The Use And Side Effects
Of Byetta
The pros and cons of 'Lizard Spit'
All the information we had before was from the official publications of the makers of Byetta who, to be fair, did warn us of the possible side effects reported in their trials
However, people are all so different from one another - they take an assortment of differing medications, they eat different types and quantities of food and they have differing activity levels
Therefore when a drug is launched into the general population all sorts of reactions occur that the trials failed to show up and diabetics, being the innovative beings they are, have found a variety of ways around these problems
My aim in this section is to give you information on the problems that users in the US have encounter and what they have done to resolve them
There is one thing that I must stress before you go ahead and read this article and think "All these problems No way am I going to even try this drug"
Despite the hassles, most users feel that Byetta has made such a difference to their lives that they would put up with almost anything to stay on it And NOT EVERYONE gets these side effects
It is sort of like the daily news In a country with, say, 60 million people, the news never mentions the 588 million who are fine but only the 02 million who have a problem
Folk who are having difficulties an Byetta are usually the ones who make the most noise as they are trying to find some answers to their problems - and they are not going to do that if they never mention them are they?
So look on the bright side, you may be one of the '588 million' However, if you do turn out to be one of the 02 million then the information below may be of use to you
First lets have a light-hearted recap on what Byetta is and does
Basically it is a synthetic version of the venom in the saliva of a Gila Monster, a type of lizard, which is why we diabetics irreverently refer to it as 'Lizard spit'
Where he lives must be kind of short on food because nature has given him a substance in his saliva that allows him to eat only a few times a year
It slows down his digestion, stops him from feeling hungry and makes all the stuff associated with digestion work more efficiently - frankly I would call him a lucky little bugger
If reincarnation exists I might just ask to come back as a Gila Monster Think about it - you can lie around in the sun all day, you do not have to worry about chasing up a meal very often and you will NOT get diabetes! What more could one want?
However thanks to some lateral thinkers we can now enjoy some of the same benefits
The effects of the synthetic spit on us are -
1. An increased sensitivity to our own insulin
2. An increase in the production of insulin, but only when we need it, ie when our sugars are higher than they should be
3. Teaching our pesky livers to work correctly and to stop creating blood sugar when we do NOT need it
4. Slowing down our digestion, thus keeping the food in our bellies longer and so making us feel full for longer
There is even the suggestion that it may 'retrain' our beta cells so that they start working as they should again and also promote the growth of new beta cells
Apparently this is what happened in trials done on mice, rats and rhesus monkeys and, if you ain't that keen on animal trials, it did the same in human embryonic and foetal pancreatic cells
I am afraid they have not mastered the 'lying around in the sun' bit but hey, you can't have everything
So, who should take this stuff
The manufacturers say it is for use by any type 2 diabetic who can't get good Bg control on oral meds alone and that it must be taken along with either Metformin or one of the sulfonylureas Just lately it has been decided that it can also be used with Avandia and Actos
It is pretty obvious that the beta cell 'retraining' is not going to happen if all your beta cells are dead, as occurs in type 1 diabetes
That said, there are doctors out there who are using it for their type 1 patients along with insulin and still getting results - lower Bg's, decreased insulin use and weight loss - so maybe we do not yet understand all that this stuff does
I must stress that this sort of use is what is called 'off label' which means they are using it for a purpose not endorsed by the manufacturer They clearly state that it is not intended to be used with insulin or to replace insulin
There is a study being done by the NIH which is looking at the effects of Byetta on Type 1's
An independent study that was carried out claims that Byetta can be given safely with insulin and when used results in delayed stomach emptying, lower postprandial BG's and reduces the effects of glycogen
There are also type 2's who are on insulin who have been prescribed this drug and seeing good results
For some it has resulted in a considerable decrease in the amount of insulin they use and others have been able to come off insulin altogether and just go onto oral meds and Byetta
It is possible that these results are due to the fact that they still have some beta cells left to 'train' and that their weight loss has improved their diabetic status
The good news -
Though it is actually intended as a medication to lower blood glucose levels one of the greatest advantages for many type 2's is that it tends to cause weight loss as opposed to the other oral meds, or insulin, that cause weight gain
Only someone who had struggled with their weight for years, has been branded a 'glutton' by those who do not understand that obesity may NOT be due to stuffing oneself with vast quantities of food and who have suffered through ever upward spiralling weight due to their diabetes meds will know what this means
I imagine I am not alone in wanting to commit murder, or at least grievous bodily harm, when my doctor tells me I must loose weight and then insists I use a drug that causes weight gain! If I refuse to use it I am called 'non-compliant' and if I gain weight I am still labelled 'non-compliant' as I must be cheating on my diet or not exercising…grrr!!!
It is no wonder then that so many people are prepared to put up with so much to take advantage of this effect of Byetta
The general amount of weight loss reported (by users, not the trials, which only reported around 6lbs) is between 30 - 40 pounds - that would do me just nicely thank you
When and how the weight loss occurs is different for everyone Here are some examples:-
Some folk lose right from the start and continue losing slowly over a long period
Some lose a lot to begin with and then start putting it back on This makes then feel really despondent and want to give up but if they continue with the medication their weight slowly begins to drop again It is thought that the initial large loss was due to 'water weight' as so often happens on any diet
Others see little or no loss at all for a few months and then it slowly starts to drop off
If you are not losing straight away do not become despondent Give yourself time
It as been suggested that the initial weight loss is due to one of Byetta's more frustrating symptoms, nausea, (as dealt with below) but though this may be responsible for the initial loss it does not explain the tendency of most patients on Byetta to continue to lose, as opposed to the norm for diabetics which is a tendency to gain
Blood glucose levels
These are what we are really taking the Byetta for and in most cases it works fantastically, especially at evening out those 'after eating' highs
However I believe it is not uncommon to initially get higher readings, sometimes on both the 5 and the 10mcg dose and sometimes only with the start of the 10mcg dose
This sudden rise sends most of us back to our doctors in panic screaming "This drug doesn't work for me!" but again one needs to be patient It may take a few weeks to bring the numbers back down
Others have reported very erratic readings, simply all over the place This also seems to settle down with time
In the occasional person who has no change in their BG levels over a period of months the doctor may decide to add another med
I have read about a women who had no change in BG's for up to 9 months (she persevered because of fabulous weight loss) and eventually her doctor added Amaryl to her Byetta and Metformin and her fasting BG's dropped to 90mg/dl (5mmol/L)
It is suggested that Amaryl (which is one of the sulfonylurea drugs) may 'give a jump start to the beta cells' and people may be able to stop taking the Amaryl once Byetta has improved their beta cells
Be careful - some people have reported very fast drops (an even better term would be a crash) in BG's when their glucose levels were very high at the time of injecting Byetta -sometimes the drop has been from 210mg/dl (116mmol/L) down to 60 mg/dl (33 mmol /L) a couple of hours later
Be warned that if your BG's are very high you may suffer such a crash (remembering also that what is high for me may not be high for you We all know what would be considered high in our own personal case) When this happens eating a small amount of food or a single glucose tablet helps
Now for the bad news - side effects -
1 Top of the list is NAUSEA
In the trials done on Byetta 44% of patients reported nausea as a side effect - so that is good news for 56% of us, we are likely to escape this one It must also be said that 18% of the people on a placebo also reported nausea so maybe the odds are even better!
However for many it definitely rates the capital letters I gave it This is not the odd twinge, it is really horrible I have heard it described as worse than a stomach virus or morning sickness
In a few folk it results in them actually throwing up and often these are the people who are unable to tolerate the drug and their doctors take them off it, but for most people it just makes them feel as if they want to be sick but they seldom actually are - yuck!
Mind you I survived nine months of continued morning sickness twice over so I suppose I can survive this In both cases the end results would appear to be worth it (mustn't let my children hear me say that, it will undo all the guilt I have been nurturing in them for years!)
Even so for some it feels so bad they decide to give up on the drug However for many the results they are seeing or hearing about make persevering worth while and the good news is that eventually the nausea does wear off Somewhere around the 6 week mark seems to be the norm for most people
It appears that your body needs time to adjust to this drug and for some that adjustment is not easy This is the reason they start you off on 5mcg twice a day for the first month and then up the dose to 10mcg
But be warned, if you are one of those who gets nauseous and the nausea has passed after the first couple of weeks on the 5mcg don't get too excited as it very often comes back again when you start the 10mcg
For some it helps to cut the dose to one 5mcg injection a day instead of two until their body has become more acclimatised to the drug and then go up to 2 injections a day
Also it may help to keep on using the 5mcg for a month or two longer before going up to the 10mcg dose Don't feel bad about this, there are some diabetics who never go above the 5mcg as they are achieving good results at that dose
I have even heard people say that they react differently to each new pen They are fine with some and others cause the nausea to return again No one seems to have worked out why yet
Some folk found that when their BG's were low their nausea was worst Test and see if this applies to you and if so eat something to raise them a little There is a tendency to skip meals or eat very little when on the 'spit' and this can cause very low BG's
So what can one do to survive this?
First and foremost you need to decide what is most important to you, no nausea or great appetite suppression
You will be told to eat "within an hour" of taking your Byetta injection However, when in that hour 'window' you do eat, is important as it appears to give different results
The rule of thumb is -
The closer to the injection you eat the less nausea you have but also the less appetite suppression
The longer you wait before eating the more nausea you have but also the more appetite suppression
In other words if you inject Byetta and eat right away you get less nausea than if you take it and eat 30min to 1 hour later
Then consider what you eat If you have just had a stomach ailment you would not cram vast quantities of food, especially spicy, fatty or greasy fried foods, into your poor abused stomach would you?
Consider eating when starting Byetta as if you are recovering from such a stomach ailment
Eat small quantities of food at a time People who have used Byetta suggest you aim at eating an amount of food no bigger than the size of your fist This makes sense as a normal stomach is about the size of a fist and that amount of food should not stress it
The food can, obviously, be a mixture of stuff but all together it must not make up a larger quantity than fist size And eat slowly
Some feel better if they eat at least 30g of carbs as part of their meal A slice of bread is about 20 g so it is quite easy to do that and makes planning breakfast simpler Lots of people just settle for a slice of toast and a piece of fruit For our US bagel lovers you will be pleased to know a half bagel is around 20g as well
If you are thinking "Oh my goodness, how am I going to survive on such a small amount of food" be comforted Byetta causes you to feel full on virtually nothing!
You will find that Byetta is a hard taskmaster If you eat more than you should it will punish you by making you feel very, very uncomfortable and nauseous for hours You can literally feel as if you are about to explode
Frankly it is just is not worth it A good rule of thumb is to stop eating the moment you begin to feel full
As diabetics we are used to trying to eat a diet containing the foods that we are told are right for us Many Byetta users have suggested that when we start out we ignore that advice and rather listen to what our bodies are telling us
For instance when you go shopping look at a food and then think about how it makes you feel If you get no 'yuck' reaction from your body then try it
It is no use forcing yourself to eat a bowl of healthy oatmeal if the first thing that happens is you throw up The toilet does not need the nutrition, you do!
(Just as an aside, many people have commented that Byetta and pizza just don't get along!!)
Eating more alkaline foods also appears to reduce a lot of the nausea Folks have been known to get relief by snacking on black (not green) olives and raw almonds
Some people get control over the nausea by staying on a liquid diet for a few days and moving slowly onto solid food
There are various things you can take that help with the nausea as well One of the most popular ones (now here's a nice surprise) is wine
Most settle for red wine, as it has other healthy properties as well but solely as an anti-nausea medication white works just the same
A glass or two with ones meal seems to be the suggested amount I am not sure how this agrees with some of the other diabetes meds but it is not meant to used in the long term - damn
Spirits such as scotch also seem to help - in small quantities please and if you use a mixer be sure it is a diet one
(Note - These are not recommended if you are trying the alkaline way of eating)
Then there is the old fashioned but still effective remedy for stomach ailments - GINGER
This can be a glass of diet ginger ale with each meal as long as it contains REAL ginger Try different brands as some people have reported better results with certain brands, Apparently those that have a more 'floral' taste tend to make one queasy
If you do not like any of the bought ones you can make your own ginger ale Try this recipe I found on the web:-
Ginger Ale
Ingredients for syrup:
3 1/2 cups water
3/4 cup peeled and chopped ginger root
2 Tbs vanilla
1 Tbs lemon extract
1/4 tsp stevia concentrate powder or sweetener of choice
Instructions:
Rapidly boil ginger root in water for 10 minutes Strain and place liquid in a jar Stir in vanilla, lemon and sweetener Cool and store syrup in the refrigerator Make drink by adding sparkling water to some of the syrup mix
Bottled Pickled Ginger is part of Chinese cuisine and eating some of that when you feel nauseous can help
Then there is crystallised ginger It contains plenty of sugar but if it is all you can find it may be worth using for your nauseous period You can worry about your numbers once you are over that patch
A tea, made by steeping some fresh cut slices of root ginger in hot water, drunk at each meal (or whenever the nausea strikes) is another way of getting that healing ginger
Here is a recipe I saw for a slightly fancier tea:-
GINGER TEA
4 cups water
2 oz thinly sliced root ginger
5 whole cloves
juice of ½ lemon
Place all the above ingredients in a saucepan, bring to a boil then reduce the heat and simmer 2 to 3 minutes Strain and serve, with sweetener if required
Ginger Altoids, if they are available in your country, seem to help as well
Then there are ginger snap biscuits/cookies Most contain sugar but 'any port in a storm' I say and if you are battling to keep anything down a little sugar won't kill you I already eat the occasional gluten free ginger biscuit dunked in tea when I just cannot face anything else
Living in the UK I am unsure exactly what these are but I am told eating a few saltine crackers helps many people I suspect they are a sort of unleavened salty cracker so maybe we can try an equivalent savoury biscuit here, like Salticrax perhaps?
Coffee increases the nausea for some people so if you are one of them you may have to temporarily give up your addiction and find some other way of waking up!
Sucking sugar free mints, chewing sugar free mint flavoured gum or eating Original Tic-tac's also appears to help
However, remember that the first two of these can increase gas
A frozen ice lolly, of a sugar free variety of course, can help One can make these oneself using sugar free drinks, or maybe freeze the ginger tea and get the benefit of both
Some of the more bizarre claims that still work for some are the wrist bands used for sea or motion sickness, called Seabands and the old sailors remedy - taping a strip of duct tape across your stomach about 2 inches below your navel!
There are some reports that say if you inject in the thigh instead of the stomach you get less nausea The logic behind this is that the stomach absorbs the medicine the fastest, followed by the arm and lastly the thigh It may be worth experimenting with the different sites
Last but not least there are the various medications that control nausea, like Phenergan, Zofran or Compazine These will require a script from your doctor but may well be life savers to those severely nauseated folk whom nothing else helps
2 Gas, or to use less polite terms, burping and farting
If you have this side effect and are one of the lucky ones you may only get it for around an hour after eating but there have been cases of folk with an all day/ all night problem
This can be a really embarrassing problem especially if you are working with the public
Apparently there is nothing dainty and ladylike about it and the smell ain't so good either - I have heard it described as similar to running over a skunk!
For some, avoiding certain foods, such as cabbage, brussel sprouts, beans etc helps but for most it does not seem to matter what they eat
Over the counter medications such as Alka Seltzer, Tums, Rolaids, Gas-X, Mylanta Gas Relief or Pepsid may ease the problem
For those who like natural remedies try the following - Take a teaspoon of dried dill, pour hot water over it and allow it to steep just as you would when making tea Strain it then drink it
Hey, it is worth a try The Gripe Water they feed to babies with wind is basically made from dill I suppose you could buy that but folk may look at you queerly if you start emptying the supermarket shelf of their whole Gripe Water supply, not to mention the expense
If you do feel an overwhelming need to belch (and are not in an awkward place) then let it out Sometimes it can be amazing how getting rid of this excess gas can relieve the nausea
If you feel you have gas build-up but just cannot get it out drink a carbonated beverage like diet coke or ginger ale These will help you belch and relieve the symptoms
3 Heartburn
This is that burning feeling you get that seems to come from your chest into your throat
Due to the way Byetta makes our stomachs empty very slowly any excess acid build up there can flow back into the oesophagus and cause this problem, which is why it is called acid reflux
The first thing to do is look at what you are eating Spicy foods and foods high in fat and acids (tomatoes, orange juice) are often culprits High fats need more acid to dissolve them
Too much food can be another cause of the problem
Certain complex carbohydrate foods, such as bread, rice and pasta can tie up excess acid so are easier on the stomach but for many of us diabetics they are no-no's as they push out BG levels way too high If you are lucky and can eat these then they are worth trying
Avoid being over-full Also remain upright, in other words either sit up straight or stand, or better yet take a walk, for at least an hour after you have eaten
One can take antacids, such as Andrews, Gaviscon, Pepto-Bismol, Maalox, Rolaids, Famotodine or Tums
Then there are ones your doctor may prescribe like Prevacid (Lansoprazole - generic), Protonix, Nexium or Aciphex
If the symptoms are bad when you lie down try elevating the head of the bed by 6-8 inches Do this by putting blocks or books under it, NOT by using more pillows Pillows bend you at your diaphragm and that makes reflux worse!
4 Diarrhea
Any of us who have been taking Metformin already know about this one don't we? For those who are started on Metformin at the same time as Byetta do consider that it may be the Metformin that is responsible for your diarrhea and not the Byetta
If you suspect that it may be the Metformin then think about when you are taking it Metformin is less likely to cause diarrhea if taken with food so don't take it before your meal Inject the Byetta, eat at the time that suits you best (but within the first 60 minutes of course) and then take your Metformin and see if that helps
Another avenue may be to switch to the sustained release Metformin (Metformin SR) I personally had huge problems on the normal Metformin and switching to Metformin SR has made the world of difference It has not totally cured the problem but it is now at least possible to live with it! Again, it is worth a try
Be careful about eating greasy foods as these promote diarrhea Also sometimes a more solid food, like a piece of dry toast, works better than, say, a salad at lessening the problem
If the problem is severe talk to your doctor and see if he or she is happy for you to use a medication, like Immodium for example, to help you control the diarrhea
5 Constipation
Byetta seems good at causing directly opposite problems in people Some get the above mentioned diarrhea while others get constipation
To start with try and eat as many fibre rich foods like fruit and veggies, whole grains, seeds and nuts as possible and make sure to drink plenty of water I know this can be difficult, what with the Byetta making you feel so full, but dehydration does not help ones constipation any
Next try a fibre supplement There are a whole range of these and you may need to experiment a bit to find the one that suits you
Below are a list of fibre supplements and the brand names they are bought under
Psyllium - a soluble plant fibre
Some of the Psyllium products are flavoured and sweetened with sugar so you need to check what you are buying
Both Konsyl and Hydrocil are sugar free and Metamucil makes a sugar free option
Methylcellulose - a fibre created from the cell walls of plants
Sold as Citrucel
Calcium polycarbophil -a synthetic fibre
Sold as Fibercon and Equalactin
Guar gum - a plant fibre
Sold as Benefiber
This is a taste free, sugar free powder that can be added to whatever you are drinking, like coffee or juice or mixed with applesauce or yoghurt, which is quite convenient
There are a few other fibre products that appear to be specific to the UK These are:-
Ispaghula husk powder
(This is also gluten free so is a great one for those with gluten intolerance)
Sold as Fybogel or Regulan
Psyllium fibre powder with probiotics
Sold as Lepicol
Sterculia fibre granules
Sold as Normacol
Methylcellulose
Sold as Celevac
The very popular Probiotics that we see advertised on TV may actually be of help to us One woman reported that eating a probiotic containing yoghurt as her meal after her injection helped her constipation, but it did take time - about a week
If the condition is really bad contact your doctor and ask about stool softeners These make hard stools easier to pass
Some brand names are:-
Colace, Dialose, Docusate, DOS, Doxinate, Fleet Sof-Lax, Hemaspan, Modane Soft and Surfak
6 Dizziness
Though not as common as the previously mentioned side effects (about 9% 0r patients in the trial reported it) this is one that comes up occasionally
For some it can be 'interesting' to say the least One woman said it felt like being on an out of control roller coaster for hours!
If you feel really dizzy then try to remain as still as possible Avoid sudden changes in position, such as from lying down to standing up or turning from one side to the other, and also any rapid head movements - don't nod or shake your head
And definitely stay away from driving your car or operating any form of machinery!
It is possible that mild dizziness could be due to the fact that Byetta's appetite suppression has resulted in you eating much less and the lack of food has made you feel light-headed
Dizzy spells can also be the result of low blood sugar so test that you have not gone much lower than you are used too You may need to eat a snack to bring your BG's up
Dizziness can also be caused by dehydration due to vomiting or diarrhea so if you are having those symptoms it may well go away when they stop
If you are taking blood pressure medication check that the combination of that and Byetta has not made your blood pressure drop too low, thus causing the dizziness Many patients report that have been able to reduce and sometimes stop completely, their blood pressure meds once they went onto Byetta
7 Jittery
This covers quite a range of feelings Some simply talk of feeling tense, restive or edgy
Others say they feel horribly shaky, sometimes externally but more often it is reported as a "shaking inside ones skin"
Another patient reported it was "like being on Speed", she just could not relax at all She just had to get up and move or she would go crazy and sleep was almost impossible
No-one seems to have any suggestions as to how to deal with this except making sure your blood sugars are not too low
Otherwise one will just have to wait and see if it subsides I imagine if you just cannot handle the feelings you may have to come off the drug
8 Headache
During the trials 9% of the patients reported these as a side-effect
It is often reported as very similar to a sinus headache and some folk even have a runny nose along with it It can be severe enough that patients describe it as "feeling like my head is going to explode"
If it is that serious you need to talk to your doctor
Otherwise I would suggest checking your blood sugars as extreme lows or highs can produce headaches
If these are not the problem then (with your doctor's permission of course) you could try taking a low dose aspirin or some such pain reliever
Remember that due to the delayed stomach emptying any meds taken after your Byetta shot may take a while to get into your system and become effective
9 Sleeping Problems
These range from insomnia to incredible vivid dreams
Those with insomnia seem to fall into two categories Those folks whose minds become so much more active at night, making it impossible for them to get to sleep and those who fall asleep easily but cannot stay asleep, they wake up after a few hours and just cannot go back to sleep
A couple of hints for the latter type of insomniac have come up on forums and I hope they do not mind me passing them on here I would accredit them to the person/persons concerned but I cannot remember where I read them
The first is to count backwards from one thousand You need to actually concentrate while doing this
The other is a bit more bizarre but apparently works - you need to turn around and put your head at the bottom of the bed
Then there are the over the counter sleep aids that might help, but check first with your doctor before trying them
He may well choose to prescribe some form of sleeping tablet for you if your problem is severe enough, at least until you have got into the habit of sleeping normally again
As far as the vivid dreams go, these appear to range from amusing ones through really weird ones to full blown nightmares I am afraid I cannot offer any help here I would suggest just treating them like a free trip to the cinema (with the exception of the nightmares of course, though many people choose to watch horror movies!)
10 Skin Problems
These were not reported as problems during the trials but have been reported by a number of users since They also cover a range of different reactions, from mild to serious
It would appear that in most cases this is some form of allergic reaction because if you treat them as you would an allergy you get an alleviation of the symptoms
The mildest appear to be slight red itchy marks or rash at the injection site, which improves when treated with an anti-histamine cream such as Benadryl or with aloe vera, which helps with the itchiness
In some people these 'slight' marks have become large, extremely itchy welts that just seem to get worse and worse There are also cases where these 'welts' have started appearing in other places on the body besides the injection sites and the person has a full blown case of hives
People have tried various things to help relieve or cure the problem Amongst these are :-
1 An anti-histamine or a similar steroid or cortisone cream
2 Aloe-vera
3 Oral antihistamine medications (such as Benadryl tablets) given an hour before taking the injection Be warned that these can make you very sleepy, which could be a benefit if you have been up night after night scratching!
4 A number of people have reported a cure by getting their acid/alkaline balance right The theory is that Byetta has an acid base and can tip your body over into being too acid, thus causing an allergic reaction
A quick fix for this is to use Alka-Seltzer (preferable the Alka-Seltzer gold) to tip your body back into a more alkaline state Then try and keep it that way by eating more alkaline
If you are wondering how to do this take a look at the list of foods supplied by a lady called Leah on diabetesblogcom Look at message number 258 (The link should open there)
A doctor may prescribe something like Zyrtec which is used to treat various allergies, and more importantly in this case, chronic hives
If the reaction is severe it is very important that you see a doctor, even if you are afraid he might pull you off this drug which may be helping you in other ways, ie with lower BG's and weight loss
Allergic reactions are not to be played around with as they can escalate into anaphylactic shock and death
It may not always be an allergic reaction though Here are a couple of other factors that have caused the problem -
Another medication When the med was stopped the problem went away
Sometimes the problem went away with a change in the injection pen and the cause was put down to a 'bad pen'
11 Feeling Cold
Many diabetics have reported that before being diagnosed and even afterwards, when they were battling with their blood sugars, they always felt hot I can relate to this as I was one of those people However it appears that for some the use of Byetta has totally changed that
Many report feeling cold, more especially after the evening shot for some reason, and this in the middle of summer in a hot climate!
For some this is not just a mild chill They really feel as if they are freezing cold, the classic 'chilled to the bone'
Folks have reported having hands so cold they are unable to perform normal chores Others have even wondered if they are suffering from frostbite because their fingers and toes are so cold that they burn!
Yet others say they shiver so badly it causes them to ache all over
All one can do is what one always does to warm up ;-
1 Wear plenty of warm clothes
2 Wrap yourself in blankets or huddle in a warm bed
3 Use a hot water bottle or one of those bags that can be heated in the microwave
4 Sit by a fire or heater, even if that does sound crazy in the middle of summer
5 Take a hot bath
6 Drink plenty of hot liquids to warm you up from the inside
Also -
Check your sugars - going to low can be the cause of chills
There are 2 plus factors in this side effect -
1 An endocrinologist told one of his patients that feeling cold was the body's reaction to losing weight - if true this seems a good trade off
2 If you have been fighting with your husband or family over the setting of the central heating thermostat for years, because you were always hot when they were cold, this problem will now have been solved!
12 Muscle cramps
These are usually in the muscles of the legs and can be very painful
Remedies you can try are -
1 If your muscle is cramping and nothing seems to be helping then running hot water over the leg (in the bath of course) will help to stop it
2 Supplementing with potassium has helped some people
3 Likewise other diabetics have had relief from taking extra magnesium Low levels of magnesium are common in diabetics, but be sure you take the right type See magnesium in our pages on Dietary Supplements
4 Talk to your doctor, he may decide to prescribe a quinine pill, something we think of in terms of malaria but which actually works to relieve cramps as well
13 Change to the sense of smell
For some this means that their sense of smell has become heightened Though this may not sound too bad it can be very frustrating as even things that used to smell nice now just seem too strong Being in public is torture as the smell of other peoples perfumes and deodorants is overpowering
Others have experienced a change in the way things smell and scents that they used to enjoy now smell horrible The smell of certain foods cooking, like bread or onions, which before they really enjoyed, now make them want to be sick
There isn't really anything one can do to treat this All one can do is try and avoid the really bad situations and wait for the side effect to wear off
14 Fatigue
This ranges from being extremely tired about an hour after taking the injection to what someone described as "debilitating exhaustion"
For the first problem the best thing you can do, if circumstances allow, is to lie down for an hour or two and sleep off the effect
Try and leave yourself enough time to do this as trying to drive a car or operate any form of machinery in this state could be dangerous
People have said that it takes a few months for this tiredness to go away but when it does you suddenly have boundless energy and seem to need less sleep
Unfortunately for those suffering with total exhaustion there seems little one can do except wait it out This can be very hard to do when your busy life is becoming impossible to operate For some this can lead to depression as well
One lady (who obviously had retained her sense of humour through it all) described herself as "being so tired I could not get out of my own way"
If you are suffering from such exhaustion it may be necessary for you to go off the Byetta until you have a free period where you can just rest - I know, I know, it is not exactly what one wants to do with ones next holiday period!
15 Tooth pain
Though this was not reported as a problem during the trials on Byetta a number of people have experienced it, along with palate pain and tooth sensitivity
When they go for a dental check-up the dentist can find nothing wrong with their teeth
Things you can do to help -
1 Before starting Byetta go to your dental hygienist for a good tooth clean
2 Take a painkiller like Tylenol
3 Take extra Vitamin C, 1500 - 2000mg per day This is said to improve the state of the gums and the membranes on the inside of the mouth
4 Use a toothpaste designed for sensitive teeth
16 Hair loss
This is another side effect that did not show up in the trials but is now being reported occasionally and is very traumatic for the people concerned
Firstly no-one is really sure that it is the Byetta that is responsible There are a number of other reasons for hair loss
Amongst these are:-
Thyroid disease
Iron deficiency
Sudden weight loss
Vitamin deficiency
Other medications
If you are suffering from loss of hair then speak to your doctor about getting tested for thyroid disease and iron deficiency
If you are also taking Metformin remember that it can deplete your body of some of the B vitamins, especially if you have been on it for a while As we need those B vitamins for healthy hair supplementing with a good B Complex may help
Other vitamins that may help are Vitamin D, calcium, Magnesium and Omega 3
Try using a shampoo and conditioner that contains biotin as an ingredient
Some people have reported success with a shampoo called Nioxin, which claims to inhibit the hormone that causes the hair follicle to shrink, resulting in eventual hair loss
Apparently it can take several months before any improvement is seen, so be patient
It may also help to increase the blood flow to the scalp by lying on a board set at a slight incline The head should be at the lowest end and one should remain like this for at least 15 minutes
(Note - As so often happens with Byetta some people have reported the exact opposite - increased hair growth!)
17 Bruising
This is reported sometimes as being at the injection site and sometimes as being 'all over'
As far as the injection site goes it could be the obvious things like bad technique in giving the injection, a blunt or 'fish hook' shaped needle (usually occurs when one drops the pen with needle attached) or you could have hit a capillary during the injection which causes bleeding
If you are bruising more easily all over it could well be that you are also taking aspirin, so often given to us diabetics to make our blood thinner and prevent clotting and heart problems Talk to your doctor if it really worries you
18 Libido
This obviously is not a symptom that many people want to talk about but there are some straight talking folk out there who are prepared to admit that their libido appears to have got up and left
For some this is not a huge problem for them or their partners and worth putting up with for the benefits they are getting
For others it may cause a rift in their relationship and if this is happening a frank and open chat with your doctor or endocrinologist is needed He may well be able to refer you to a specialist who can help
19 Heart palpitations
This is not an uncommon side effect but, as long as you get it checked by a doctor, preferably a cardiologist, and receive a clean bill of health, it is nothing to worry about
Some people have started taking Byetta, been alarmed by this side effect and stopped taking it until they have had a medical check-up
Once they got the all clear they started taking the Byetta again and the symptoms eventually went away
For more information on Byetta visit www.byetta.com