Stalking Byetta

I'm assuming you must get a prescription from your medical doctor for byetta. Correct? Also, I'd like a byetta rep to contact me so I can the info to my Dr.

I am borderline insulin resistance. I got my first free sample of Byetta. wow I lost 10 pounds. I have been denied every since I went back for refil. My dr. increased 10mcg. and I receice a polite refusal letter.

I though insurances were about prentive care. obesity is widespread and deadly. Byetta is a lot less expensive than a gastric-bypass surgery. FDA and drug companies should look at this from all points 

alice virginia

Dear Alice,

It is sad but true that the Food and Drug Administration approved Byetta only for people with diabetes. While doctors can prescribe it ("off-label") for anyone,I don't know of any insurance companies that will pay for it. Of course, you can pay for it yourself, but it's more than $200 a month!

Dear David,

try $285.00 in the state of Al.  I can not buy it.

But I believe in God. I know he will make a way were there seems to be no way. He tells to watch our words. I will receive this medication somehow.

I have to stay upbeat and postive.

Look out FDA one mighter than we will

turn this situation around. I may sound crazy to you. I just have to stay postive

thanks  DAVID

Dear Alice,

I understand and appreciate your situation. But, of course, drug prices vary depending on the vendor even more than what state you happen to be in. Fortunately, with the rise of the Internet we now have the beginning of nationwide price competition. And the best Byetta price that I have been able to find is much better than the $285 price you found. At drugstore.com you can buy 1 Byetta pen for $226 or 3 of them for $217 each. 

Dear Tambry,

Thanks for your extensive -- and positive -- post about Byetta. I have also written about how the pancreatis scare was far overblown (http://www.healthcentral.com/diabetes/c/17/15142/byetta-perspective/)

If you send me your postal address, I will send you my Byetta carrying case, which I rarely use now that refrigeration is not required -- at least in Colorado, if not Texas.

Best regards,

David 

thank you so kindly for the offer of the travel pack, it is greatly appreciated. 

 P.O. Box 532584

  Grand Prairie, TX 75053

let me know how I can pay you for the shipping.

 I am told that I did better than people on the original studies, guess I was also very determined (this was the last ditch effort before insulin).

Love me that Byetta!!!

All of the literature for Byetta says not for use with insulin, however, there are Docs who have prescribed it for those on insulin, have a friend who is one of those.  Her success was ok, not quite a wonderful as mine.  My doc says that there is a different weight loss drug for the non-diabetic.

Byetta works on liver function, not on "squeezing" the pancreas for more insulin.

Be sure you take it BEFORE you eat, and try not to wait as much as 20 minutes, lesser times help some with the initial nausea.  Since it hits your system pretty quickly and food takes a little longer, I have even taken it pre-first bite.  I have heard of confusion on the waiting times.  The real reason it works for weight loss is that it DOES bring down your overall sugar levels (A1C), one does depend on the other.  You will want to eat less, this also helps.  Don't be discouraged with the nausea if you have it, believe me a little stomach upset is SO worth the changes the Byetta brings!

Frankly I compared it to having the surgery, I absolutely ate less and lost weight easily, but thankfully not too quickly.  Once your Doc prescribes the med, you should get a starter kit the lesser dosage, and full instructions, this can also get you more time to determine if your company will pay. 

The interesting thing I found was that with mine it went straight from non-existent to formulary, I always have paid a smaller copay from day one! And I started on Byetta the month after it hit the market!

Good luck!

My dawn effect is still my highest point, I work an odd schedule and don't get to eat at regular times.  Doc says that the dawn effect is when the Byetta has "worn off" for me. 

Looking forward to the once a week shot (about another year out), so that I can lose the peaks.

overall the numbers are lower so it is good news, just could be better.

inches was my first change!  in fact the education nurse accused me of cheating since I didn't lose at first.

She was the one to point at me after 70lbs, and try to take credit.

The inches felt great, and the weight loss would follow.....

Before starting Byetta, I did a lot of research. Reading other users comments, the general consensus was that the nausea wasn't as bad (or went away completely) if you watched the fat and sugar intake. Since starting Byetta, even though I usually only have mild nausea, it is much worse with a meal high in fats such as hamburger and fries. Could this be the reason why your PM meal doesn't make you as sick as your AM meal?

I find that if I drink milk with the meal the loose stool problem improves.

also, since it is early, you may have the kind of metabolism that changes inches before poundage (like me).

the energy may also be improved blood glucose, don't be discouraged if it wanes a bit as you continue.

The directions that come with the Byetta pen say not to continue using it after 30 days, even if there is some Byetta left in it.  Perhaps it becomes ineffective after 30 days, as your experience seems to indicate.

Dear Dan,

Thanks for asking! Yes, I wrote about it in a more recent article here. Please see:

"A Byetta Pancreatitis Perspective" at http://www.healthcentral.com/diabetes/c/17/15142/byetta-perspective/ 

Dear Boroguy,

I have never heard of a doctor committing a patient to a mental facility for refusing to take a medicine. But that's not the question. The question is what you are doing to control your diabetes. Can you actually control it without Byetta or insulin. Is your A1C down to a normal level yet? 

David:

  Right now my A1c is more than likely not where my PCP would like it.

I don't recall off hand what the reading was last time it was done on me in November 2007. 

What have I been doing about the diabetes, well I have been taking my medicine.

I think what you really mean is what have I been doing to control this genetic mess.

Well I don't count calories or what ever else there is, yeah something called carbs.

Well I am a meat and potatoes person, always have been and always will be.

Have I lost weight since I was diagnosed over 13 years ago, yes. I believe that my total weight loss is in the range of 65-70 lbs.

Do I have a scale to weigh myself...no because over the years I have discovered that when I hit an area where the weight won't come off, I get very very frustrated.

I don't mind taking oral medications, it is the medications that are injectable that I totally detest and refuse to use. I have a number of black and blue marks on me from the injections of Byetta.

I was told in November, at my last PCP visit, that I have to take Glyburide/Metformin and Byetta or Insulin because of a second existing medical condition which ironically is partially caused by my having diabetes.

In 2003 I was diagnosed as having "Nash" which is Non-Alcoholic Steato-Hepatits. Which means that I have Non-Alcoholic Cirrossis of the Liver and Non-viral Hepatitis.

Because of the above mentioned disease(s)  I am limited to the number of oral medications that I can take.

I have told my PCP that I am willing to take oral medications as long as they don't have any adverse affect on my already damaged liver.

When I was diagnosed, my then Doctor said the following statement to me "Why aren't you dead?" The reason for that question was that my blood sugar was at or above 500. As for me I felt fine. My Doctor at that time was relocated by the HMO and not allowed to notify his patients of his relocation and has since moved to the State of Washington.

Why don't I want to use insulin...well to me personally I feel that when I am injecting myself I feel that I am like a "junkie" who is shooting up and I am not going to become a "junkie". Over the decades I have seen to many people who have overdosed from injecting themselves and I am not going to do that to myself.

Sorry for the long winded response.  

Dear Boroguy,

Bruises from injections are not normal from Byetta or anything, like insulin. Are you sure that you are using the best needles? Make sure that you get thinnest needles, which are 31 gauge. BD makes "Ultra-Fine III Mini Pen Needles," which I use myself.

Re nausea, please read:

http://www.healthcentral.com/diabetes/

 c/17/2085/nausea-byetta/

Yes, I have also had to wait a long time to get an appointment with an endo. There just aren't enough of them to go around.

Too bad that your PCP is rude. All I can add is that if you really don't like and respect her, you might well consider going to a different one. 

David:

  I have the box of needles in front of me right now and it reads BD Ultra-Fine III

Short Pen Needles.

The label from the pharmacy reads as follows: B-D UF III Penndle Short.

These needles are 31G x 5/16's (8MM) Needles.

These are the needles that my PCP prescribed.

I guess the only other reason that I am bruising like I am is because my platelet count must be dropping again.

As I mentioned in a previous post, I do suffer from a number of other conditions.

One that I had not previously mentioned is that I have an enlarged spleen as a result of having had mono nearly 30 years ago.

The combination of having residuals of Mono and Diabetes Type II are the causes of my existing condition known as "NASH".

Or at least that is what my Gastroenterologist has told me.

I am in sort of a "Catch-22" medical situation as when my platelets drop, my PCP really wants me to see my Hematologist who in turn tells me that I really should see my PCP since she, my Hematologist, really has stabilized this condition.

Also I used to see an Endocrinologist, who has terminated me as a patient. There was a personality clash between us.

The Endocrinologist used to get mad when I would talk to the Gastroenterologist about the Diabetic Medicines that I was taking. I did that because I did not want any of those medicines to adversely effect my already damaged liver.

And since we all know that certain second generation oral diabetic medications can have an adverse effect on the liver.

I am facing the fact that I will eventually need to have a Liver Transplant. Knowing that I will need the transplant eventually, I would rather avoid taking any medication that can harm my liver so that this transplant might be 10-20 years down the road instead of 10-20 weeks down the road. I have already walked away from one PCP and been sent away from an Endocrinologist because they would not listen to what I had to say regarding the medications that might have an adverse effect on my Liver. Some Doctors only seem to want to look at one problem and not the entire picture. I am the patient and I have to live with that entire picture for the rest of my life. And the longer I can live without having to take anti-rejection medication, the happier I will be.  

You might try the needles that I suggested the next time. The Mini needles are shorter than the Short needles.

David 

Yes, it will absolutely get better. Try taking it just once a day until it does. I have a lot of other tips about how to deal with the nausea at http://www.healthcentral.com/diabetes/c/17/2085/nausea-byetta

Best regards,

David

Thanks for your response David. I also have another question. Starting yesterday after I ate my blood sugar dropped fast. I started feeling shaky and took it about an hour after eating. It was 75. Is that too low so soon after eating? I'm worried its going to drop too low! It makes me feel horrible (because I am also dealing with the nausea). I can't really function at work (I'm a teacher).  What should my target levels be after eating? What is too low? Should I only take the byetta once a day if they are dropping too low? I take it at lunch and at dinner. Is that too close together?

I guess i had more than one question. lol. Thanks for all your helP!

Also.....

The doctor called me in a prescription for premethazine for the nausea. I took half a pill today and it made me VERY out of it. I didn't actually get sick today, though I definitely felt like I could. I don't know if its better to just get sick and get on with the day or not get sick but feel like I need to and be totally zoned out...

A BG of 75 is low, but not too low as to be a real problem. However, when I first started taking Byetta, my level dropped to 80. That was because of the other medications I was taking for diabetes. My doctor had me stop them right away, and my level didn't drop quite that low again. Byetta will absolutely not cause you to go too low -- but in combination with other drugs it can. So that's my guess about your problem. Please discuss it with your doctor.

Best regards,

David

Dear Shannon,

The first thing that I would suggest that you do (in consultation with your doctor) is to go back to the 5mcg dose and/or a once a day dose as long as is necessary.

Please also check our my nausea guide at:

http://www.healthcentral.com/diabetes/c/17/2085/nausea-byetta

Best regards,

David

I would, but the issue is that no weight loss occured on the 5mcg dose, which is why he put me on it in the first place. I am going to try to stay on the 10mcg until the 18th, giving me 2 weeks to hopefully get used to it. I will check that guide out though, thank you.

Good question. Yes, blood glucose is the more technically correct term for blood sugar.

Best regards,

David