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BYETTA

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Dennis

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West Sussex
Type of diabetes
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Non-insulin injectable medication (incretin mimetics)
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People who join web forums to be agressive and cause trouble
BYETTA users

Hi all, This is my first post on this blog - type 2 for 5 years and about to start using a combination of Glucophage and Byetta. I know that Byetta is only recently licenced for use in the UK so wondered if any of you have any experience of it?
 
No responses so I guess not. Surprising as Byetta is being touted as the new gold standard for treatment of type 2. However it is more expensive than the current treatments and my experience is that, while my consultant is eager to get me started on it, my GP can't or won't prescribe it because of the cost.

I now find myself in the situation where, having contributed to Nat Insurance all my life, I can't get on the NHS the treatment that a specialist says I must have. I am having to pay for it myself, £100+ per month. :(
 
Oh it is here in the new stuff:

http://www.bnf.org.uk/bnf/extra/current ... tm#detail6

<font color="blue">Byetta® (Lilly)

Injection, prefilled pen, exenatide 250 micrograms/mL, net price 5-microgram pen (60 doses) = £68.24, 10-microgram pen (60 doses) = £68.24

BNF section 6.1.2.3. Type 2 diabetes mellitus in combination with metformin or sulphonylurea or with both.</font id="blue">

If it needs injecting and has to be taken in combination with an existing oral what is the big advantage?
 
It has just been licenced last month for use by NHS Scotland. NICE always takes much longer to review new drugs. I want it but i'm wary of the nausea most Americans seemed to complain of. Especially as I am prone to reflux acid. Sitagliptin is due for review next month by the Scottish Medicines Consortium. It is an oral drug with similar end effects as Byetta. Hoping to try sitagliptin as it significantly reduces insulin doses.



Marty B
 
Yes, Byetta is approved and on the NHS list, but prescribed by very few NHS GPs because of cost. GPs would rather we all just used insulin as it is cheap. My consultant describes insulin as the biggest spanner in the box, and shouldn't be used when there is something far more appropriate.

I think the main advantages of Byetta are in the way it works and its beneficial side effects. It is an incretin, which is the substance that is secreted by the stomach when it senses food and triggers the pancreas to produce insulin. As soon as there is enough insulin to deal with the food, the incretin stops calling for it. That means it can never cause a hypo. The great side effect is that nearly everyone on it experiences weight loss - without even trying to diet. On the down side, yes it has to be injected and it can cause nausea, although I haven't experienced that.

With many type 2s incretin production is suppressed to some degree, so the pancreas gets either half the message, or no message. Unlike Byetta, which tops up the suppressed incretin, Sitagliptin stops the suppression, thereby allowing the stomach to create and use its own incretin. This explanation is probably a huge over-simplification, but I am not a medical man.

Both are very new - I believe that the action of incretins was only discovered in the 1990s.

Dennis

PS Marty, is that the Aberdeen & ManU legend?
 
Unfortunately, MB of Man U is no relation. Glad you are geting on ok with Exenatide. Keep posting.

BTW Sitagliptin inhibits the enzyme which degrades the incretin GLP, thereby prolonging GLP action.

Marty B
 
Marty, Looks like its still just me on this forum. I'm now on my third month and it is having the desired effects of lowering BGs, reducing appetite and weight loss. I've had no problems with nausea, even on the full strength 10mcg dose. The nausea seems to affect women far more than men. I also post on an American users forum. Some of them have been using it for around 2 years and only one contributor has suffered mild pancreatitis.

Its been approved by NICE, although with a lot of strings attached before a GP is allowed to prescribe. However, my local PCT has banned GPs in this area from prescribing on cost grounds.
 
Don't hink I will get it as am on Insulin and Metformin. My diabetologist (a newbie) has started 5 people on it. I am due to see him soon and will try to get sitagliptin. Will post if successful. Iam glad it works well with you. Are you still paying for it yourself?

Marty B
 
Marty, If you are on insulin then you probably won't be allowed Byetta, unless it could be used to replace the insulin. Interestingly Eli Lilly are just completing trials of Byetta used alongside insulin and are expected to announce very soon that it is a safe combination. It is already being prescribed with insulin by some Drs in the US in advance of the results.

Unfortunately I am still paying for it, and likely to continue until it becomes more widely accepted.
 
I hear a lot of the Glasgow diabetoloigsts aare very impressed with Byetta. I tried it on again todsy with my diabetologist- but he is sticking to the guidlines (not for insulin users at the moment).

I am just about to change from Lantus to Levemir and will go on a bisphosphonate next week (probably) for my Charcot's foot problem. No point in adding in something extremely different at the moment.

Marty B
 
Started my first day on byetta have been very sick I was put on to insulin acouple of months ago just to top up my avandenet i endede up on 4 injections a day aND blood sugars going up from 8 to 26 then they realised the more insulin i had the worse i got then they realised i am insulin resistant i hope the sickness goes away after a few weeks
i have got mine on the NHS. in america the nick name for byetta is
Lizard Spit apparantly some guy discoved that this giant lizard could help diabetics STRAIGHT UP NO KIDDING it is of course made syntheticaly now WELL I THINK IT IS WILL LET YOU KNOW HOW I AM GETTING ON

SUE
 
bbsue - good luck. There are a few tips from memory- like taking the byetta just before you eat and avoid the spicy stuff. I am sure Dennis can tell you more. Look up the US forums to get more advice. It seems most people get over the nausea.

Marty B
 
Hi bbsue, nice to have a fellow byetta user on here at last. I presume you have started on the 5mcg pen? I was on that for a month, which appears to be the norm, and now on the 10mcg for 2 months. Interesting that you are able to get it on NHS because many PCTs refuse to let doctors prescribe it, even though NICE have approved it. Which PCT do you come under?

Hopefully your nausea will wear off after a few days. Mine did although the nausea symptoms seem to wear off quicker for men than women. As Marty says it helps for the first couple of weeks if you avoid anything spicy, but once the nausea goes you can eat pretty much as normal. You can take the injection any time up to an hour before eating, and many have found that the longer the gap between the jab and the food then the less hungry you feel so will eat less. Whatever you do don't have the jab and then not eat, or take the jab after you have eaten. Either of these can result in a serious hypo.

If there's anything you are not sure of on byetta just ask. I'll answer if I can, but I can recommend the byetta users blog in the States. Some of the contributors have been using it for 2 years or more and are very knowledgeable about it. This is the link to it http://lizardspit.blogstream.com/
 
Anyone on Sitagliptin yet?

I shot myself in the foot this week (HBA1c 5.9% on Monday). Mind you, I am taking loads on insulin to control my BS. Put on 10 pounds since October. I want sitagliptin as an insulin sparing thing. Maybe I have to raise my HBA1c to increase my chances of getting it.

Marty B
 
I did mention both today to my absolutely fab diabetic nurse who'd been off sick since before christmas and it felt like my arm had been removed. My pct won't even entertain prescribing it on cost grounds. It
doesn't seem to matter if it's beneficial to patients if it costs more than the price of a plaster unfortunately:(

>^..^<
 
Dennis


Had my first appointment with the hospital Diabetic Consultant re my haphazard blood glucose results. She has now prescribed Exenatide injections which hopefully will bring down my levels and also stop me putting on weight which the Pioglitazone (Actos) was doing. At my retinal eye check up last week it was found that I have quite a lot of black spots in both of my eyes so the plates have been sent off for furtehr *******ysis.


Has anyone had experience of this treament yet?

Pauline Jones
 
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