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<blockquote data-quote="Dennis" data-source="post: 45694" data-attributes="member: 1338"><p><strong>Re: Anyone use Byetta?</strong></p><p></p><p>Hi HLW and Nativenewyorker,</p><p></p><p>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.</p><p></p><p>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).</p><p></p><p>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!</p><p></p><p>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.</p></blockquote><p></p>
[QUOTE="Dennis, post: 45694, member: 1338"] [b]Re: Anyone use Byetta?[/b] 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. [/QUOTE]
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