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Old 02-03-2010, 10:08 AM   #1
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Byetta and Carb Intake...

So, I saw an Endocrinologist this week- and he's sending me for blood work to rule out Type I. But, if I am Type II and insulin resistant, as I suspect, he wants to start me on Byetta. I'm not opposed to this, as I am just not getting the type of BG control I need from diet and exercise alone. Even eating 0-30 carbs a day, my morning readings are still consistently above 120, often in the 130's.

My question is for those of you that take Byetta. I recently read the following statement, and wanted to know what fellow low carbers have experienced:

"•Byetta is reactive — if you do not eat enough carbs in your meal you may not trigger the Byetta and you will not see the expected positive BG impact.
◦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."

Where were you at carb intake when you started Byetta- and did you need to up your carb amounts to trigger the Byetta to work? I start the pen on March 1st, and am doing as much research as I can before then.

At the present time I am on Metformin twice a day, and I ~JUST~ started on Januvia yesterday.

Thanks!
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Old 02-03-2010, 10:20 AM   #2
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On Jenny's site is a complete explanation of Byetta.

Blood Sugar 101

Link is on the "Diabetes Drugs - Quick Summary" page. Scroll down to the bottom and click on the "Byetta."

Simply excellent information from all perspectives.
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Old 02-03-2010, 10:27 AM   #3
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Quote:
Originally Posted by chiody View Post
On Jenny's site is a complete explanation of Byetta.

Blood Sugar 101

Link is on the "Diabetes Drugs - Quick Summary" page. Scroll down to the bottom and click on the "Byetta."

Simply excellent information from all perspectives.
Thanks so much, and GREATLY appreciated!

I really am at a loss, after reading about both the Januvia and the Byetta, I'm not sure WHAT to do. I want to do the ~right~ thing, but sometimes it's not easy to figure out what that is. While I know lots of people have great success with diet and exercise alone, I don't seem to. I'm losing weight, but even the weight loss is not getting my numbers under tight control.

Last edited by Chickamomminy; 02-03-2010 at 11:17 AM..
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Old 02-03-2010, 10:40 AM   #4
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Quote:
Originally Posted by chiody View Post
On Jenny's site is a complete explanation of Byetta.

Blood Sugar 101

Link is on the "Diabetes Drugs - Quick Summary" page. Scroll down to the bottom and click on the "Byetta."

Simply excellent information from all perspectives.
I just read the article regarding hospitalization with diabetes. I work on a Peds floor that is also typically mixed with diabetic patients, gynecologic patients and post-op patients. (Yeah, we get a pretty good mix! ) It is true that most diabetics will, upon admission, be placed on an ADA diet ranging from 1500-2000 calories. Insulin pumps are typically removed. Patients are placed on "hospital sliding scale" protocols, which is just as much of a thorn in my side as a nurse as it is to you as a patient.

The article was well-written and presented the reality quite well. However, a lot of undue blame was placed upon the nursing staff. It's important to remember that the nursing staff are limited by the equipment provided by the hospital, the physician's orders and hospital policy.

No, I don't like giving you pre-prandial coverage with a pen and sliding scale with an insulin syringe. I'd rather give you one shot. Or let you do it yourself. But I'm not allowed to do that.

I think it's erroneous of the author to carte blanche blame the nursing staff for things that are most definitely not in their control.
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Old 02-03-2010, 11:47 AM   #5
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I took Byetta for awhile but stopped it about the time I went back onto Atkins, just co-incidental timing.

Ask your doctor about the possibility of using Symlin instead. I like it better. It would be an "off label" use since it's only meant to be used with insulin, but it has the same effect of slowing digestion as Byetta and helps suppress the appetite.

If I were you and it was just a matter of lowering my blood glucose a LITTLE bit like that, I would get Levimir long acting insulin and start with one unit in the morning and one at bedtime. One unit is NOTHING. Some diabetics take 200 units of insulin a day or more... It just gives you a little help with less side effects than the oral meds.

The pens are just like the Byetta, so it would be no more difficult or painful, and it's cheaper too.

The units on the insulin let you vary the dose from one time to another as needed.

At this point, I take 12 units in the morning if my fasting level is right under 100 and I plan to eat normally that day. I might go as low as 10 or as high as 13 if the fasting reading is different or I know I will be eating more or less than usual.

At night I take 8 units normally, but up to 10 if my reading at bedtime is above 110.

I know insulin seems scary, but it's really a LOT more straightforward and easy to control than most other diabetic meds. Think about it!

Oh--the underlying answer here is NO! Don't let them bully you into eating more carbs. That is just counterproductive.

Last edited by ravenrose; 02-03-2010 at 11:49 AM..
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Old 02-03-2010, 01:07 PM   #6
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Thanks ravenrose, more food for thought! The doctor never even mentioned insulin, I think because he wanted me to lose weight, and the Byetta seems to help in that department. But, I was not having any trouble losing the weight on my own, not like I'm stalled or anything, I still see the scale inching it's way down, slowly but surely, by eating low carb. I just did not want to go on the Byetta, try something I'm not entirely sold on, and eat too few carbs to have it do it's thing. Seemed counterproductive to me. But, then again, so did eating too many carbs. Sort of a 'Catch 22'...

Also, can I ask what you like better about the Symlin? I'm off to research it now, but since you have experience with both, I'd love to know why you feel it's the better choice. Thanks!

Last edited by Chickamomminy; 02-03-2010 at 01:12 PM..
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Old 02-03-2010, 05:08 PM   #7
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I have been on byetta 2 years and like it. But having said that I find it strange your
dr. doesn't try you on metformin first. With your blood suger levels as well controled
as they are it might be all the help you need and it helps some people lose a few pounds.
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Old 02-03-2010, 05:44 PM   #8
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byetta has 2 main actions

Quote:
Originally Posted by Chickamomminy View Post
My question is for those of you that take Byetta. I recently read the following statement, and wanted to know what fellow low carbers have experienced:

"•Byetta is reactive — if you do not eat enough carbs in your meal you may not trigger the Byetta and you will not see the expected positive BG impact.
◦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."

Where were you at carb intake when you started Byetta- and did you need to up your carb amounts to trigger the Byetta to work? I start the pen on March 1st, and am doing as much research as I can before then.
I took Byetta for 20 months. In that time my carbs were generally between 40 - 80g per day (total, not "net carbs"). I did notice that when my carbs were a bit higher, my BG would be a bit better, maybe 10-20 points. No, I did not eat more carbs deliberately to have a better Byetta-BG result. Regardless of the carb count though, my primary benefit from Byetta was the second action of the reduced appetite (as in getting full/nauseous) and that definitely helped me lose weight. I dropped from about 265 to 220 in that 20 month interval.

I dropped the Byetta in late December, and now eat generally zero-carb. Works for me so far, and my weight loss has actually quickened a bit. I think I'm eating a bit less than I did on Byetta.

Good luck, and good for you for investigating.
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Old 02-03-2010, 10:17 PM   #9
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I am convinced that the weight loss with Byetta is the same water weight you will already have lost with Atkins and you won't find it actually helps in that regard. But apparently that isn't something they have researched, so the doctor won't know that or probably think it's true. But in my experience it's true. If you are on Byetta and you start Atkins, you don't get the water weight loss, and vice versa.

To be honest, I'm not remembering all the details of why I switched from Byetta to Symlin. I had told my endocrinologist I was super serious about losing weight and reducing my insulin (the insulin in my blood, whether from my pancreas or from an injection) to do so. He thought the Symlin would help more than the Byetta.
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Old 02-04-2010, 07:13 AM   #10
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Quote:
Originally Posted by ravenrose View Post
I am convinced that the weight loss with Byetta is the same water weight you will already have lost with Atkins and you won't find it actually helps in that regard. But apparently that isn't something they have researched, so the doctor won't know that or probably think it's true. But in my experience it's true. If you are on Byetta and you start Atkins, you don't get the water weight loss, and vice versa.

To be honest, I'm not remembering all the details of why I switched from Byetta to Symlin. I had told my endocrinologist I was super serious about losing weight and reducing my insulin (the insulin in my blood, whether from my pancreas or from an injection) to do so. He thought the Symlin would help more than the Byetta.

what is symlin
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Old 02-04-2010, 07:57 AM   #11
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Does anyone know whether Symlin is ever used off-label for non-diabetics who have hunger/satiety issues? I was trying to get an answer for this from Bernstein's book, but not sure if he really addresses it in non-diabetics.
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Old 02-04-2010, 10:57 AM   #12
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The thing is, your doctor can legally prescribe it if you convince him or her to do it, but even for diabetics it's almost impossible to get medical insurance to pay for Symlin. It's a newish drug and pretty expensive. From what I know, I don't think it would hurt you, gettingwell, though there is always the possibility of that on top of your own insulin giving you hypoglycemia. I have been low carbing ever since I started the Symlin, and I don't find it impacts my insulin requirements. I think I am going to try phasing it out and see if it really is doing anything.

Babsy, just google Symlin and read the company website. It's too complicated to try to explain a drug like that, sorry! *s*
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Old 02-04-2010, 09:21 PM   #13
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Quote:
Originally Posted by ravenrose View Post
I am convinced that the weight loss with Byetta is the same water weight you will already have lost with Atkins and you won't find it actually helps in that regard.
My own experience doesn't match this - the weight loss was because I ate a lot LOT less food - if I hadn't reduced the food volume, I would have been vomiting after every breakfast and dinner (I took Byetta just before breakfast and dinner). For example, I would only eat about 1/2 cup cooked vegetables and maybe 4 oz (pre-cooked weight) of a meat for dinner, 1 oz of pecans for dessert. That's not a lot of chow. I would be full on this amount.
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Old 02-05-2010, 08:38 PM   #14
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ah, yes, it is supposed to suppress appetite. I never found it helpful that way.
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Old 02-10-2010, 08:43 AM   #15
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I have been on byetta for about 5 months. I have never been sick on it and I have lost 20lbs. I have upped my carbs some maybe from 20 per day to about 15 or 20 per meal. It does help me stick to low carbing more and I'm not hungry a lot now. I am, however, freezing most of the time...I use to complain of sweating all the time but now it's cold. I'm kind of anxious to see how it is this summer since I live in Florida. Anyway I'm drifting off subject...LOL Byetta is wonderful to me!!
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Old 03-24-2010, 09:38 PM   #16
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I just started the Byetta two days ago. And, I have had to up my carb intake- as I almost immediately started having low readings. I have definitely ALREADY found out that too much food volume and Byetta definitely don't mix. I ate a 'normal' portion (for me)- 3 egg spinach omelet for dinner the first night...and, well, let's just say the next time, it will be TWO eggs...lol...as I'd like to keep it down! However, I have to say, I'm shocked at how well it's lowering my fasting numbers. Nothing I did would get me below 125, and I tried everything (not eating after dinner, bedtime snack, wine, cheese, exercising before bed, waking up at 3:00AM to eat)- and yet, the last two mornings, I have been at 94 & 95. Too early in the game for me to jump for joy, but definitely am cautiously optimistic that this might do the trick. Not sure it will help with my weight loss, as I was doing pretty good in that area just with diet alone.
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Old 03-25-2010, 12:14 AM   #17
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chickamomminy, I'm glad to hear the Byetta is working for you.

I had never heard that users must have 30-40 g of carbs in a meal for it to work. I'm skeptical about that.

The drug's action is dependent on at least some elevation of blood sugar being present. That's not hard to accomplish if you have some carbs or protein in your meals.

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Old 03-25-2010, 12:31 AM   #18
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What about being on insulin and then switching over to Byetta?
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Old 04-12-2010, 09:47 PM   #19
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Chickamommy - I am so glad byetta is working for you. My doc gave me a sample and I immediately lost weight and began seeing my bg numbers in the double digits for he first time EVER. But alas, my insurance won't cover it and it is quite expensive.

But there is another new drug that is injectable once per day called Victoza. It is half the cost of byetta. I may give that a try. I am currently on Januvia and despite low-carbing I cannot get my numbers down to double digits.
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