Byetta Does Not Cause Pancreatitis

Click the video to pause play. This video is 3:00 minutes in duration and took 15 seconds to load over a DSL connection. You will need the latest version of the Free QuickTime Player to view it. Additional help for Mac users.



Byetta Does Not Cause Pancreatitis

Review of the records of deaths from patients who died of pancreatitis seems to have no reason to believe that Byetta plays a role in their deaths.

Remember that the “FDA Amendments Act requires dissemination of safety data, including in cases where causality has not been definitely determined.”

These deaths were all in type 2 patients, a diabetes group that has three times more common incidence of diabetes when compared to the general population. One million patients have taken Byetta which gives a rate of 0.34 events per 1,000 patient years.

The causes of death were as follows.
• Morbid obesity with extensive gallstone disease.
• Patient had stopped taking Byetta some months before the pancreatitis.
• Two patients died of complications of gall bladder surgery.
• One died of recurrent leukemia 2.5 months after recovering from pancreatitis.

David Nathan, Chief of the Diabetes Unit at Massachusetts General Hospital sees any cause is “not clear.”

“I’ve had 550-plus patients on Byetta and not a hint of pancreatitis,” Joseph Prendergast, founder and medical director of the Endocrine Metabolic Medical Center, told BioCentury. “I would think that we must get the information on those people who died, all their previous history, how it was used, and what kind of physician was using it.”

He added: “I don’t consider it to be a problem, and I surely don’t consider it to be related to the drug.”

Kenneth Burman, chief of the endocrine section at Washington Hospital Center, Washington, DC also did not find a reason to attribute pancreatitis to Byetta. The other endocrinologists at his center have not hesitated to use Byetta as before.

BioCentury Vol 16, #39, Pg. A15-16

Once a Week Byetta

Mouse over the video, or right click, to activate the controls. This video is 1:40 minutes. You will need the Free QuickTime Player to view it. Additional help for Mac users.



Text Summary
Once-weekly byetta.- Diabetes Care, 2007 June; 30(6): 1487-93

This is the first publication on the new Byetta product given weekly. It was approved by the FDA in early December but will not be released for use in the USA until the summer of 2009.

Beta cell mass is expected to double from the treatment and the weight loss will triple as compared to the present twice a day treatment

Oral communication on the product during the ADA meeting in early February 2008 also added more information that generally a 60 to 70% drop in nausea is expected as well.

How David Mendosa uses Byetta

Mouse over the video, or right click, to activate the controls. This video is 2:20 minutes. You will need the Free QuickTime Player to view it. Additional help for Mac users.

Click here to see David Mendosa's book on Amazon.com.

Byetta for Type 1 December 8, 2007

Mouse over the video, or right click, to activate the controls. This video is 1:26 minutes. You will need the QuickTime Player to view it. Additional help for Mac users.

Dr. Joe refers to an article in Science News

A Byetta Story

Mouse over the video, or right click, to activate the controls. This video is 3:43 minutes. You will need the QuickTime Player to view it. Additional help for Mac users.

Losing Weight with Diabetes Medication

Mouse over the video, or right click, to activate the controls. This video is 1:49 minutes. You will need the QuickTime Player to view it. Additional help for Mac users.

Byetta Pancreatitis

Mouse over the video, or right click, to activate the controls. This video is 1:21 minutes. You will need the QuickTime Player to view it. Additional help for Mac users.

Byetta's First Ad

For all of us who have had wondered when the first ads for Byetta would come and what they cover, look here.

Click here to watch.

I doesn’t say much really but it also suggests that it will out there like all the other diabetic agents. It also suggests that there will be a much expanded use by many physicians.

Interview with John Dodson

Mouse over the video, or right click, to activate the controls. This video is 9:00 minutes. You will need the QuickTime Player to view it. Additional help for Mac users.

Byetta and Diabetes Complications

Mouse over the video, or right click, to activate the controls. This video is 1:17 minutes. You will need the QuickTime Player to view it. Additional help for Mac users.

Free Byetta

We have free Byetta coupons for the 5 mcg pen. These are for any of our patients. Come in and pick it up with the Rx if you can use it.

They expire by the end of this month!!!!!!!!!!!!!!!!!!!

Byetta and Insulin Relase

Exenatide, with the trade name of Byetta, has been a useful addition to treatment options for type 2 diabetes. It is particularly useful in regulating after meal glucose. Diabet Med 2006 3;23(3):240-5

Since the timing of insulin dosing in relation to a meal is critical to such glucose regulation it is important to know the optimal time of Byetta administration. This research is an observation that the insulin values are markedly increased if the Byetta is given after meal as compared to Byetta given within an hour before a meal. Could the optimal time to give byetta be after a meal in certain circumstances?

This study provides very reassuring information suggesting that there is a large before meal window during which the drug can be administered.

Further research is warranted to understand the mechanisms underlying and the implications of the exaggerated insulin rise if the drug is administered after a meal.

Insulin Resistance in Children

This is a very informative paper relating to children early in life already manifesting early cardiovascular and diabetes 2 risk. This study evaluated age 13 year old patients’ risk factors. Their level of insulin resistance was then measured. They initially were evaluated at mean age of 13 then follow up at 15, and 19 years of age. Hypertension 2006 10;48(4):730-6

3 risk factors and the clustering of the factors associated with fasting insulin were followed. The results on follow-up found that the degree of change of insulin resistance from age 13 to 19 predicted levels of the classic risk factors, i.e. increased systolic blood pressure & serum triglycerides, with lower HDL cholesterol. All of these risk factors clustered with the fasting insulin.

This is the first time childhood insulin resistance were shown to significantly predict future levels of risk factors independent from the effects of weight. The authors felt that this suggested that higher degrees of insulin resistance predict a clustering of risk factors that represented what many call insulin resistance syndrome (dysmetabolic).

This allows early treatments of insulin resistance with traditional medications including Byetta.

Byetta and Autonomic Neuropathy

More Byetta information in response to problems.

Dr. Joe, Now that I am using the 10mcg 3 times a day I am having a constant problem with my hands and feet being extremely cold - there is almost no time of day, other than when I am in hot bath, that they are warm. I am concerned that this is a sign of a circulation problem - is there anything that can be done for this? Should I be concerned about long range impact here? Otherwise it is working great and helping me to my goal!

These symptoms are not from circulation but from the Byetta stimulating the autonomic nervous system. Since you are losing weight, your metabolism wants to "shut down" to prevent heat loss.

The first thing is to make your trunk warm. Sweater, jacket, long John's and the like. Secondly wear a hat. Lastly gloves.

This is normal.

Nausea and Byetta

I will be sending out a regular email concerning the use of Byetta for type 1 and 2 diabetes. I have observed many people dropping out for various reasons that could have been circumvented with a suggestion or two.

Nausea is one of the first things that people find incompatible with living with Byetta. Although it is frequently gone after a month, it will persist in 4% of patients. This is what we suggest.
1. Ginger in all forms, not sugar free, a short while before the shot.
2. Coca-cola

If the nausea persists, we use phenergan 25 mg pills for use in anticipation of problems.

It that does not work we retreat on the dosage of Byetta. That might be going back to the 5 mcg twice a day or switch to whatever dose given usually to only at bedtime.

Most of these things work and then we would just go slowly for a month or longer before we even think of raising the dose. It just takes longer to get to goal. Don’t even think it’s not possible to get there.

If you have dropped out, we are waiting to help you reach your goal. It’s your time.