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Byetta

J

Jacqhar

Active Member
Messages
31
Hi

I was diagnosed 2 years ago and have only just been referred to a DSN who has suggested I start taking Byetta but my GP is not sure as he says he would rather me try other options first. I am taking Metformin and Ameryl and have in the past 6 months tried Gliclazide (put on over 2 stone on this).

Please can someone tell me who is right my GP or my GSN?

thanks
 
jacqhar, hi and welcome. On the face of it, your GP at least knowing about Byetta is a good sign even the point that he is willing to try other treatments. Your Nurse might be a little more Gen`d up having recommended it directly. As a T2 what you dont need is the extra weight gain, that worsens insulin resistance.

Byetta is licenced for use with other treatments. If you look at the several Byetta threads on here you will see postings of the experiences of loads of peeps. In the main it does work, but better if you make some lifestyle changes - particularly dietwise.
It has some side-effects most noteably the possibility of nausea which is mostly short lived. Not everyone experiences this however. The other is weight loss which happens for most people again particularly if you make some lifestyle changes.
The normal route once accepted is to start on 5mcg pen for 1 month then if ok to proceed to the higher 10mcg.

I am on Byetta and have been for 3 months. I have weight loss and have made diet changes. From my experience i would advise you to ask for it. Many Primary Care Trusts will only issue it to those with high Body Mass Index which may explain your doctors approach.

I hope this gives you something to go on
Let us know how you get on

Dave P
 
Hi Sixfoot

I wish I had a pound everytime soem one said I need to change my life style. My diet is reasonably good - NEVER eat junk food or fried food, have never added sugar to my diet and pre-diabetes only ate chocolate or biscuits once a week. I was diagnosed with an underactive thyroid after the birth of my son 24 years ago and have struggled with my weigh ever since. I've started back at the gym three times a week since changing to Ameryl and have lost a couple of pounds. I know this might sound crazy but as long as I am 'fit' and my sugars are under control I don't really care about the weight.
thanks for your support I have taken your advice and looked at other postings on Byetta - the side affects are a bit worrying as I hate feeling!!! :oops:

Will keep you posted with
Jac
 
Hi Jacqhar,
Both Amaryl and gliclazide are sulphonylureas and they do have the unfortunate side effect of ecouraging weight gain. Byetta has the opposite claim of encouraging weight loss, as well as stimulating the pancreas to produce insulin (which is what the sulphonylureas do). However, Byetta also does a number of other things that the other drugs do not do and has been proven to be enormously successful in the treatment of Type-2 diabetes.

I can understand why your GP would be reluctant to prescribe Byetta because it is more expensive than many other diabetes treatments, but I'm surprised your DSN should recommend it if your blood sugars are already under control (unless it was suggested only for its weight-reducing properties). If you don't mind my asking, what is your HBA1C and your daily test readings?
 
I looked up the prescribing protocols. David Mendosa,the renowned journalist, used Byetta and lost a lot of weight and currently is not using any medication( low carb eaing)
I asked about it myself and was told I'm too well controlled and not heavy enough.
Here are the protocols
Exenatide is indicated for the treatment of Type 2 diabetes mellitus in combination
with metformin and/or sulphonylureas in patients who have not achieved adequate
glycaemic control on maximally tolerated doses of these oral therapies.
In addition it is intended that exenatide is used in overweight (BMI> 30Kg/m2)
patients where adding insulin therapy would be the alternative treatment leading to
further weight gain. NB Glitazones are currently not licensed for use in combination
with exenatide and are not indicated for use within this protocol.
I assume it's very expensive.
 
hanadr said:
I assume it's very expensive.
Click to expand...
Hi Hanadr,
Cost to the NHS for a byetta injection pen is £68 per month. I believe that some types of insulin cost more than this.
 
Thanks All

My last HBA1C was 9.2 but may have come down because my recent daily readings are 6.5 to 8.2 (fasting). My BMI is 34 so after speaking to my DSN and taking advice on this site I yesterday asked took the plunge and asked the DSN for Byetta. She really is good my GP is still not sure so she (DSN) sent me a prescription from the Consultant which arrived this morning less than 24 hours from my request - I wish the rest of my lift was that organised!

Thanks again for all the help I will keep you posted on how I progress and now have found this site you'll be hearing from regularly. It feels so good to have a group of people who understand your fears and hopes. :D
 
Hi Jacqhar,
From those readings you seem to meet all the NICE requirements for byetta treatment. I have to say it was a bit of a cheek that your DSN went behind your GP's back to get you onto byetta! I think if I was the GP I would be feeling a bit peed off with her!!

Good luck and please keep us informed of how you get on, and in particular whether you get any side effects.

Also make sure that you are started on the 5mg pen, not the 10mg. This is absolutely vital - the manufacturer's practitioner guidelines are adamant that all patients MUST be started at 5mg, but some doctors (even consultants who should know better) think they can take a shortcut and start patients at the 10mg dose. I have come across many patients who have been started on the 10 pen and in nearly every case they experienced extreme nausea and were unable to continue byetta treatment.
 
Jacuar I simply echo what dennis has said and wish you well with it. Oh and i should start saving for that new bikini cos in a year youll probably need one :D

Dave P
 
Started on Byetta today!!!!

Was expecting to feel ill all day but all that has happened is that I have a horrid taste in my mouth - metallic. Is this normal and if the sicknes is going to arrive would it have kicked in by now? The needle didn't hurt as much as the pen I use to test and my BS level was down to 5.2 before lunch but up to 7.2 before my evening meal this is loads better than this time last week. Didn't think it would work this quickly.
 
Hi Jacqhar,
One or two in the States have mentioned the metallic taste but it tends to wear off in a few days. The nausea is your body's reaction to what is in effect a foreign substance. Generally if you are going to experience it, this will start within the first 2 days. If you do find you are feeling queasy, just try doing the injection immediately before you eat - many people find it helps reduce the nauseous feeling. The nausea (if you are going to get it - 44% do, 56% don't) generally wears off in a week to 10 days once your body becomes acclimatised to the byetta. Unfortunately it comes back again when (or if) you move up to the 10mg pen, but again it only lasts for a week or so.

I presume you are still on the metformin and Amaryl? If so then you will need to watch your BG very carefully because the Amaryl, when used in conjunction with byetta, can cause a hypo. If you find your levels are dropping too low, just ask your GP if the Amaryl dose can be reduced. The Amaryl you are taking simply forces the pancreas to produce insulin. Byetta mimics the incretins that tell the pancreas to produce insulin, so by taking both meds, your pancreas can end up producing too much, hence the hypo. The fact that you dropped lower than you are used to before lunch is evidence of the additional insulin your pancreas is producing, which is why you need to monitor the situation.

Well done - sounds like you have made a good start.
 
Hi Dennis

Thanks for your advice, I contacted my DSN yesterday and told her about your post and she advised that you are right and as the Byetta is working and I am not having any major side affects it would be a good idea to stop taking Ameryll for now and if b/s does not stablise look at putting me back on it.

The taste in my mouth is absolutely awful - cuppa's taste like old pennies!!

Do you know what would happen if I took the Byetta and then took longer than one hour to eat - just thinking going out for a family meal soon and speaking from experience when we all go to a resturant it some times takes over an hour to get the main courses (there is usually at least 28 of us - thank God it's only twice a year).

thanks

Jac
 
Hi Jac,
Like you, I was on Amaryl as well as the byetta, so know what the effects can be. When I first started on Byetta I was on 4mg Amaryl and my consultant halved this to 2 mg. After 3 months he halved it again to 1mg and after another 2 months dropped to half a 1mg tablet. I have now been off it completely for a month and no noticable increase in BG levels throughout that reduction.

If you have your injection a little more than an hour before eating it won't make any difference. Byetta doesn't just switch off after an hour. But if you are not able to eat within a hour and a half, then you may suffer a hypo. This is because the byetta causes the pancreas to start producing insulin (this is called first-phase production), but there won't be much blood sugar for the insulin to work on. Also by the time you do eat the first-phase production will have stopped so the byetta will be less effective and won't be able to control your raise in blood sugar as well as if you had eaten earlier. For an odd occasion going a little over the hour probably wouldn't matter.

What I usually do if eating at a restaurant or at friends or on holiday, is take the pen with me (not forgetting a needle) and just before the food arrives I just excuse myself, pop off to the loo and do the injection. The tray in the pen box has compartments to take different sized needles. Some people have said they inject at the table, through their clothes. Personally I don't like the idea because other diners may find it off-putting and also sometimes you can get a drop of blood at the injection site, which doesn't do a lot for the smart top or dress you put on to eat out! The pens don't need to be constantly refrigerated now (the manufacturers used to recommend this), so they are ok to take with you to a restaurant.

I hope the metallic taste soon goes, it can't be very pleasant.
 
I am on Metformin and Byetta and once I started taking the higher dose of Byetta got the horrible metallic taste in my mouth. That also contributed to my nausea. At the moment we are juggling a little with doses of my meds to see what works best.
I fully sympathise with you over the horrible taste.
 
Horrid taste has gone - yipee BUT hunger has returned. Need to learn more about the Lo-Carb diet that stops hunger pangs. I love bread, potatoes and eat a lot of fruit. My B/S has been wonderful ove the last couple of days 5.2 and 5.6 which is such a huge improvement - I think I have also lost about 3lbs.

I usually have 2 Weetabix and an apple or banana for b/fast - don't have time to cook. For lunch have a wholemeal roll with ham or chicken and salad. For my evening meal its usually a small potion of pasta or boiled potatoes, Veg or salad followed by fruit. I know many of you will say there is too much carb in this diet but I have found that if I cut out the bread or potatoes I sometimes have mild hypo just before lunch (3.3) which makes me feel rough all afternoon. I am a terrible cook and would end up with food poisoning or something if i tried to cook anything at lunch time plus I sometimes work whilst eating.

Any suggestions - apart from emplying a full time cook!! :lol:
 
Hi Jac,
That's great news. The control is looking really promising so far - now you've got it down to the low 5s, the challenge is to keep it there!!

Your mix of carbs just goes to prove that what works for one person is not necessarily the solution for everyone. Your carb intake is more than I would be able to manage, but it seems to work fine for you. Plus you know that, if the numbers do start to creep up, then you can always drop a few carbs to compensate.

Not sure if my GP does full time cooks on prescription. You probably have to go private for that!!
 
Hi not been on for a while and feeling very sorry for myself. Been on byetta for 3 months now and am still getting nausea, today the vomiting was back too. How can it be getting worse and not better?
I have a permanent bad taste in my mouth and dread meal times. I've lost over 3 stone (which is great) but feel like throwing in the towel just to get up in the morning and feel "normal". At the moment the family are eating their dinner, I can't go anywhere near them because of the smell and sight of it, I've not eaten since breakfast and do not feel like eating anything. Shopping trips are avoided and eating socially is spoilt by the after effects.
I've tried, ginger biscuits, sipping ginger beer, adding ginger to meals. I eat straight after injecting. Has anyone else had these symptoms continue? Has anyone been able to solve it? :?:
thanks for listening
snorkmaiden
 
After going on to the 10mg pen I got exactly the same symptoms...bad taste and more or less constant nausea...couldnt even look at food in the supermarket let alone cook it. Spoke to my diabetic nurse and we tried halving my Metformin first but I still was being sick so I have now gone back down to the 5mg pen and things are much better...I actually cooked a roast dinner today...3 months on the 10mg have been a nightmare. You need to talk to your diabetic nurse and she what she suggests.
 
Thanks I will talk to her.....unfortunately she is one of the "eat 30 mins after your injection" brigade....but I think I will request reducing it back to 5 mcgs for a while, my body seems to be going into starvation mode and not losing weight, and if I ever come off it I certainly don't want to put all the weight back on by looking at a new potato! Did you find a total inability to eat meat? I survive on melon, strawberries, occasional banana and soup.....and I cannot drink anything today.. :(
 
Yes I really struggled with meat...couldnt even look at it in the shops. Lunch times weren't too bad but evening meals were a real struggle. I felt really ill all the time and was worried about going anywhere in case I was sick. I just have to hope now that the 5mg dose keeps working on my Hba1c. I don't want to put back on the weight I have lost either.
Met some people I know yesterday and hadnt seen for a long time and they said I looked really good...I still have some weight to lose but I have gone from a size 24 to a 16....and havent been that size since I was 16 lol.
Keep in touch and let me know how you get on. Its good for me to know that i am not the only one whos had the same problems.
 
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