Lantus to Byetta?

[Erica Nurney]

Hi, I'm new here and despite my jokey username I am male, 61 had T2 for 10 years and now on 36u Lantus daily, with 15-22u pre-prandial Aspart as required. I also take Metformin 3 x 850mg, various BP meds and aspirin. Just to add to the daily cocktail I take loratadine at this time of the year for hay fever.

I am 108 kg in weight, 5ft 8in tall, BMI 36 in the morbidly obese range. I saw the doc last December and suggested to him that I might be put on Byetta, as I am desperate to lose weight. He said that Byetta might not work because my HbA1c and FBGs suggested my pancreas was knackered, and I might get no benefit from Byetta if my islet cells were severely reduced in number.

Rather than Byetta, I got put on a course of Xenical, the anti-obesity drug, which reduces your body's ability to absorb fat. Unbeknown to me but logical when you think about it, the Xenical reduced my basal BG levels and I started getting hypos all over the place until I adjusted my insulin downwards. My lantus reduced to 36u from 52u, my aspart from 20-28u to 15-22u. Weight is slowly, very slowly dropping off at about 2kg a month but I still have to stave off hypos from time to time with glucose tablets, this is not helping me to lose weight, of course.

I regularly exercise in a gym and work full-time in a fairly active job, though like many folks I could exercise more. My diet consists of reduced quantities of "normal" food, with due consideration being given to fresh fruit and vegetables, high fibre and low GI products

I wondered if anyone has enough expertise to say whether going on to Byetta might be more helpful to me than my present regime. I am p1ssed off with the constant battle with hypos, my surgery threatens to withdraw Xenical if I don't start dropping off more pounds, not knowing that I have to ingest useless calories from time to time to stave off hypos.

Having used needles for some time that does not have any fear for me, and the the thought of nausea as a side-effect seems no worse than the Xenical induced oily diarrhea (sorry to be so graphic) I currently put up with.

What are your thoughts - if there are any professionals on here I would welcome some advice.

Many thanks.

EN

 

[martinbuchan]

One of the effects of Byetta relies on enhancing native insulin production. But its other varied effects are still useful. I am keen to use it for it's weight reduction effects and post prandial BS effects. My diabetologist is slowly coming around to my way of thinking.

Like you I have Beta cell failure with Type 2. Byetta is not really licensed for cases like us yet. I came across an anecdotal report from Coventry looking at 33 insulin using type 2s who were put on Byetta. The insulin requirements dropped by a third. I don't know what the range of insulin use was. I use 100 units levemir a day and about 50-60 novorapid in total. I think the levemir costs £1000 per year as a rough guess.

Also, Byetta has been shown to bring Beta cells back to life functionally. That would be brilliant if to be believed. It seems you will be less insulin resistant as your weight comes down.

At the moment it seems it is either / or with insulin and byetta. I want both but this is uncharted waters.

Good luck

 

[sixfoot]

Fellas am T2 on Byetta for about just over a month. Not everybody gets the nausea i havnt on both dose rates. I does help with the appetite suppression and i speak as someone who does like their grub. On my induction to Byetta in late March there were some 6 others who were using Insulin and all were telling the same stories as you. I have a review comming up on 19th May when all this stuff comes up for discussion - will let you know