Tell me about Byetta

[minkydog]

My doctor is adding Byetta to the metformin. One of my complaints about metformin is that if I take 2 tablets I'll be nauseous for hours on end, and even vomit sometimes. She says that Byetta *might* not be as bad--but it could be worse. Not to mention the fact that it's an injectable. Really not crazy about that!

I googled Byetta and found a LOT of discussion about severe vomiting, diarrhea, debilitating nausea. I am really nervous about it. I'm pretty sensitive to the metformin, though as long as I mind my diet I don't have too many problems. I have heard that I will *really* have to watch my carbs and fats on the Byetta or suffer the consequences.

Has this been your experience? I feel like a prisoner on death row, thinking about my last meal. We went out for pizza tonight, first time in months, because I know I won't be eating pizza again for a very long time. I have to take the first shot in the morning and I don't even know what to eat. I'm scared to death that I'm going to be sick all the time.

 

[My2Cinderellas]

I have taken metformin for several years and used byetta for about 2 years. Metformin can have gi side effects especially diarrhea. I take a non-formulary version called Fortamet. It's an expensive co-pay but I tolerate it better than generic metformin.

I loved byetta once I got thru the intro period but it ea no longer effective for me after awhile. The side effects for me were nausea, burping, and occasional vomiting. It was like being newly pregnant where you don't feel 100%. it took a week or so to adjust to the med - and the same again when I went up to the higher dose. You are to take it up to 1 hr before breakfast and supper - if you forget don't take a dose after beginning the meal. I did it once and vomited for the next 4 hours.

The injections are no big deal the needle tips are tiny. The strict temp controls have been relaxed a bit, but you will need to have a travel chill pack.

Pros to byetta - it promotes weight loss - the med works by slowing down your digestion so you feel full quicker and stay full longer. It also encourages healthy food choices - anything greasy or fatty triggered the nausea side effect.

 

[minkydog]

It was like being newly pregnant where you don't feel 100%. it took a week or so to adjust to the med - and the same again when I went up to the higher dose.

See, this is what I'm afraid of. I was sick as a dog for months--morning, noon, middle of the night sick. Like terminal car sickness. Like I'd have to feel better to die! OMG, is that what I'm in for? I feel like crying.

 

[My2Cinderellas]

Maybe it won't be so bad. I rarely actually vomited when pregnant, just felt like I could.

 

[Swimnoid]

I take metformin and used Byetta about 3 years ago for a short time. I never had any problems with the metformin. The Byetta didnt bother me a bit either. While I was on it I did lose a bunch of weight pretty quickly. It also made me a lot more diligent about what I was eating. The reason I stopped was my insurance wouldnt pay enough for it and I couldnt afford it. The injection was kind of a pain in the neck but it didnt hurt.

 

[PatsMom]

I am currently doing Byetta three times a day (non-FDA approved dose), along with 1000 milligrams of Metformin (one tablet, twice a day). I was able to cut back on the metformin after about a year on Byetta - I was starting to have some bad side effects from the metformin. I also stopped using Lantus when I started Byetta so I was really trading in one injectable for another that had different side effects.

When I was on the Lantus, I had an awful time with lows. I haven't experienced that with the Byetta. I did lose some weight when I first started, but I don't know if it was because of the Byetta or because I started an exercise and diet program at the same time (switch of doctors encouraged me). I am fortunate that my prescription coverage is paying for the Byetta at the higher dose, although I pay a full co-pay ($25) every 20 days. So I guess I am paying over a dollar a day for the Byetta.

I do not seem to experience more side effects if I eat more carbs/fat. I don't have a ton of side effects from the Byetta anyhow. When I first started, I had some nausea. But one trick that my educator shared with me was to do all the injections into the thigh and skip the belly - it seems to really help with the nausea. I still get it once in a while, but nothing serious. It passes very quickly.

The needle stick is very minor. Very short, very fine pen needle. My needles are provided free by my insurance company but before that happened, I used to re-use needles, even though technically you are not supposed to. But my educator told me the trick. I still do sometimes when disposal isn't handy and I don't want to carry around a bunch of used needles. Disposal in my state isn't difficult. I use a stiff plastic container (currently a laundry detergent bottle but on vacation I sometime use a hard beverage bottle such as Vitamin Water). When it is full, I mark it with a Sharpie as medical waste - do not recycle and duct tape it shut. Then I throw it out.

When they teach you to give injections, they'll show you to wipe with an alcohol pad. That lasted around a week for me. It was more trouble to carry them around than it was worth. I just put on the needle, and do the injection. If I am wearing thin clothing (like stockings) I just inject through the clothing if it is not convenient to remove it. I've been doing this for three years with no bad effects. At restaurants, if I don't have a good place ahead of time, I just do the injection at the table if I am wearing suitable clothing. Just takes a little advance planning. I avoid rest rooms because they just don't seem very sanitary to me. But I use them if I have to remove jeans or something to do my injection. In a pinch I'll inject into my stomach right at the table but that does seem to trigger nausea more often for me.

Good luck to you. Byetta isn't really bad once you get used to it. I am probably going to switch to Victozza (waiting for insurance to add it to formulary - expected later this year). Victozza is in the same class but requires injection only once per day and does not need to be timed with a meal. So it will be simpler - I'll just add the injection to my morning routine.

In the meantime, I use a frio pack when out and about in the heat and it works well. I wouldn't use it to keep my unopened stuff refrigerated but it keeps the in use pen nice and cool. And in the single pouch, I can still tuck a couple of needles.

Injectables are kind of a tough mental hurdle but once you get over it they aren't really bad at all. Maybe you can give up the metformin and then you'll only be dealing with one medication again eventually! I also gave up Actos when I went on the Byetta. Probably not soon enough since Actos has been linked to bladder cancer and I am currently getting ready for my second surgery for bladder cancer!

All the meds seem to have side effects - its kind of like trading one set for another as far as I am concerned.

 

[minkydog]

Well, I managed to give the first shot this morning--I was awake several times last night worrying about whether I would be sick,but so far not too bad. I ate about 1/2 my usual breakfast, a bite of a pretzel and a bite of chicken around 12noon, some chicken soup and 1oz cheese at 2pm. I have that "almost could be queasy feeling" and almost no feeling of hunger at all. One thing I've noticed is that food is unappealing. Wonder how that's going to affect my cooking meals for the family. Right now, I could care less. Hmm, we'll probably all lose weight. Which wouldn't be good for anyone except me.

My doctor dropped me from 3 500mg Metformins/day to just one in the afternoon. I"m thinking that if I stick to small bits of meat & cheese, small bits of whole grains and fruits, plus sugar-free liquids I ought to do pretty well. I'm a little worried about getting my protein in. I don't want to lose muscle mass. I've tried one of the protein drinks, EAS, in the past. It's pretty nasty, unless you chill it very cold and mix it with milk. Any other suggestions?

 

[PatsMom]

Peanut butter is a good protein. I find I do pretty good with a slice of whole grain toast and peanut butter for breakfast. I do my injection when I get my second cup of coffee and by the time I am done showering and ready to eat, it is about 30 minutes and time to eat. I don't snack as much between meals.

The shots do get easier with time. Now I don't even think about it!

I always thought that cutting back on the metformin side effects made up for any Byetta side effects.

Do you see an educator or a specialist? Or are you treated by your family doctor? I found my control got much better when I saw the educator and switched to an endo. I'm switching back to my primary care for my follow ups though because she just brought in a CDE who is also an ARNP to her practice. I'll see my primary every six months and see the CDE/ARNP for the other quarterly follow ups.

Also, I know from your other posts that you have a lot of stress in your life right now. That really messes up my control! I swear I haven't had good numbers since I was diagnosed with bladder cancer in early July either! When they did my pre-op physical I was afraid my A1C would be so high they would refuse to do the surgery!

With Byetta I think you also have to make sure you eat enough. If I undereat I don't go low like I did on insulin but I do get a little queasy. And the effect of really not being hungry at all wore off on me after a month or so. I think that is the "honeymoon" when you lose the most weight and that alone helps with your control! Now it does seem to help with snacking which is always a problem for me.

 

[minkydog]

I"m seeing a bariatric specialist. She doesn't do weight-loss surgery. It's all weight loss the hard way. So far I've dropped 50-lbs. My blood pressure has dropped from 150/90 to 110/70. The triglycerides have dropped from a whopping(and critical!) 493 to 140 and my good cholesteral is slowing climbing toward the acceptable range. And the diabetes is much better controlled. So, lots of good things happening.

Yes, I do live with an enormous amount of stress and it has made it hard to stick with the diet. In fact, I've been at a plateau since April, when we rolled our car and camper. And I was very depressed for about 8wks in June-July. But I haven't gained anything back, so there's that. I have at least 30-lbs to go and I'd like to lose 10-20 more than that. I'm 5'3". I weighed 90-lb all the way through HS and never got about 115 in college. I weighed less than that when I got married. I don't know that I will ever be that small again, especially with type 2 diabetes. Diabetes reallly works against weight loss, just by the nature of the disease. But if I could get into a mroe reasonable range where I could buy clothes off the rack easily, I'd be satisfied. Right now I'm a 16, but at least I'm not a 22 anymore!

 

[jbthi]

I have been taking Byetta about three years. I was on metformin for 6 or so years but I took myself off of it about 6 months ago. I couldn't handle the stomach issues any longer.

I was sick for close to a month on Byetta but it wasn't so bad I couldn't handle it. I have very gradually lost weight on it. Without doing anything different I have lost 25 pounds. I have found that if I take the Byetta at least 1 hour before I eat, I am not as likely to have nausea.