Full Version: Short Half Life-> Hi/Lo...

From: 56_kruiser (EWINGR) [#1]
 24 Nov 2009
To: ALL

I've been on Byetta since 2005, and have thougth I've been pretty successful. Have lost close to 50lbs, and maintain low to mid 6 A1cs.

But I have always been concerned about peaks and valleys in my BG readings. The Dr's have just said "Tha'ts part of having diabetis. Be happy you are in the 6 range".

Well, I'm experienceing neropathy in my feed, and having had the Dr say there is nothing that can be done, I decided to search out some forums and do some reading.

One thing I read this week, which was something I kinda knew, but it turned on a light bulb. The post said that Byetta's half life of 2 to 2 1/2 hours often leads to false sense of security aruond readings, and over teh past 2 weeks I've been doing lots of readings and find this to be true. For example, they say "Test 2 hours after starting eating. Look for 140 or below". Well, I always find that. But, test 3 hours after eating, when the Byetta has past it's half life, and it's a completely different story. This I am finding to be what is leading to my roller coaster readings. Well, don't take me wrong, it doesn't cause them. But the Byetta is just not doing the job all day long for me. And my night readings are 150-170 all night long.

I'be been wishing for the LAR version, but it keeps being "in the future"

I've done some serious carb fasting this week, and for sure it makes a difference, but I can't live on 20-30 carbs per day.

I'm seeing my Dr. again next week to see what other options there are. A lady that works with me moved to insulin, and is doing serious tracking of carbs and monitoring in order to know how much to use, but her numbers have been fairly level, in teh 100 - 110 range.

I guess I've gone on long enough.

I guess the main point is that I think people on Byetta need to be sure they monitor beyone the 2 hours after eating, and know your whole picture.

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From: Teri_in_CO (TERI_IN_VA) [#2]
 24 Nov 2009
To: 56_kruiser (EWINGR) [#1] 24 Nov 2009

When I started on Byetta almost 3 years ago, I was also taking insulin, so I learned fairly quickly that my post prandial peak on byetta did not occur at 2 hours, it was more like 3-4 hours. Now I find that my peaks are even longer after byetta, more like 5-6 hours. So it is important to test frequently, to find these things out.

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From: toneylee in VA (TONEYLEE) [#3]
 25 Nov 2009
To: 56_kruiser (EWINGR) [#1] 25 Nov 2009

I agree with Teri. I wouldn't blame these readings so much on Byetta's half-life as on its slow stomach-emptying effect. Which leads to the high post-meal numbers coming at 3-4 hours rather than 2. Often that means changing food choices as you say. Like fewer carbs and, for sure, complex carbs. If I remember correctly, Byetta is completely out of your system at about 9 hours.

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From: 56_kruiser (EWINGR) [#4]
 25 Nov 2009
To: toneylee in VA (TONEYLEE) [#3] 26 Nov 2009

Yes, I agree with the statements above.

My main point is that it's interesting that the doctors say to test 2 hours after eating, which with Byetta seems to give great readings, but if you don't do other testing, you are not in as good a shape as you think. I bounce around from 70 (with lows in 50s occasionally) to 170, with all night long readings in teh 150 and 160s. Yet my A1c is 6.3 which my Endo and regular doctor are thrilled with.

While my A1cs are relatively good, based on the guidelines, the fact is I now realize that I run a very broad range of BG readings, which from what else I am reading, is a likely cause for my growing problem with neropathy. It seems the most important aspect of relieving that is level readings (and of course below 140 max).

Certainly, low carbs and diet is important, as well as exercise. I exercise every day at least 30 min, and often twice a day, and have added strength exercises at a gym on top of that.

I do have difficulty eating less than 60 carbs avg per meal. I often do, at the expense of really having a meal I enjoy.

What I'm thinking is if I need to also rely on some type of meds, I'd like to use something that gives me more consistent benefit than I am getting from Byetta. In particular, I need to get my nights leveled out.

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From: Sue (SUEFIRST50) [#5]
 25 Nov 2009
To: 56_kruiser (EWINGR) [#4] 26 Nov 2009

What you are saying about Byetta not keeping your numbers regular throughout the day is something I've always realized and wondered about. Maybe some people have better results with it but I find the same problem you do that my numbers are not consistant. Even though I test a lot I am aware that when I am not testing my numbers are telling a different story than what I see when I test. I really don't know if this happens with everyone because I've noticed that others talk about really good numbers all the time. It makes me wonder what their numbers are when they are not testing. I've always thought it was normal for numbers to fluctuate depending on when we eat, how much we consume, what we have, how long we go without eating and of course if we exercise and if we are under stress. I wonder if any medicine is really able to keep our numbers stable all the time (24/7) and think that if anything can do that it would be a real miracle.

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From: 56_kruiser (EWINGR) [#6]
 26 Nov 2009
To: Sue (SUEFIRST50) [#5] 28 Nov 2009

Definitely, the things you list make a difference. It seems the thing we really need to do is learn to limit carbs as much as possible, while also trying to make the carb intake consistent, from what I've been reading.

Maybe when the Byetta LAR comes out, it will be quite helpful.

I also think that in fact some people's diabetes is worse than others, so some may do very well with just Byetta (and whatever accompanying meds), while others it still requires extra low carbs and consistent exercise. As a person with this for 20 years now, I am reaching that stage it seems.

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From: toneylee in VA (TONEYLEE) [#7]
 27 Nov 2009
To: 56_kruiser (EWINGR) [#4] 28 Nov 2009

Well, you're right about that. And yet, even the Amylin Helpline asks for 2 hour readings. It's all so complicated!

Maybe you could keep the carbs and still enjoy meals by choosing those with a low glycemic index? Here is a long article about that from David Mendosa (just a starting point): http://www.mendosa.com/gi.htm

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From: Sue (SUEFIRST50) [#8]
 28 Nov 2009
To: 56_kruiser (EWINGR) [#6] 28 Nov 2009

It still comes down to how we are all different and how our bodies react to what we put into it and do with it. Meds affect us differently so we have to try to figure out what we can eat and how much except that even when we do that it doesn't always give us the same results. We can eat the same things in the same amounts each day and still have different readings with some being good ones and others being bad. That is what is so frustrating about all of this.

Hopefully the LAR Byetta will be the answer to help our numbers stay even and end so much of the frustration we all seem to face when dealing wtih this.

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