Switching from Byetta to Insulin

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agilestatue

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Type 2
Hopefully this is the correct forum to put this in - if not please accept my apologies:

I have been a type 2 diabetic for over a year now - first having taken Metformin, then Glicazide, then Glipizide, and now complementing that with 5mg Byetta once or twice a day depending how well I feel. At first I did put up with the side affects (sickness, bloatedness, dizziness etc.) but now after 4-5 months of being on the stuff and seeing no end in sight to them I am sorely tempted to ditch both drugs in and switch to Insulin (my GP has already told me that it is really the only option left open to me now). Has anyone else been down this route and could they share their experiences with me regarding how much better / worse they felt and if the blood sugar level was a lot easier to control bearing in mind from what I have been told, there is a much greater risk of 'hypos' when on insulin compared to my current regime.

Thanks in advance,

Mark
 
There are people on the forum who use byetta, so they are in a better position to help you. I'm sure someone will be along soon.

Just wanted to say good luck with the transition, I hope you feel better for it.
 
Hi Mark, welcome to the forum :) We have quite a few byetta users, but not sure how many for whom it didn't settle down and subsequently went onto insulin (we do, however, have many insulin using Type2s).

From what I know of the way Byetta works, I would think that hypos are more likely on insulin, but that doesn't mean necessarily that you will suffer from them should you be started on it. If you can get the doses correct to match your food intake and lifestyle then you can quite happily live without much fear of hypos - this is especially true if you are only put on a basal (slow-acting) insulin like lantus or levemir. The main dangers of hypos come when you take too much fast-acting insulin for your body's needs, or when you hve made significant lifestyle changes like increased activity or weight loss without appropriate adjustment of insulin doses.
 
Hi Mark
I'm T2 but on Metformin only, so I can't comment on Byetta or insulin. I just wanted to say 'Welcome to the forum!':)
 
Hi Mark, I'm a Byetta user. I started on June 9th and so far I'm ok with it so hopefully for now I won't need insulin. I know how you feel with the side effects, thankfully I only had 2 weeks of it when I started the 10 pen. I found that by changing what I ate and drinking ginger tea I managed and now I feel ok again.The bloating is pretty awful but I have got round that by reducing my intake. I probably eat a third of what I used to at meal times and rarely snack. I have had 1 hypo but it was only 3.9 and although I felt awful I suppose on the scale of things it wasn't that bad. For a while I felt odd at 4.5 or less but now I seem ok and rarely go much lower than about 4.3. I hope you manage to find a solution.
 
Hi and welcome Mark i started the 23rd april 10 and i am finding it great luckily i have avoide any major side effects and i have lost 10lb on my last weigh in.I do hope things start to get better you now have this place to refer to and the ones amogst us on byetta will be here to answer anything anytime x
 
Hi mark - have just re read your post and am wondering how much advice you had from your doc when you started Byetta? I got mine from the hospital clinic and had to undergo a training morning which was very good. We had no option of using it once or twice a day depending on how we felt. We were instructed to use it twice a day before meals for a month (5 pen) and then we were seen again and put up to the 10 pen. I'm wondering if this taking it when you feel ok may be the problem . I kinda feel I just had to go for it and do the twice a day and actually it didn't take long to get past the side effects and appreciate the advantages which for me were a huge reduction in BG levels, steady weight loss of 1 kg a week and reduced blood pressure. I have been using it as prescribed for 2 months and haven't skipped a dose and feel pretty good now. The only time I feel not so good is if I over eat so I try very hard not to and at last I have realised I don't need these filling things any more.
 
Hi Mark,

Was put on byetta in January, first couple of weeks felt wierd, but then settled and moved to 10ug in Feb and ever since. Long term bloods trickling down, just about to DSN approval but reminding me it is experimental and if not working then insulin here I come. Some weight loss too, but I am claiming the credit for that with my running!

In the meantime things seem to be OK, I am also on a twice daily 10ug rather than a variable thing. I have never hear dof variable so that is possibly worth a question to Dr. I also had to do the education session at the clinic before taking any.

hope things settle and my advice, for what it is worth, would be try to do something consistently for a while and then you can get a truer gauge of where you are.

Good luck
Malc
 
Have they considered Victoza? As some people find that they can tolerate that after having been unable to take byetta. I would assume that if you fit the criteria for byetta then it would be preferable to try rather than insulin which studies show will increase weight.

Or depending on your A1c a gliptin might be better tolerated, if the byetta is working to bring blood glucose down then a gliptin should have some benefit.
 
byetta

Ive been a type 2 since 2000 and on metformin then 2004 insulin was introduced as well, but my sugar was all over the place. untill may 2009 i joined slimming world and lost 6 st, now insulin i no longer take, but i now take byetta the 5 one because the 10 made me feel rubbish, and now my sugar is stable, the byetta certainly knocks my food intake down making me feel bloated and disturbs my toilet visits, but its a trial and error thing.
 
Hi Mark

Welcome to the forum. From what you say it seems that you have had a lot of changes in your meds to try and control your levels but you don't say if there has been any advice given. I know advice is sketchy accross the country and so is the support we all need from experts.

I am lucky to have a wonderful DSN who has cared for me and supported me all through my battle with T2 for 10 years now. Because of my weight problem, I have only been "allowed" Metformin and with insulin reportedly prone to increase weight gain, Byetta was really the only choice for me. I had a consultation with another DSN who specialised in Byetta and all 3 of us have worked closely since I started on it last October. My own DSN is keen to take on board all I have to say on the subject (which is a lot- a bit of a chatterbox here in case you haven't noticed!) and she has shared my findings with her team. This is how it should work - sadly it doesn't always.

I can only share with you my own experiences Mark and maybe give you some pointers as to what works for me- it is an everyday battle with me to control my eating and I have a long way to go so all experiences and ideas are welcome on here and I suggest you take anything you find on here which may help and if in doubt discuss it with your team - knowledge is power so they say;)

So here goes:

I was told quite clearly to inject twice a day - the medication will not be effective if you do not follow this regime - the medication needs to be regular to sustain the effect which is to change and slow down the way you digest your food. In cases where the full 10mcg dose could not be tolerated, patients who do respond to the 5mcg dose by lower levels can be put back down on to this lower dose. Please check back with your team about this as randomly injecting may be why you are not getting the levels you want?

The Byetta should help to make you feel full and thus you can lose weight - but I haven't found it stops me eating things I might fancy - you still need to watch your intake if weight loss is one of your problems. In my own case, I found the bloating feeling I got, especially after a lunch of sandwiches, was helped by lowering my carb intake. By cutting carbs at brekkie and recucing them at lunchtime, my levels came down nicely and I feel a lot better. I have carbs with my evening meal as, quite frankly, I like them!

Most of us on Byetta are on Metformin if tolerated but I have heard that after time some meds might be dropped-depends on the individual but I have not yet heard of anyone who is just on Byetta alone- I guess the meds work in different ways and compliment each other? So, there is always room for adjustment here if the cocktail you are on doesn't work for you :) I am a little surprised to hear that you have only been diagnosed for just over a year but have had so many different meds thrown at you - how can the doctors tell what is and isn't working - it can take months for one med alone to work!

I hope some of this helps Mark and please don't be afraid to ask questions- just be prepared to go back again and again to your medical team to get advice- after all, if we don't report back, how will they learn:D

Best of luck x
 
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Thanks for all the replies so far. It does seem in my case that I have missed some advice or help from a DSN or my local hospital - neither of which have I had any contact with since being diagnosed with the condition (apart from the yearly eye test held in a mobile van in the car park). I am now trying to get referred by my GP to the hospitals diabetes group which should hopefully at least give me some advice on managing how I feel on Byetta. I was originally on 5mg twice a day but after having been back to my GP due to the side affects I kept getting, he had said that if I didn't feel too well I could miss a morning dose or an afternoon dose since the actual level of the drug in my system should not come down to much from the plateau it had reached. The sickness I do seem to have mostly stopped now by taking ginger every morning though the not wanting to eat feeling I have with me constantly. Recently I have been feeling very 'odd' (almost like an aura which is worrying as I also suffer from epilepsy) though this may have been down to the fact my blood sugar had been quite low - I did wake up one morning at 1am with it at 3.7.

Again thanks for all the messages and advice you have left - they are all really helpful.
 
agilestatue said:
Thanks for all the replies so far. It does seem in my case that I have missed some advice or help from a DSN or my local hospital - neither of which have I had any contact with since being diagnosed with the condition (apart from the yearly eye test held in a mobile van in the car park). I am now trying to get referred by my GP to the hospitals diabetes group which should hopefully at least give me some advice on managing how I feel on Byetta. I was originally on 5mg twice a day but after having been back to my GP due to the side affects I kept getting, he had said that if I didn't feel too well I could miss a morning dose or an afternoon dose since the actual level of the drug in my system should not come down to much from the plateau it had reached. The sickness I do seem to have mostly stopped now by taking ginger every morning though the not wanting to eat feeling I have with me constantly. Recently I have been feeling very 'odd' (almost like an aura which is worrying as I also suffer from epilepsy) though this may have been down to the fact my blood sugar had been quite low - I did wake up one morning at 1am with it at 3.7.

Again thanks for all the messages and advice you have left - they are all really helpful.
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Hi Mark

Good luck with the referral. I am afraid I don't know anything about epilepsy - are you on meds for this which might complicate your diabetes treatment perhaps? With regards to the very low blood sugars, I believe that Glipizide (and the Glicizide) are in the sulfonylurea class of medications? Using these with Byetta can cause low blood sugars - this is taken from the Byetta guidlelines on their web site and in the patient leaflet you get with the pen:

Your risk for getting low blood sugar is higher if you take BYETTA with another medicine that can cause low blood sugar, such as a sulfonylurea. The dose of your sulfonylurea medicine may need to be lowered while you use BYETTA.

I would imagine your GP has taken all this into account when prescribing for you but thought I would mention it as maybe it is the Glipizide which needs adjusting rather than the Byetta? Please check this out though - I am only passing on to you what I have gleaned from various sources and wouldn't wish to contradict the medical profession and especially your own GP who knows your history :D
 
"Your risk for getting low blood sugar is higher if you take BYETTA with another medicine that can cause low blood sugar, such as a sulfonylurea. The dose of your sulfonylurea medicine may need to be lowered while you use BYETTA."

Interesting that one, my DSN has just increased my gliclizade dose! But has said if I get lows then drop back again.

I also understand the feeling odd 'aura' type comment and I can get that feeling when my bloods are in the 5s. Almost an out of body experience eg a moderate hypo, maybe I was born needing higher blood sugars (that bit is a joke for those shouting 'denial') as I know that it is more likely that my body has been used to too high a level it for far too long.

The key agilestatue is to keep trying and keeping using this site for support, I have found it very useful in my continual battles.

Malc
 
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