Diabetes.Blog.com

1 - QUESTION:

I'm thinking it's pretty apparent I'm getting too much in
oral meds with the low's I've been having. If I was to
make a decision on how to cut back which drugs should I
choose? I'm currently taking Glipizide 20 mg, lantus 15u
at bedtime and Metformin 1,000 x 2 daily. I have already
cut my evening glipizide in half. Thinking I
should half the morning dose also. Anyway the order
I think would be glipizide, lantus, metformin. Any
thoughts? Don't worry if you think I'm asking for medical
advise, I'm not. I see the endo on Tuesday, just giving
some thought based on what I know the drugs are doing for
my diabetes. At night I have to have around 80 grams of carbs to keep from having a low. I don't want that many at most would be 45. Until I cut back on the meds I feel
I'm eating to meet my meds needs.

Jeanna (Comment this)

2 - Guess we'd need to know if you are having side effects from any of the meds--if you are, reduce the dosage of the one that is causing them. For me, that much metformin would affect me badly, so I would look to reduce that. Also, I take 2.5mg of glip, so 20 mg sounds like a huge amount. Also, glip can cause lows. Let us know what you find out.

Peggy in St. Louis (Comment this)

3 - JEANNA - RE:CUTTING BACK MEDS

Jeanna, I have no experience with glipizide or lantus so my only experience with those is listening to others. I do have the impression that those are a type of med that you basically have to have some carbs to offset or they can crash you. I use the 1000 Metformin X 2 same as you along with Byetta 10. I concur with it being a low priority to drop. It doesn't cause any problems for me (no lows) simply helps bring the general glucose levels down but does not crash them. (Comment this)

4 - OUT TO DINNER - First time out to eat in 2 weeks of gilly use. Used my travel pack from Byetta and everything went really well. Ordered, took shot, food arrived in 20+ minutes (a grilled chicken salad).

Have lost about 7 lbs in 2 weeks and other than the occasional queasy feeling, no problems. Biggest concern is the lows, was 83 at bedtime and 67 this morning. Had about 4oz oj before going to bed. (Comment this)

5 - Neva Gail
You probably need to look at any other meds you are taking. Byetta alone can't cause lows (except in substantial overdose situations). I don't take oral meds, but I decreased my insulin until it is almost nothing thanks to byetta. Pat in Idaho (Comment this)

6 - Hello, I am a new user of byetta. I started using the 5mcgs on Jan 16th. My numbers have been in control all along my Endo wanted me to use Byetta for weight loss. I eat 1200 cal or less aday and exercise 4 days aweek for 1 1/2 hours. My issue, I have gained 7 pounds since I started taking Byetta. I also take 2000mgs of Metformin aday. Since taking byetta I have not been nauseated,nothing. It is making me hunger all the time, my stomch grawls as I am eating and never stops. Is this normal? I see my Endo again in 2 weeks. I feel like I dont want to take it anymore because its not working. Thanks for listening. (Comment this)

7 - Lisa,
A couple of things to think about-- Are you following the directions for how and when you are to take it carefully. I'm always careful to make sure I eat about 30 minutes after injecting so I get good appetite suppression. Are you regularly checking your bg levels? I can tell byetta is working with each meal by testing for the decrease in bg that occurs. Has your pen been kept at the proper temperature? Storing the pen where it is outside of 36 to 46 degrees will destroy the drug. Was it refrigerated at the pharmacy where you got it? Pat in Idaho (Comment this)

8 - Pat - I take actos 15mg x 1 day as well as blood pressure (4) and cholestrol medications. Hopefully, the dr will cut the Actos at my visit on the 27th. My numbers before Byetta were generally under good control (80-120) with an A1c of 5.4 in January, 2006. Have tried to watch protein and diet more closely, will hit right combination soon I'm sure.

Dr. Bill - thanks for the new forum. For those of us in rural areas with slooooooow dial up - this will be great! (Comment this)

9 - Re POSTING ON OTHER FORUMS:
To those who asked (Donna M. and Carolyn in Texas I think), thank you for your concern at my disappearance here for a bit (and thank you Shari for answering)a few of us have been discussing some interesting topics in "Odds and Ends" and lately (my favorite and most comfortable forum "Meals, Eating, and Nutrition" where we can talk about what else.....FOOD! ha,ha,.) You may want to join our research there. I had a second semi-queasy morning all throughout Church services but I made it. Nothing serious, just an uncomfortable and discontent tummy. I feel better than I have in a very long time and LOVE the energy. Still learning all I can about slow-emptying of the stomach and the ingredient in our Byetta called Mannitol. (discussions in those other forums). Some great questions and helpful answers are posted here and glad to hear most of the newbies are getting along well.
TO LISA:
Sorry LISA that things are working differently for you. You asked if your stomach growling non-stop and constant hunger was normal and I personally do not recall anyone saying that before. Some hunger reported mostly from those who went on the 10 dose after the 5 for awhile but not like what you described I do not believe. Most of us don't really have much hunger, it is supressed. I heard an EXCELENT tip on here that the longer we can wait up to the hour mark after our shot the better the appetite suppression is. Worked for me. How soon are you eating after your shot? You are certainly eating the right amount for weight loss at 1200 calories or less and the exercise is great. Is the Metformin the only other medication you are taking? (not just Diabetic meds, but any meds?) Hopefully your Endo can figure this puzzle out for you. Hope you can stay with the gilly and with us. (Comment this)

10 - Thanks for talking with me Cindylou, Other meds? I also have asthma, therefore I am taking advair,singular,and albuteral when needed (which is seldom). Also, a diaretic. I have spoken (pre-byetta) to my Endo about me eating 1200 cals aday and the exercise I do, I got the impressing he did not believe me. As far as how soon do I eat after shooting up? Within 30 minutes. (Comment this)

11 - Idaho Pat, I guess Im following the directions correctly, the Endo just gave me the stuff and said watch the tape it will answer your questions. (evidentally not if Im on here) I do keep the pen in the door of the refrigerator. I keep it there at all times. I just received that carring pouch for it. The doctor had the drug in thier refrig before giving it to me. My bg's have been great even before the spit. Anything else? (Comment this)

12 - LISA ReOTHER MEDS:
Hey Lisa, I do believe inhaled steriods for asthma can cause weight gain. At least the ones I have had in the past. I don't know if that could be conflicting with the ability of the Byetta to help you with weight loss. I also understand the weight loss doesn't necessarily happen for everyone and for each of us at different rates. For some of the gillies it has really dropped off and others of us it has been slow, very slow, but still coming off and not really gaining unless temporary water weight for particular reasons. What type of exercise is it that you do? (Comment this)

13 - LISA - with your exercise, is it possible the weight gain is muscle? Have you lost inches? Seems I have heard along the way that muscle weighs more than fat and it is not unusual to gain some weight when exercising. Just a thought. (Comment this)

14 - Lisa: Good #
I am a little confused if you had good # what was the reason for putting you on byetta? Is it for just weight loss? Just curious what other things the gilly juice is good for. Thanks (Comment this)

15 - Jeanna, I think you should call your doctor and ask about cutting back the glipizide, which is a sulfonylurea like Amaryl -- an insulin stimulator. But ask first. I had to come completely off it to stop the lows after I started on Byetta.

Lisa, I'm sorry the lizard spit doesn't seem to be working for you. But it sounds like you had really good control before you started it, so I wonder if maybe your body doesn't need the incretin-memetic at all? It seems to me that if your body is producing it, your receptors will all be filled up with your own hormones. But that's just wild ass guessing on my part. Can you get an appointment with your endocrinologist to talk about the problem? There have to be some people for whom the stuff just doesn't work, after all.


 (Comment this)

16 - Lisa:BGS
Also lisa if your blood glucose # is good when you take byetta does it make your # go low? Or stay the same?? Sorry so many ? I just don'nt understand how it does not make you go too low if your # is good to begin with. It goes to prove even those of us on the blog for 7 months can still learn something new. (Comment this)

17 - Lisa, If the juice in the pen is going down and your not getting wet then it must be going in.You could be one of the lucky ones with no side effects, so we can't go by your lack of nausea, etc. Try eating a huge meal..if you throw up, it's definitely going in ..lol.. just kidding!

You said you started in January, If you're still on the 5, maybe you need the 10? It's a real mystery if your're
doing 1200 calories and execising. How's your thyroid??

 (Comment this)

18 - Lisa, forgot to ask. Are you losing inches..if not pounds. The monster likes to eat our fat! (Comment this)

19 - I have been on byetta 5 for one week. Also take Starlix before each meal and Avadamet in AM and PM. My readings are extremely inconsistent. I readings these blogs I don't hear of many people taking Starlix. Can anyone give me suggestions about how they time their Stalix before meals. It seems that the byetta which is supposed to slow down digestion would counter against the Starlix which is supposed to work immediately. Any suggestions would be greatly appreciated. (Comment this)

20 - Great idea in Meals, Eating, and Nutrition forum about maybe exercising after the 2 hour bg test to keep the 4 hour from rising. Hummm...something else to consider. (Comment this)

21 - UGH, EXERCISING:

Cindylou, I am going to take my own advice, and you confirming it, to see if it makes a difference. I can pretty well count on a decrease of 10 points in my bg # per 5 minutes on my exercise bike, so I'll do it and see if I can keep it from increasing at that 3 to 4 hour test. (Comment this)

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 (Comment this)

23 - Joe Starlix,
Sorry Joe I have no information on starlix. But I do want to welcome you to the blog and our GILLY CLUB. Hopefully some of the other gillys can help you with Starlix. Welcome aboard! (Comment this)

24 - Oh wow so many people talking to me, I wasnt expecting that. I will try to answer everyone. My Endo put me on the byetta for weight loss. He also told me that I would have better control of my sugars. Now, my numbers do go up over night. And it was staying up longer after eating. I have noticed that my numbers come back down faster after I eat now. As far as exercising, I do 20 mins of strength training and at least 1 hour of cardio keeping my heart rate at 145 or higher. This week I will be measured I do that monthly. I will then know if the drug is working in respect. I kept thinking I wasnt getting the medicine so acouple of times I would shot it up in the air just to see if any was coming out and yep it was. Thyroids are find my A1C has been 6.5. I could be wrong but I don't think advair and singular are steroids. Im so frustrated! (Comment this)

25 - SHARI, ReEXERCISE AFTER THE 2 Hour bg test:
Shari, for some reason only part of my post to you was printed. Odd. Anyway, glad you made it through the construction zone and found your way here and I think you might be right about the need to exercise then. I am going to try to remember to do a 2 hour post test then a 4 hour post (or 2 more hours after that) and see what mine is doing. Could be spiking a lot later now. May be a good tip for all of us... (Comment this)

26 - TO LISA CONCERNING BYETTA WEIGHT GAIN:
Lisa, I sure can understand your frustration. I think you need to hand all the peices of this puzzle to your Endo. Don't leave anything out. That is a lot of exercise you are getting imo, so you might be building muscle and losing fat and as Neva Gail said, the muscle weighs more. I took Asthmacort and it was an inhaled steriod and could cause weight gain but I'm not sure about the side effects of yours. You might want to look them up. Are you eating enough food for the amount of exercise you do? You might be storing fat because your body is afraid you will starve it. It might be signaling to you the hunger pangs because you really are hungry and not getting enough food. I know we are just asaulting you with questions, sorry about that but it is most perplexing, we do care, and we just want you to think about all the possibilities. (Comment this)

27 - JUST A QUICK REPORT ON FATIQUE...just wanted to let those know who responded to my questions concerning the fatigue as I begin my 5th month on the spit...the reduction of my Lantus and the elimination of the night time lows seem to have helped a lot. I'm still not a ball of fire, but do feel lot better now that I'm not sinking so low at night. Morning numbers are a little higher than they were, but they are ones I can live with.

Since I am beginning month 5, I plan to move to the long term forum when Dr. Bill opens it again. Thanks to all of you...Danielle, John, Warren, Cindylou (just to name a few) for all your help and encouragement. I wish everyone great success wtih your Gilly adventure...maybe we should have a 'spitoon' store on ebay to get rid of all our clothes, etc. that don't fit any more...we could donate the money raised to diabetes research. Happy days! (Comment this)

28 - Sharon from Great state of TexasRE Long term
I will visit you on long term to see how your doing. I figure as more of the newbies take over here helping the ones just coming onI can go to long term more often. I am so glad you are feeling better. Guess your Gilly just had to be adjusted with your other meds. (Comment this)

29 - ANSWER to QUESTION

Thank you all again for your comments. I do see my endo
on Tuesday I'll let you know what he says. Actually I
saw his PA when I got the Byetta and she told me to feel free to play with my meds and told me the order. The
problem is for this old feeble mind (I did just have a birthday!) I can't remember the order. I had it for over a month before I actually started on the Spit.

This time I will go in with paper and pen in hand!
Beth, where in Arizona are you? I'm in the Desert Ridge area.

Jeanna (Comment this)

30 - Sharon,

Wow.!! month 5.
Good luck... I'll miss you here.

John (Comment this)

31 - === off-topic post ===
I have added a new Discussion Forum to share info about where you live, and e-mail addresses.

If you want to share, simply tell someone here to go to
Who and where are you?

Hope this helps! (Comment this)

32 - LISA - I am just finishing up my first month on the 10 after being on the 5 for one month. I did find that while on the 5, there were quite a few days where I was RAVENOUS! There wasn't enough food in the supermarket to fill me up! I listened to folks here, who suggested waiting at least 30 minutes after injecting before eating, if not longer. I tried that, and it seemed to help some. I found that this business of being hungry all the time was definitely better after I moved to the 10 pen. I was one of the lucky ones and never got nauseous, but I also haven't lost much weight - only 2 lbs. in 2 months. I like to look on the bright side . . . that sure beats gaining 2 lbs. in the same time! You might try waiting closer to an hour after your injection before eating and see if that helps. Going to the 10 may also make a difference. Also, I don't know about Cingular, but Advair is definitely an inhaled steroid. I get occasional asthma if I have the flu or a really bad cold, and have taken it a couple of times.

Hope that helps. Good luck and stick with it! (Comment this)

33 - Joe- I was taking Starlix, Avandia, metformin and Glucotrol XL when I started Byetta. My doctor immediately took me off of the Starlix. I have since been able to stop the Blucotrol XL. I recently went back for a 5 month checkup and asked her about taking my Avandia, metformin and cholesterol meds, because I was having middle of the night lows when I tried taking the meds separate from my meals. She told me that I can take them with my meals, same as always. She said that the manufacturers are being extremely cautious, but she doesn't feel that absorption will be changed just because of a slow emptying stomach. You should probably ask your doctor just to be sure, but that was the recent advice of my doctor. My A1C dropped from 7 to 5.5 so something is working fine! (Comment this)

34 - Began byetta in midNovember after gaining almost 20 lbs. on Actos. No nausea but it has taken this long to lose 8 lbs and this is with 2 weekly 1 hr. sessions of wateraerobics and extra walking. My blood sugars are also up . My next HA1c is due next week so will get some feed back (Comment this)

35 - I did 10 mcg this weekend, and my appetite is gone! I am completely miserable however, definitely not hungry. My 3 month supply should arrive in a few days. I fell asleep and skipped dinner and the dose because I didn't want to eat so late when I woke up. I checked my BG to make sure I wasn't going low and seems fine to me. My worry of course is I interupted the dosage amount internally, I will get a double whopping of nausea tomorrow when I take it.

My stomach is sore still, maybe the little time off will do some good... I will let you all know. (Comment this)

36 - LONG TERM FORUM

Sharon, you mention the long term forum opening again. From what I'm seeing today in how things have been rearranged I don't know that will happen. My vote would be to keep it this way anyway. I don't see any advantage to splitting the long term people out. I think that over time that forum would be really slow considering that people get busy and after while it just isn't new and exciting so probably not as much motivation to go visit it all the time. Besides I see that there is a constant stream of new people coming on here needing the wisdom of those with experience in this forum. I now the new people certainly have questions about the immediate effects they are experiencing BUT it would also be advantageous for them to take in the conversations of the experienced people so they also know what to expect tomorrow and the week after that and the month after that....

My vote is to keep us together as a community like its just been changed to and do the one week at a time shift. Other subjects to other forums.... great. But Byetta newbies and experienced Byetta people are one big family that can do a lot to support each other if we are kept together.

[You are quite correct, there is no intention to reopen a separate long-term Byetta Forum. And thanks for your vote of support! Bill the diabetesdoc.] (Comment this)

37 - DR BILL, BETTY, DANIELLE, TIM F. / TIM FAT / TIM SLIM, KATE, LYNN, GRANDMA JEAN, CINDYLOU, The Whole GILLY GANG,

We have all been on a wonderous trip into the undiscovered country together as we has expolred the future and the posibilities of better health and the challenges of getting there. This blog has been a wonderful companion, first as mentor to me as a newbie, then as student as I have been able to share some of what I had learned.

The growth of this community over the last 5 months has been amazing and overwhelming. I am afraid that this overwhelming growth has become too much for me. I do not have the time to keep up with all the new family members here, and all the cherished friends. I will come back and post updates occassionally, but as a "regular" I am afraid that I am going to sign off.

Be assured that I AM NOT stopping the Byetta, I just cannot keep up with the growth here.

My thoughts and prayers will be with you,

Jim in DC (Comment this)

38 - Jim in DC- I don't know if you will read this posting but I want to wish you the best in the future. You had some comments that were valuable to me.
TO ALL THE GILLY GANG- What happened to the regular February forum? Why was it moved from the roster of discussions? I guess I tuned in late.
In any event, I started today with a bs of 107. Things seem to be moving in the right direction. Generally I feel fine on the little brother. This morning I have a dentist appt. Hope the extra vitamin C will prevent gum "hemhorraging(!)" Wish me luck. Later- (Comment this)

39 - UPDATE:
I've been on little brother for four weeks tomorrow. I had major bs drops this weekend. Woke up saturday with a 128. Within an hour after eating it was 90. Thirty minutes later 72.
Same thing Saturday night, Sunday morning and Sunday night. This morning's reading was 100. I've had my meds and my breakfast. I'll definately carry OJ when I leave the house for work. I'm taking 1000mg of metformin about thirty minutes to an hour before taking the spit. Hope the doc will try dropping my dose back to 500.
JIM IN DC:
Only been here a short time but I really enjoyed your posts and wish you the best in the future. (Comment this)

40 - Jim in DC
Since Sept.7 you along with the others you mentioned got me thru some of the hardest days of my life. Byetta would not still be part of my life without your informed information,sense of humor,and encouragement to keep going. I will look forward to your posting as I would a letter from an old friend. God Bless. (Comment this)

41 - Lonnie;OJ
Thats a real good idea till you find out what is causing the drops. Your Dr. may take you off one of your oral pills since byetta is working so well. Good Health (Comment this)

42 - TO JIM IN DC:
I really don't want you to leave the forum!!! You have been my mentor and given me the ultimate goal to strive for. I'm glad you will drop in from time to time, please don't forget us! When we have the big GILLY SPITOON CONVENTION I want to meet you there! May God bless you and keep you and your wife in good health always. (Comment this)

43 - LONG TERM FORUM:
Warren, that was beautifully expressed and I hope all the long-term gillies will all join in here knowing the family grows each day by leaps and bounds and that they will continue to give us all the benefit of their wisdom and experiences. Most every new person beginning this adventure is scared and anxious and uncertain as many of us can all remember being. This is such a special family of support, and like any family we have the wisdom of the great-grandparents and all the other family members down to the little children. We need everybody.

I also think combining the two into a weekly forum is a great idea! (Comment this)

44 - Re Byetta alone & lows. I am a newly diagnosed Type 2. Started Byetta 2 weeks ago, 5mcg. a.m & p.m. Started having morning lows (56) when before starting Byetta my 2 hr post prandials had been above 180.

Called my doctor who re-asked me about other meds I was taking. He couldn't figure it out, so told me to drop down to 1 dose per day in the evening. However, talking with him got me to thinking & I entered all meds I'm taking in an online drug interaction program. Turns out the prescription allergy medication I'm taking had pseudophedrine in it (Zyrtec-D) and pseudophedrine (under many different names) is one drug that can cause lows when taken with Byetta. Stopped the Zyrtec-D on Saturday & haven't had a low since. (Comment this)

45 - Courtney
First Welcome to the byetta blog{gilly club] Thank You for being so informative to us all. I was not aware of such an on-line service. I am glad they were able to determine your problem so quickly. And I am sure a lot of us gilly's both old and newbies will be checking that on line service. Once again welcome. (Comment this)

46 - TO COURTNEY ReDRUG INTERACTIONS:
Wow thanks Courtney for such an informative post! Great info on the on-line drug interaction program as well as letting us know this drug can cause the lows. Good that you found out the problem immediatly and I guess now you are back on the fully gilly dose of 5 twice/day? Hopefully you will continue to do well with the spit from here on! (Comment this)

47 - IMPORTANT QUESTION:
Has anyone out there experienced itching, rash -- typical beginning allergic reaction symptoms, and then had them go away -- so that you were able to continue Byetta? About 10 days or so ago BOB reported that his face had broken out.
If you're out there BOB, could you post and tell us outcome re Byetta?

I am hyper allergic and cannot take many, many common drugs. I had hoped so strongly that I could take Byetta. After 4 days on Little Brother, I have lost 3 pounds and an inch off both my waist and my hips --- have low stable BG #'s plus lower blood pressure. In addition -- and because of Dr. Bills blogs -- I have "caught the vision" -- what this wonderful drug might mean to posterity.

My symptoms are being controlled with very minimal Benedryl -- and I plan to postpone a.m. shot -- kind of tread lightly -- and see what happens. Over Christmas I was gran'puppy sitting and developed an allergy to the puppy. I may have omitted washing one particular robe afterward. Can't recall for sure, so I'm hoping a few puppy cells may be the culprit. That's probably a pipe dream, but I do not want to have to give up my now-beloved Monster.

The reaction could be to any component in the make up of the shot. I read the ingredient list, but there were one or two usually benigns but unknowns. I have carefully avoided eating any new food and taking any new med, giving Byetta every chance I possibly could. Related information from any of you will be carefully read and greatly appreciated. (Comment this)

48 - CAROLYN FROM TEXAS RePOSSIBLE SKIN REACTION TO BYETTA:
Hello Carolyn, go over to the forum on Skin Complications; I posted a message to you there concerning your allergy! (Comment this)

49 - BYE,BYE, LONG TERM:

Thanks, dr. Bill for inviting us oldies to stay on here.

Well said, warren. My, and I'm sure others, sentiments exactly.

I was beginning to feel compelled to go permanently to the long term blog, like an old cow having to go "Out to pasture."

[I giggled repeatedly after reading this, then realized this was off-topic. Oh, phooey, I'll let it stay!
Bill the diabetes doc] (Comment this)

50 - TO THE EVER FUNNY SHARI CAT MOMMIE ReTHE LONG TERM BLOG:
My morning happy chemicals dancing in my brain are from you Shari! You make me laugh out loud at some point nearly every day! Hopefully all the "oldies" will feel as you do. We need you all here with us! (Comment this)