Lows, Highs, Carbs, Needle & other meds
Is taking Byetta with other oral meds and/or insulin a real
requirement? If it is, that is just the opposite of what I was told by
my Endo. Over the last year he has put over 50 people on Byetta and
several of them have been taken off all oral medications. He advised
me that it may be possible for me to reduce or completely come off my
oral meds at some point.
Two days ago I transitioned from 5mcg to 10mcg. I have had a few lows
that I began to get the shakes and sweats. I start to feel the lows
when I get near 80. The lowest I have had is 60. I cannot imagine a
low in the 20’s. The biggest problem I have is high fasting bG
levels. Seems my liver is releasing allot of glucose. I have been
told that there could be some control on that by eating a late night
snack, which I usually avoid. Apparently, the body begins to think it
is hungry for fuel and then signals the liver to release glucose.
Still have not gotten a handle on it yet.
Seems I am learning all over how different carbs affect my overall bG
level performance. For years I have been on an extremely low carb diet
limiting my daily intake to 30-50g perday. I was first diagnosed in
1992 with type II and started on just controlling it through diet.
Found out real quick how much of an impact the carbs were having and
decided to get with a plan to limit their intake.
In 1997 my family doctor sent me to an Endo and I was later put on oral
meds to assist in the bG control. For years my A1C stayed between 5.6
and 6.0. Then during the last two years it began to gradually creep
upward. The Endo began trying different meds and dose level and they
all seemed to be short lived. When the A1C crossed over the 8.0 mark I
began getting real concerned. Having lost over 120 lbs from 330 down
to 210 during the 12 year period, I was still always hungry. I would
practically starve myself for days and then occasionally decide ‘what
the hell’ and sit down and eat 3-4 slices of pizza or have a baked
potatoe. My bG would shoot above 300 and sometimes above 400. My
fasting bG levels began to also creep well above 250 almost daily.
Now that I am on Byetta, the hunger has disappeared. I am once again
dropping a few pounds. I am seeing my average fasting bG levels
dropping. I am checking my bG level 8-10 times a day and having to
systematically try different foods to see what the effects are on bG
level. That coupled with my riding my bike 2-3 miles each morning, I
hopefully will get a handle on everything and once again see my A1C
levels below 7.0. I have five more weeks before my next lab work and
am keeping the fingers crossed there will be positive results.
As far a needle size, I started with the 5mcg Byetta that came with the
BD 5mm 31g pen needle. I was told by my Endo to make the injections
only in my stomach area because that is the only place I had enough
fat. The pen needles seemed to work just fine and there was no
discomfort. I filled an Rx for additional needles and was given Reli-
On 8mm 31g. I used them and always had discomfort and about one of ten
injections would cause bruising. I have used all the Reli-On needles
and am back using the BD 5mm 31g with no discomfort at all.
This is a great group that shares in their experiences in using Byetta
and the unique and individual techniques found to work for some but not
all. Most important is the communication between each other and our
own doctors to help us manage our type II diabetes.
March 15th, 2007 at 9:07 pm
Jim, per the FDA, the answer is Yes. Byetta is not intended to be a
stand-alone drug and should be used with one or more oral medications used
to treat type 2 diabetes (see my post from last night).
March 16th, 2007 at 1:59 am
Michael
Jim
March 17th, 2007 at 7:52 pm
thanks for sharing, jim………….baz
Two days ago I transitioned from 5mcg to 10mcg. I have had a few lows
that I began to get the shakes and sweats. I start to feel the lows
when I get near 80. The lowest I have had is 60. I cannot imagine a
low in the 20’s. The biggest problem I have is high fasting bG
levels. Seems my liver is releasing allot of glucose. I have been
told that there could be some control on that by eating a late night
snack, which I usually avoid. Apparently, the body begins to think it
is hungry for fuel and then signals the liver to release glucose.
Still have not gotten a handle on it yet.
Seems I am learning all over how different carbs affect my overall bG
level performance. For years I have been on an extremely low carb diet
limiting my daily intake to 30-50g perday. I was first diagnosed in
1992 with type II and started on just controlling it through diet.
Found out real quick how much of an impact the carbs were having and
decided to get with a plan to limit their intake.
In 1997 my family doctor sent me to an Endo and I was later put on oral
meds to assist in the bG control. For years my A1C stayed between 5.6
and 6.0. Then during the last two years it began to gradually creep
upward. The Endo began trying different meds and dose level and they
all seemed to be short lived. When the A1C crossed over the 8.0 mark I
began getting real concerned. Having lost over 120 lbs from 330 down
to 210 during the 12 year period, I was still always hungry. I would
practically starve myself for days and then occasionally decide ‘what
the hell’ and sit down and eat 3-4 slices of pizza or have a baked
potatoe. My bG would shoot above 300 and sometimes above 400. My
fasting bG levels began to also creep well above 250 almost daily.
Now that I am on Byetta, the hunger has disappeared. I am once again
dropping a few pounds. I am seeing my average fasting bG levels
dropping. I am checking my bG level 8-10 times a day and having to
systematically try different foods to see what the effects are on bG
level. That coupled with my riding my bike 2-3 miles each morning, I
hopefully will get a handle on everything and once again see my A1C
levels below 7.0. I have five more weeks before my next lab work and
am keeping the fingers crossed there will be positive results.
As far a needle size, I started with the 5mcg Byetta that came with the
BD 5mm 31g pen needle. I was told by my Endo to make the injections
only in my stomach area because that is the only place I had enough
fat. The pen needles seemed to work just fine and there was no
discomfort. I filled an Rx for additional needles and was given Reli-
On 8mm 31g. I used them and always had discomfort and about one of ten
injections would cause bruising. I have used all the Reli-On needles
and am back using the BD 5mm 31g with no discomfort at all.
This is a great group that shares in their experiences in using Byetta
and the unique and individual techniques found to work for some but not
all. Most important is the communication between each other and our
own doctors to help us manage our type II diabetes.
Jim
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March 18th, 2007 at 5:00 am
Are you a member of the ADA? This month’s Diabetes Forecast magazine has an
article about Byetta and Symlin on page 23. At the top of page 25 it states
what I posted yesterday. I found several websites that mention Byetta as a
monotherapy but they stated that the FDA would consider this and I did not
find any source that stated it had been approved as a stand-alone treatment
for type 2. Nor did I find any reference to monotherapy when reviewing the
prescribing information on the Byetta.com website.
March 18th, 2007 at 2:15 pm
I was taking Glucovance and it gave me severe digestive problems and my
doctor suggested I try the Byetta as a stand-alone medication. During the
first three months I did have some problems with lows between 32 - 48 a few
times but not since month four have I gone below 72. Most of the time I
range between 94 and 104.
I just started month six and my numbers are now averaging from 104 - 112
which concerns me. I guess my A1C in late July will determine if I have to
add something else in. I think it may be my fault — I have been trying to
eat less carbs and every time I do that my BG rises.
March 20th, 2007 at 7:29 am
There is no medical reason why byetta was approved to be used in
combination alone. I think it was a marketing tactic. It found a niche in
which to market itself,ie. those who had just about exausted other meds
before moving to insulin.
Had they introduced it first as a mono med they would be competing with 3
or 4 classes of existing drugs. When looked at on a broader level it is
similar to other meds alone in its effect on a1c glucose. It however has
an effect different then the others and has an combination impact greater
then any other two classes of meds. Recalling that in the niche market
those other combinations were already failing to arrest the progress of the
disorder.
The other med januvia which is also related to the incretin effect was from
the first tested and approved as a mono or combination med.