Full Version: Byetta and Carbs

From: Grace (GRACIEDAWN) [#1]
29 Apr 10:44
To: ALL

Hello, I am new here but not to Diabetes. I have been a diabetic since 2000 and I am also a RN. I have recently been placed on Byetta. Attempting to learn more about it, I read the byetta.com website, and also found this site helpful. There is one problem I have run across in the information on Diabetes Monitor in their information on Byetta and carbs. On http://www.diabetesmonitor.com/byettafaq.htm
under the eating catagory, they state,"◦An initial rule of thumb is to eat 35-45 carbs with each meal. However, you have to track your carbohydrate consumption and your BG testing to determine what is the best level of carbs for you. Some people do very well eating less carbs "per day" than the recommendation in the rule of thumb."
This is directly from American Diabetes Association for blood glucose control. This is not from the good folks who make Byetta. This needs to be clarified. I ended up calling Amylin at the Byetta 800 number for clairification. I do not eat that many carbs in one meal. For years I treated my diabetes with diet and exercise until my body refused to do so anymore, nature of beast, so to make sure I did not have to eat that many carbs, I called. According to Amylin and please call them yourselves for your own peace of mind, they said they have no dietary requirements for the use of Byetta.
I would ask that DiabetesMonitor.com correct this in their information. While it is helpful for those who are new and eat too many carbs, it is also confusing for those of us who can not tolerate eating that many carbs. Or at least get a statement from
amylin on the product.
Grace

From: Mark_in_MO [#3]
29 Apr 14:23
To: Grace (GRACIEDAWN) [#1] 29 Apr 17:44

Hi Grace,

I am the original author of the Diabetes Monitor webpage "Byetta Basics". When I first wrote this webpage, Byetta had been on the market for a very short period of time and many people were having issues with side effects. Additionally, some of the consumers of Byetta were not getting full/consistent information about this new med from their medical professionals that were prescribing or providing diabetes management advice. Thus, after a constant barrage of "how does this work" and "what do I need to do" questions on the forum, I basically tried to codify the experiences of those Byetta users who had been using the medication for the longest periods of time (even that was often less than one year). Under no circumstances is any of the information represented as being from Amylin, nor have we tried to post official statements from Amylin. Other than Byetta consumer's real-life experiences, we normally have suggested that individuals should contact Amylin directly if they need additional information (e.g. pen setup, bubbles, contamination, etc.).

Many of the early adopters found that if they did not consume sufficient carbs after taking a shot they were still experiencing higher than desired BG numbers. As a worst-case example, one individual was starting Byetta and trying to follow the Adkins diet (no carbs at all) and could not understand why the Byetta was not working. Several people found that when they ate more than a minimal amount of carbs they actually got lower BG numbers, thus the recommended "rule of thumb". If I understand your comment, the guidelines in the webpage are the same as those offered by the ADA? If so, then I guess the Byetta users that reported that these levels of carbs worked for them found that following the ADA guidelines also worked for Byetta. Or is the issue that you feel we have misrepresented where the information originally came from (Amylin vs. ADA)?

You will note that there are several precautionary statements in that section of the Byetta Basics: "An initial rule of thumb is to eat 35-45 carbs with each meal. However, you have to track your carbohydrate consumption and your BG testing to determine what is the best level of carbs for you. Some people do very well eating less carbs "per day" than the recommendation in the rule of thumb."
1) - this is clearly marked as a "rule of thumb"
2) - a strong recommendation to "track your carb consumption"
3) - finally - "some people eat less carbs per day that the rule of thumb"

This was truly designed to be a starting point for those individuals who did not have a good handle on their carb consumption as they started using Byetta. If there is a better recommended level of carbs can you provide that information, and also the source of the information? If we need to correct the "rule of thumb" I will be glad to make any changes that will provide better information to the Byetta community.

Thanks for your input. I appreciate the opportunity to improve the Byetta Basics FAQ webpage.

From: Sue (SUEFIRST50) [#5]
29 Apr 15:54
To: Grace (GRACIEDAWN) [#1] 29 Apr 17:44

Much of what you read here are recommendations and experiences of the contributors who take Byetta. Most are not not medical professionals but we discuss what we have learned and what we have been advised by professional and what we have learned on our own. The information we share is meant to help those who need some help along the way.

Being new to the blog it is important for you and others to know that what works for some people does not always work for others and that you must try certain things to see what works for you. That includes seeing how many carbs you need to consume because your body may use them differently and your requirements can be totally different. Most of us believe in testing our sugar frequently so we know how we are doing and at different times of the day. If you do that you will have a better idea of what you may need to do to adjust your diet.

From: Grace (GRACIEDAWN) [#7]
29 Apr 17:44
To: ALL

Thank You Mark, and the rest who have answered. I believe that maybe I did not make myself clear. The information is a great gathering from many who have used Byetta. Yes I realize it was not written with the folk from Amlyn or other medical professionals, nor was I dissing this. I was only say that while you have recommendations for the carbs, it is also misleading in the way it is written.
I also know of the people who started on Byetta when it was new and the effects they dealt with and had to compensate for. I am also aware that many newly diagnosed DM pts eat way too many carbs, I know this because I was once one of them.
All I was saying is that maybe you could plainly state that some people need less than the 35g of carbs as well as those who need more.
Take my sister and I for example, we are 8 years apart in age, I am older, I was diagnosed in 2000 and she in 2001. I spent 7 years without any medications what so ever, while she has never had a day go by without needing them. I can't eat more than 25g a carbs in a meal without getting sick to the point of vomiting, where she can eat as many as 45 and be fine. Everyone is different, is what I was pointing out and that maybe the language in the information should reflect that.
Evidently I stepped on many toes here from the responses I have recieved. As such I am sorry if I hurt feelings or offended that was not intended. I was only seeking a furthering of clear language for some who might need it.

Again Sorry
Grace

From: Sue (SUEFIRST50) [#9]
29 Apr 20:58
To: Grace (GRACIEDAWN) [#7] 30 Apr 12:16

Grace, I don't think you rubbed anyone the wrong way with what you said about clarification about the amount of carbs, etc. If you read the blogs I'm sure you saw that not everyone agrees with everything on here because of the differences we often experience. This is a good place to come to ask questions and give opinions and we all know not to take everything we see here as the final word on anything.

From: Mark_in_MO [#11]
30 Apr 12:12
To: Grace (GRACIEDAWN) [#7] 30 Apr 12:16

Hi Grace,

No offense and certainly no hard feelings - getting different points of reference and experience is how this compendium of information was intitially developed. Also you will notice that the header states that it has been updated - the reason? lots of new information that we needed to provide and/or correct. So don't worry about bumping any one's opinions - we are all here to learn and help others along the way. Most of us are never sorry for disagreeing with each other - it is often the best way to learn something new! (nod)

Question for you - I thought the way I had stated the comment - "Some people do very well eating less carbs "per day" than the recommendation in the rule of thumb." - was pretty self-explanatory. In other words, it is a starting point, but you may need more or MUCH less than what is included in the "rule of thumb".

Do you have any thoughts regarding wording that would make this more clear for those new users who have no idea what they should be eating?

Thaks for your input.

From: Grace (GRACIEDAWN) [#13]
30 Apr 12:25
To: Mark_in_MO [#11] 30 Apr 12:48

Mark,
I have been thinking of the wording for the last 24 hours lol. The reason I pointed that out is because most people read the first part for the "rule of thumb" then skp the rest. Most people don't completely read anything. We have gotten into habits of skimming for information when we are either overwhelmed( the new DM pt who has so much new information and is so overwhelmed they can't think clearly or process so much at once) or the pt who is scared by their diagnosis.

I worked critical care for 10 years and had found thru work that most people who had their first heart attack so overwhlemed and emotional when asked a few weeks later what they had been told said one of two things, either they remembered the highest importance of certain things or they couldn't tell you a word of what was said to them at the time. Same if someone is given a life altering diagnosis.

Then they start to read information from all sources, trying to educate themselves, but still skim the information after a few minutes of trying to read completely.

I honestly don't have an answer to your question, other than maybe finding a way to make it it's own "important" bullet point. Stated separately, not as an after thought.

My husband has been educating himself on my DM, he had no experience with it before me. He has read and read and read massive amounts of information, from diagnosis, signs and symptoms, treatments, to what meds I was on before Byetta to diet and exercise. For a layman he has invested alot of time and effort, but occasionally he still skims information because he reads so fast. I have to say I am eternally thankful for his understanding and support and care of me.

From: Mark_in_MO [#15]
30 Apr 13:04
To: Grace (GRACIEDAWN) [#13] 30 Apr 13:06

Hi Grace,

I agree with your impression of the average individual skimming information. That is why I tried to keep the Byetta Basics FAQ in the form of very short snippets of information - too much explanation simply does not get read or certainly is often not retained.

I will have to think about the "structure" and how we can improve the FAQ wording. You know, it can be hard for an author to re-structure wording, simply because it was thought to be clear when originally written, and it can be difficult to re-interpret. You know - like the need to have a different pair of eyes review something you wrote - otherwise you miss errors because you are reading what you thought, and not always what you have actually written.

Sounds like you have a great partner as a member of your diabetes management team. Having someone who can help watch for changes in symptoms and treatment, as well as remind you to do the right things, can make all the difference in successfully managing your DM.

I hope you will continue to participate in the Diabetes Discussions forum - we can all learn from each other's experience and input, and especially from another medical professional - NOTE: that is not to say that Dr. Bill's input is ever anything less than excellent! :-)

Thanks for your suggestions, they are appreciated.

From: Grace (GRACIEDAWN) [#17]
30 Apr 13:14
To: Mark_in_MO [#15] 30 Apr 13:32

Mark,
I have published some nonprofessional essays and it always has helped to have not only a some who can proof read but also someone who could "edit" in a way to help me get my point across.

Sometimes I forget and talk "nurse" as Hubby says and then he has to remind me, he isn't one, so talk normal.

I will look foreward to seeing the changes you make. You did a great job on the information and I really did get alot of info that had changed from when I first learned about byetta years ago.

Good luck
Grace

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Full Version: Byetta and Carbs

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