake it 30- 45 mins before a meal
     
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