At first John Dodson wasn’t a good diabetes patient, he says. For the first 10 years after he learned that he had type 2 diabetes in 1985, he thought that managing his diabetes was up to his doctor.
“I tried to do what he said, but of course I failed,” he told me. “My blood sugar was generally between 150 and 250, so I had an awfully hard time.”
The doctor who he saw at that time was a general practitioner. That doctor prescribed the only oral drug we had at that time for diabetes, one of the a sulfonylureas called glyburide. Later he switched to an endocrinologist, who gave John an unpleasant wake-up call.
“That doctor told me that there was nothing he could do for me and that after five years I would be on dialysis,” John recalls. “I walked out of that office thinking that this is not going to be my future.”
So he switched right away to another endocrinologist, Dr. Joe Prendergast. He is one of this country’s leading endocrinologists and a pioneer in many areas. I have known him since 1999 when I wrote about his telemedicine practice in an article that I wrote for the American Diabetes Association’s website.
“The very day that I saw Dr. Joe,” John remembers, “he said, John, I think I’ve got something that will help you.” That was in June 2005. A diabetes medication in a new class of drugs called GLP-1 agonists, Byetta (exenatide), had just become available. John became the first person in the county to take Byetta.
John Dodson near Moss Landing, California, in February 2008
Byetta was what connected John and me. We started corresponding in early 2006 when he wrote me about my post here, “Stalking Byetta.” His encouragement for me to start taking Byetta even if I couldn’t work out my insurance coverage did a lot to get me started a few days later. Since that time John became my role model and ultimately my best friend, and we have visited each other often.
John is now 79 and finally retired this year. Between 1978 and 1999 he was the pastor of the Los Altos United Methodist Church near San Jose, California. He was greatly loved there, as is apparent when reading a book, Pastor John’s World, that one of his parishioners wrote. Between 1999 and early this year he was a consultant to his church, including assignments as interim pastor in Aptos, California, and Anchorage, Alaska, where I visited him three years ago and had the opportunity to see his dynamic performance.
Before Byetta, John was much less active and had a big problem with his weight. He had weighed 250 pounds then; he weighs 161 now.
But Dr. Joe and his nurse practitioner, Penelope Mays, also taught John about the importance of diet and exercise. “It was not a part of what we did when we had diabetes,” he says. “Dr. Joe has a more comprehensive approach; he looks at everything we do.”
Penelope had such a level of commitment that she introduced John to hiking. “She is so committed to helping her patients with diabetes that she took me hiking on her day off. I checked my blood sugar before we started the hike and after we ended it. It was down 30 points, and that proved to me that hiking makes a difference. So I made hiking a part of my life.”
The New York Times featured John’s success on Byetta in an article about him in 2006. He used it for at least three years, but eventually it stopped working for him in spite of his trying everything he could think of.
“I did a lot of experimenting,” he says. “I put it together with Symlin. Dr. Joe didn’t think it would do much good, but it actually did help me lose more weight.” Byetta is approved for two shots a day -- before breakfast and dinner -- but John also experimented with taking another shot before lunch, even though his insurance didn’t cover it.
I asked him whether he meant that it stopped controlling his blood sugar or his weight.
“In terms of my weight,” he replied. “It certainly helped, but not like it originally did.” His A1C levels recently have ranged between 5.8 to 6.1.
So to help him control his weight, when a newer drug in the same GLP-1 class became available, John switched to it. Victoza (liraglutide) came on the market in February 2010, and soon after that, John started taking it. This newer drug requires only one shot per day. But eventually Victoza too stopped helping him control his weight.
But the same company that introduced Byetta in 2005 introduced an extended release version of it early this year. Unlike Byetta, which requires two shots per day, this extended release version, Bydureon, does its thing in one shot per week. Mixing the drug with the extended release powder can be tricky, he says, so now his wife Vicky reads the instructions to him page-by-page.
On January 27, 2012, I wrote here that the FDA had approved Bydureon and emailed John about it. “I saw that, and bam! I jumped on it right away,” he told me a few days ago. So John must be one of the few people who have used all three of the new GLP-1 drugs.
Like when he started Byetta, he was the first person in his county to use Bydureon. “I wanted to keep that record.”
How is Bydureon working for you? I asked John. “It’s working wonderfully for me: it is reassurring, so steady, so constant. They have an amazing support system behind Bydureon. It is a fantastic drug and makes me feel like I am tremendously served. It has basically saved my life.”