Byetta

[Zad]

I have just seen this posting. My mum was on a Byetta trial for around 12 months up to early this year. She had to leave it because of the side effects. Right from the start it gave her nausea, and it just never really went away. I don't know whether it was forming a mental association with various foods, but she went off quite a few dishes that she had previously really liked, and still isn't back to normal. I guess it was the Byetta as much as the aversion, but her weight loss was good. Not fast, not slow, just consistently steady. She gave it a really good go, but it was getting to the point where nausea was there most of the time and nothing they prescribed seemed to help. A huge shame because it really did consistently sort her sugar levels and help with weight loss. She didn't have any real problem with the pen applicator, and she is in no way mechanically minded.

Fingers crossed for you all that you get down to your target weights and don't need to take it!

[Mermaid]

Zad said:

I have just seen this posting. My mum was on a Byetta trial for around 12 months up to early this year. She had to leave it because of the side effects. Right from the start it gave her nausea, and it just never really went away. I don't know whether it was forming a mental association with various foods, but she went off quite a few dishes that she had previously really liked, and still isn't back to normal. I guess it was the Byetta as much as the aversion, but her weight loss was good. Not fast, not slow, just consistently steady. She gave it a really good go, but it was getting to the point where nausea was there most of the time and nothing they prescribed seemed to help. A huge shame because it really did consistently sort her sugar levels and help with weight loss. She didn't have any real problem with the pen applicator, and she is in no way mechanically minded.

Fingers crossed for you all that you get down to your target weights and don't need to take it!

Did she take Byetta just before eating, or did she wait. Little or no nausea if you take the byetta just before you start eating is the experience of many people.

It's the smell of certain foods (steamy, oily) that the Gila monster dose not like. Baked foods works well, as do sweets for hardly any smell. It may surprise a cloths peg on the nose helps too.

[Mermaid]

Zad said:

I guess it was the Byetta as much as the aversion,

alternative now approved

http://www.nursinginpractice.com/default.asp?title...

[Zad]

Cheers Mermaid, I will print that off and show it to her. She took Byetta before eating, but it didn't seem to make much difference either way unfortunately. Hopefully she will be able to get a Victoza / liraglutide trial.

[Mermaid]

Zad said:

Cheers Mermaid, I will print that off and show it to her. She took Byetta before eating, but it didn't seem to make much difference either way unfortunately. Hopefully she will be able to get a Victoza / liraglutide trial.

some more reading for you.


1. Diabetes Care. 2010 Jun;33(6):1300-3. Epub 2010 Mar 23.
Switching to once-daily liraglutide from twice-daily exenatide further improves glycemic control in patients with type 2 diabetes using oral agents.
Buse JB, Sesti G, Schmidt WE, Montanya E, Chang CT, Xu Y, Blonde L, Rosenstock J; Liraglutide Effect Action in Diabetes-6 Study Group.
Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. [e-mail]
Abstract
OBJECTIVE: To evaluate efficacy and safety of switching from twice-daily exenatide to once-daily liraglutide or of 40 weeks of continuous liraglutide therapy.
RESEARCH DESIGN AND METHODS: When added to oral antidiabetes drugs in a 26-week randomized trial (Liraglutide Effect and Action in Diabetes [LEAD]-6), liraglutide more effectively improved A1C, fasting plasma glucose, and the homeostasis model of beta-cell function (HOMA-B) than exenatide, with less persistent nausea and hypoglycemia. In this 14-week extension of LEAD-6, patients switched from 10 microg twice-daily exenatide to 1.8 mg once-daily liraglutide or continued liraglutide.
RESULTS: Switching from exenatide to liraglutide further and significantly reduced A1C (0.32%), fasting plasma glucose (0.9 mmol/l), body weight (0.9 kg), and systolic blood pressure (3.8 mmHg) with minimal minor hypoglycemia (1.30 episodes/patient-year) or nausea (3.2%). Among patients continuing liraglutide, further significant decreases in body weight (0.4 kg) and systolic blood pressure (2.2 mmHg) occurred with 0.74 episodes/patient-year of minor hypoglycemia and 1.5% experiencing nausea.
CONCLUSIONS: Conversion from exenatide to liraglutide is well tolerated and provides additional glycemic control and cardiometabolic benefits.
PMCID: PMC2875443 [Available on 2011/6/1] Free Article
PMID: 20332351 [PubMed - indexed for MEDLINE]
Related citations




2. Acta Biomed. 2009 Aug;80(2):93-101.
Liraglutide in type 2 diabetes: from pharmacological development to clinical practice.
Rossi MC, Nicolucci A.
Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Chieti, Italy. [e-mail]
Abstract
The novel drug class of GLP-1 analogues is extremely promising, since existing evidence suggests they can address many of the unmet needs of diabetes treatment, i.e., long-term efficacy, low risk of hypoglycemia, cardiovascular protection, weight loss, long-term safety and tolerability. Besides the already available exenatide, liraglutide is expected to arrive soon on the market. It is a human GLP-1 analogue with high homology (97%) to native hormone. A comprehensive phase III evaluation consisting of six randomized clinical trials--the "Liraglutide Effect and Action Diabetes (LEAD) program"--was recently completed, involving 6500 people seen in 600 sites in 41 countries worldwide. Aim of the LEAD program was to evaluate efficacy and safety of liraglutide as monotherapy and in combination with commonly used antidiabetic drugs. In all studies, once-daily liraglutide was well tolerated, significantly improved metabolic control, and reduced body weight, with low rates of hypoglycemia. Transient nausea was the most common side effects. Additional beneficial effects ofliraglutide on beta-cell function, systolic blood pressure, and cardiovascular risk were also documented. If these encouraging results will be confirmed by long-term studies, liraglutide will acquire a prominent role among the main therapeutic options not only as add-on treatments in case of secondary failure, but also as an early strategy to reduce the burden of diabetes and its complications.
Free Article
PMID: 19848045 [PubMed - indexed for MEDLINE]
Related citations




3. Vasc Health Risk Manag. 2009;5(1):199-211. Epub 2009 Apr 8.
Potential of liraglutide in the treatment of patients with type 2 diabetes.
Deacon CF.
Department of Biomedical Sciences, Panum Institute, Copenhagen N, Denmark. deacon@mfi .ku.dk
Abstract
Liraglutide is a long-acting analog of GLP-1, being developed by Novo Nordisk and currently undergoing regulatory review for the treatment of type 2 diabetes. Upon injection, liraglutide binds non-covalently to albumin, giving it a pharmacokinetic profile suitable for once-daily administration. In clinical trials of up to 1 year duration, liraglutide has been demonstrated to have beneficial effects on islet cell function, leading to improvements in glycemic control. Both fasting and postprandial glucose concentrations are lowered, and are associated with lasting reductions in HbA1c levels. Liraglutide is effective as monotherapy and in combination therapy with oral antidiabetic drugs, and reduces HbA1c by up to approximately 1.5% from baseline (8.2%-8.4%). Because of the glucose-dependency of its action, there is a low incidence of hypoglycemia. Liraglutide is associated with body weight loss, and reductions in systolic blood pressure have been observed throughout the clinical trials. The most common adverse events reported with liraglutide are gastrointestinal (nausea, vomiting and diarrhea). These tend to be most pronounced during the initial period of therapy and decline with time. Further clinical experience with liraglutide will reveal its long-term durability, safety and efficacy.
PMCID: PMC2672437 Free PMC Article
PMID: 19436648 [PubMed - indexed for MEDLINE]
Related citations




4. Diabetes Care. 2004 Aug;27(8):1915-21.
The effect of liraglutide, a long-acting glucagon-like peptide 1 derivative, on glycemic control, body composition, and 24-h energy expenditure in patients with type 2 diabetes.
Harder H, Nielsen L, Tu DT, Astrup A.
Research Department of Human Nutrition, LMC, The Royal Veterinary and Agricultural University, Rolighedsvej 30, DK-1958 Frederiksberg, Denmark.
Abstract
OBJECTIVE: Glucagon-like peptide (GLP)-1 is a gut hormone that exerts incretin effects and suppresses food intake in humans, but its therapeutic use is limited due to its short half-life. This was a randomized, double-blind, parallel-group, placebo-controlled trial investigating the effect of the long-acting GLP-1 derivative liraglutide (NN2211) on glycemic control, body weight, body composition, and 24-h energy expenditure in obese subjects with type 2 diabetes.
RESEARCH DESIGN AND METHODS: Thirty-three patients (mean +/- SD) aged 60.0 +/- 9.5 years, with HbA(1c) 7.5 +/- 1.2% and BMI 36.6 +/- 4.1 kg/m(2), were randomized to treatment with a single daily subcutaneous dose of 0.6 mg liraglutide (n = 21) or placebo (n = 12) for 8 weeks. In addition to weight and glycemic parameters, body composition was assessed by dual-energy X-ray absorptiometry (DEXA) scanning and 24-h energy expenditure in a respiratory chamber.
RESULTS: After 8 weeks, liraglutide reduced fasting serum glucose (liraglutide, -1.90 mmol/l, and placebo, 0.27 mmol/l; P = 0.002) and HbA(1c) (liraglutide, -0.33%, and placebo, 0.47%; P = 0.028) compared with placebo. No change in body weight was detected (liraglutide, -0.7 kg, and placebo, -0.9 kg; P = 0.756). There was a nonsignificant trend toward a decrease in total fat mass (liraglutide, -0.98%, and placebo, -0.12%; P = 0.088) and toward an increase in lean body mass (liraglutide, 1.02%, and placebo, 0.23%; P = 0.118) in the liraglutide group compared with the placebo group. Twenty-four-hour energy expenditure was unaffected by the treatment (liraglutide, -12.6 kJ/h, and placebo, -13.7 kJ/h; P = 0.799).
CONCLUSIONS: Eight weeks of 0.6-mg liraglutide treatment significantly improved glycemic control without increasing weight in subjects with type 2 diabetes compared with those on placebo. No influence on 24-h energy expenditure was detected.
Free Article
PMID: 15277417 [PubMed - indexed for MEDLINE]
Related citations

[Zad]

Thanks for the info. It seems I am behind with events, mum saw an article in Monday's paper and is planning to bring up the subject at her next trip to the diabetic clinic in 3 weeks. Very promising looking trial results there, it will be interesting to see if anyone here gets to go on it, and what the results are.

[TedMaul]

From what I have read (somewhere can't find link sorry) Victoza is supposedly less prone to cause nausea than Byetta but it is much more expensive, but it looks very good.

Start Byetta Sat, massive stomach bug Tuesday night, lost about 2 stone already

[Saddle bum]

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

[TedMaul]

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

[Mermaid]

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.
.

Most likely.

Byetta once a week will be available at some stage.

http://www.drugs.com/news/once-weekly-diabetes-boo...

[Saddle bum]

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

[Mermaid]

Saddle bum said:

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

did you eat anything in the 2 hrs before you took Byetta?

[Saddle bum]

Mermaid said:

Saddle bum said:

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

did you eat anything in the 2 hrs before you took Byetta?

Not normally, however nursie says leave it a good hour before eating, which is probably not what I was doing previously.

[Mermaid]

Saddle bum said:

Mermaid said:

Saddle bum said:

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

did you eat anything in the 2 hrs before you took Byetta?

Not normally, however nursie says leave it a good hour before eating, which is probably not what I was doing previously.

Eat nothing in the 2 hrs prior to taking Byetta. Take Byetta and then eat immediately.

BUT don't finish all the food on the plate, leave 20% behind

[TedMaul]

Mermaid said:

Saddle bum said:

Mermaid said:

Saddle bum said:

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

did you eat anything in the 2 hrs before you took Byetta?

Not normally, however nursie says leave it a good hour before eating, which is probably not what I was doing previously.

Eat nothing in the 2 hrs prior to taking Byetta. Take Byetta and then eat immediately.

BUT don't finish all the food on the plate, leave 20% behind

My diabetic nurse has said quite the opposite and that an hour before jab is ideal time for maximum effect. Interesting about not eating prior to jab - easy fro morning jab but not so for evening I guess!

[Mermaid]

TedMaul said:

Mermaid said:

Saddle bum said:

Mermaid said:

Saddle bum said:

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

did you eat anything in the 2 hrs before you took Byetta?

Not normally, however nursie says leave it a good hour before eating, which is probably not what I was doing previously.

Eat nothing in the 2 hrs prior to taking Byetta. Take Byetta and then eat immediately.

BUT don't finish all the food on the plate, leave 20% behind

My diabetic nurse has said quite the opposite and that an hour before jab is ideal time for maximum effect. Interesting about not eating prior to jab - easy fro morning jab but not so for evening I guess!

I suspect your diabetic nurse does not use Byetta, and nor the Consultant...

An hour is theoratically ideal, but compliance is better than an ideal situation. But suck it and see what works for you. Nausea is one of the main reasons why people give up on Byetta, and yet these are the very people who need it most IMO.

Jabs have to be 6 hours apart, so it is easily possible not to eat for the 2 hours prior to the jab.

[TedMaul]

Mermaid said:

TedMaul said:

Mermaid said:

Saddle bum said:

Mermaid said:

Saddle bum said:

TedMaul said:

Saddle bum said:

After a consultation yesterday, my treatment is being changed from Byetta to the once a day material, which I presume is Victoza.

I think Byetta is now being viewed as a first generation medication. It can be aggressive, but with me it has been very successful. I have been prepared to endure the negative side, but the constant acid reflux is becoming a bit wearing.

When you say reflux, was it full on vomitarium or rising acid/heartburn type thing.. ?

No vomit. Just acid heartburn. Gaviscon by the bucket.

Forgot to take Gaviscon out last week on a 30 mile bike ride, absolute misery. Having a hiatus hernia is the major cause. Byetta just makes it worse. Looking forward to better days with new treatment.

did you eat anything in the 2 hrs before you took Byetta?

Not normally, however nursie says leave it a good hour before eating, which is probably not what I was doing previously.

Eat nothing in the 2 hrs prior to taking Byetta. Take Byetta and then eat immediately.

BUT don't finish all the food on the plate, leave 20% behind

My diabetic nurse has said quite the opposite and that an hour before jab is ideal time for maximum effect. Interesting about not eating prior to jab - easy fro morning jab but not so for evening I guess!

I suspect your diabetic nurse does not use Byetta, and nor the Consultant...

An hour is theoratically ideal, but compliance is better than an ideal situation. But suck it and see what works for you. Nausea is one of the main reasons why people give up on Byetta, and yet these are the very people who need it most IMO.

Jabs have to be 6 hours apart, so it is easily possible not to eat for the 2 hours prior to the jab.

3 days in and 5 jabs. Only time I felt sick was eating a scone and jam mid afternoon yesterday, proper greed not hunger situation, but it was part of a surprise birthday treat and I was tired and a bit dehydrated too if I'm honest.

Thanks for reminding me of the six hour interval, unlikely to be a problem for me given the hours I work, but I would forget.

Only on 5microgram doses so far, but so far, so good (so what for you Megadeth fans...)

[Mermaid]

TedMaul said:

..
3 days in and 5 jabs. Only time I felt sick was eating a scone and jam mid afternoon yesterday, proper greed not hunger situation, but it was part of a surprise birthday treat and I was tired and a bit dehydrated too if I'm honest.

Thanks for reminding me of the six hour interval, unlikely to be a problem for me given the hours I work, but I would forget.

Only on 5microgram doses so far, but so far, so good (so what for you Megadeth fans...)

Excellent news.

The occasional indulgence is fine (but it does get punished!!!) unless you keep the volume of the food down. i.e half a scone and you may have got away with it.

The 6 hours interval is crucial.

5mcg is easy to cope with, 10 mcg is going to bring about more benefit but a lot more discomfort. I would stay with the 5mcg for a good while. Once you are on 10mcg, your discipline will have to be of the highest order for maximum benefit.

[TedMaul]

Mermaid said:

TedMaul said:

..
3 days in and 5 jabs. Only time I felt sick was eating a scone and jam mid afternoon yesterday, proper greed not hunger situation, but it was part of a surprise birthday treat and I was tired and a bit dehydrated too if I'm honest.

Thanks for reminding me of the six hour interval, unlikely to be a problem for me given the hours I work, but I would forget.

Only on 5microgram doses so far, but so far, so good (so what for you Megadeth fans...)

Excellent news.

The occasional indulgence is fine (but it does get punished!!!) unless you keep the volume of the food down. i.e half a scone and you may have got away with it.

The 6 hours interval is crucial.

5mcg is easy to cope with, 10 mcg is going to bring about more benefit but a lot more discomfort. I would stay with the 5mcg for a good while. Once you are on 10mcg, your discipline will have to be of the highest order for maximum benefit.

Six days in and all is well in terms of the meds. I need to find something constructive to do in the hour between the morning jab and breakfast and shceduling evening jab is proving troublesome as goalposts keep moving for evening meal timings which is proving annoying, but the meds themselves seem to be ok.

[Mermaid]

TedMaul said:

Mermaid said:

TedMaul said:

..
3 days in and 5 jabs. Only time I felt sick was eating a scone and jam mid afternoon yesterday, proper greed not hunger situation, but it was part of a surprise birthday treat and I was tired and a bit dehydrated too if I'm honest.

Thanks for reminding me of the six hour interval, unlikely to be a problem for me given the hours I work, but I would forget.

Only on 5microgram doses so far, but so far, so good (so what for you Megadeth fans...)

Excellent news.

The occasional indulgence is fine (but it does get punished!!!) unless you keep the volume of the food down. i.e half a scone and you may have got away with it.

The 6 hours interval is crucial.

5mcg is easy to cope with, 10 mcg is going to bring about more benefit but a lot more discomfort. I would stay with the 5mcg for a good while. Once you are on 10mcg, your discipline will have to be of the highest order for maximum benefit.

Six days in and all is well in terms of the meds. I need to find something constructive to do in the hour between the morning jab and breakfast and shceduling evening jab is proving troublesome as goalposts keep moving for evening meal timings which is proving annoying, but the meds themselves seem to be ok.

It's no problem. IMO, to have your indulgence at about lunchtime - a bar of choc, or a full fat yogurt or whatever takes your fancy.