BYETTA

Re: Anyone use Byetta?

descartesmum said:

Why should I have my metformin in the middle of my meal? I usually take one (850mg 3 times a day) right before my meal. Carol

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Hi Carol,
I feel so sorry that you have been suffering for so long - I just wish there was something more positive I could do to help you. The advice with both standard metformin and the slow release version is to take it with food, ideally with some water in the middle of your meal. This means that it is being digested with food rather than on its own, which reduces the side effects of indigestion (and sometimes nausea).

I have come across one other sufferer on Byetta, similar to you, who'se GP switched her back to the 5mg dose for a couple of months. She found that her body was able to accept the reduced dose with no side effects, and then when she was moved back up to the 10mg dose, she suffered only a few days of nausea the second time around. Might be worth suggesting to your GP?

Re: Anyone use Byetta?

sixfoot said:

As i see it there is only one draw back to all this healthyness and that is that i shall almost certainly need new trousers by Christmas, all my tops and tees are now nicely baggey.
Dave P

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Hi Dave,
I know that problem well. 18 months ago I was a 44" waist. I dropped to 42" and bought a whole new wardrobe. A few months later I was 40" - more new trousers. Then 38" - yet another batch of trousers. I was on holiday last week and just before we went I realised that yet again I was having trouble keeping my pants up, so yet another new stock of 36" waist.

If you see news of M&S profits going up, you'll know why!

Re: Anyone use Byetta?

Dave,
You lucky devel! Which part of Cyprus are you going to?

Re: Anyone use Byetta?

fiona35 said:

Have to say that being shown how to do the Injections were not that bad at all.

I'm a bit worried about the nausea side effects and wondered if someone could clarify what is the best way of trying to avoid the nausea. Is it worth getting some ginger biscuits in?

Also I've been told to inject before my b'fast and evening meal but what happens if I have my main meal at lunchtime for example I've had an injection at 9am for b'fast and am having lunch at 2pm like on a Sunday, do I wait till the evening or just have it earlier?

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Hi Fiona,
I just asked on the other thread whether you needed any info, only to find you have already asked for it on this one. Nausea is by far the worst side effect. It seems to be worse in females than males (no-one is sure why). It generally lasts for a week to 10 days, although in some people it disappears after just a day or two (and a few lucky souls never experience it at all). There are several ways you can reduce the nausea:
- have your injection immediately before you eat. The instructions say that you can inject up to an hour before you eat, but many people find that the longer the gap between injection and food then the worse the nausea.
- until the nausea wears off steer well clear of greasy or spicy foods - try to stick to food as bland and easily digestible as you can
- if you are also taking metformin (or glucophage) take them with some water in the middle of your meal so that they are digested along with the food rather than on their own
- rather than ginger biscuits (high carb) I would opt for a diet ginger beer - but diluted as it can be a bit fiery so not quite what you really need. A better alternative is Bottle Green ginger and lemongrass - available in cordial or presse versions. If you go for the cordial this is very strong so needs just a small amount with a lot of water.

The injections must be a minimum of 6 hours apart, so the recommendation is before breakfast and before your evening meal. It doesn't matter if your main meal is at lunchtime because the morning injection remains active for up to 6 hours and so will still be effective for lunchtime. You should still have the second injection in the evening, even if you are only going to accompany it with a snack meal.

One last thought - make sure that the dose you are started on is the 5μg dose, not the full 10μg. The active ingredient of Byetta is exenatide. Although very similar to the human body's own GLP-1 hormone, exenatide is not natural to humans and the body will try to fight it (hence the nausea). Despite the warnings given by the manufacturers, I have come across several doctors (and some consultants) who think they know better and start their patients straight on the higher dose. The result is always the same - the body rejects the exenatide, the patient is violently sick for several weeks, and can't be re-started on the correct dose for several months (sometimes never). You need to take the 5μg dose for a minimum of 1 month (preferably 2), so that you body is completely acclimatised to it, before moving up to the 10μg dose.

I can't think of anything else you might need to know at this stage, but just ask if you have any questions.

Good luck.

Re: Anyone use Byetta?

Janesi said:

I saw my consultant for the 1st time yesterday. I have been Type 2 for 4 years, now on 52 units of insulin daily along with 3 x 80mg gliclazide. My sugars are under excellent control. They have decided to put me onto Byetta. I'm used to injecting, so although needlephobic, I'mnot worried about that. What really concerns me is the nausea. I'm starting tonight on 5mg dose. I've been told to reduce my insulin by halve and also the gliclazide. I'm also concerned in doing that, that my sugars will go up again! Having spent the best part of a year getting them to this level I don't want ruin it all. I'm really worried about the whole thing.

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Hi Jane,
I can see what your consultant is trying to do, and it wouldn't surprise me if you did see an initial rise in your blood sugar, but this should be temporary so I wouldn't worry too much about it. I think it is likely that your insulin dose will need further adjustment as your body becomes used to the Byetta and is producing more of its own insulin. Certainly once you have progressed from the 5μg to the 10μg dose your insulin needs will need to be re-assessed.

As far as the nausea is concerned, either you will experience it or you won't. Unfortunately there is no way in advance of guessing which it will be for you. If you do suffer from it then following the tips I passed on to Fiona above will help reduce the effects.

Re: Anyone use Byetta?

Hi Fiona,
I know just what you mean. I have always had a bit of a phobia about needles so was very apprehensive about how I would manage with the injections, but I found it to be surprisingly easy.

Taking Byetta shouldn't prevent you from doing whatever activities you normally do. I would say that it is always wise to check your BS before undertaking any strenuous exercise, but Byetta on its own should never be able to cause a hypo.

The advice about refridgeration is now out of date. The manufacturers say that it can be stored at room temperature. It is ok provided it doesn't freeze or go above 25C (77F). They always insist that it is refrigerated before first use, but this is because the warehouses that pharmaceutical companies use can get very hot. But once you have got it home then you don't need to keep it in the fridge. I have to admit that I normally do - but that is more out of habit because when I first started on it, the instructions were refrigerate at all times. We were away last week and I just kept it in a drawer in my room at normal room temperature. It is a clear liquid and the temperature doesn't seem to make any difference to its viscosity.

One last pointer before you start - you inject the dose by pressing in the plunger at the end of the pen. It is very important that you keep the plunger fully depressed until the needle is completely withdrawn. If you release the plunger too soon then this can create a partial vacuum and draw blood up the needle and into the pen chamber. Once this happens the exenatide is ruined and you will need to get a new pen. its something you will only ever do once!!

Almost forgot to mention, the pen doesn't come with needles, so hopefully you have been given a prescription for some? If not they can be purchased over the counter. You will need 8mm 31gauge BD Microfine needles.

Keep in touch and let us know how you get on.

Re: Anyone use Byetta?

Hi Fiona,
The pharmacist is simply repeating the instructions that they are given by the manufacturers, Eli Lilly. These are that the pen must be kept refrigerated until first use - this is simply to ensure that stocks of it are not stored in a warehouse right next to a heating vent where they will be subjected to high temperatures (anything over 25C will kill the exenatide). Once youv'e got it home you can store it in the fridge or at room temperature. As I keep mine in the fridge, partly to keep it out of reach of our young grandchildren, I always inject it chilled, but it makes no difference whether it is chilled or warm on injection.

If you read the leaflet that comes with the pack it explains about storage in more detail. You will find the instructions show you how to prime the pen ready for first use. Although they say to go through the process once, I have always found that you need to do it twice as nothing ever comes out at the first attempt!

If you ever get stuck with a question and I (or one of the other Byetta regulars) am not around, then you can phone the Eli Lilly UK helpdesk (details in the pack). I have always found them extremely helpful. Also the Byetta website has some pretty useful information.
http://www.byetta.com/index.jsp

Re: Anyone use Byetta?

Hi Fiona,
When I go out I take the pen with me in its box - this has compartments either side of the channel the pen sits in that are shaped to store needles. Don't ever fit the needle before you need to use the pen - it will allow air into the chamber and a big air bubble can restrict the amount of Byetta that gets expelled when you use the pen.

I occasionally give my stomach a rest by injecting into my thighs, but like you my thighs are quite lean. I bought a box of 5mm needles that I use for thigh injections. Even then I can't pinch very much fat so I have to inject at an angle to prevent injecting into muscle. If you should inject into muscle, you will certainly know about it because it is quite painful - and the Byetta doesn't work properly when injected into muscle.

Re: Anyone use Byetta?

Hi John and a warm welcome to you.
When I first learned I was to go on to Byetta my biggest fear was over the injecting as I have always been a bit needle-phobic and have been known to pass out on seeing blood samples being taken - I always have to look the other way when I go in for my HBA1C sample. I surprised myself by taking to injecting easily - it seems very different when it's you doing it to you!

If you have a look back through this thread (its a pretty long thread) I suspect that you will probably find the answers to most, if not all, of your questions, but if not then please feel free to fire away and I will do my best to answer them.