sooo confused please help!

Diseases & Conditions Diabetes
1
My BG today was 433. Hasn't been that high in months! But I stopped taking my Byetta last night and today. I COULD NOT DEAL WITH THE NAUSEA! I threw up almost every day this week, twice while riding in the car. Ugh. And it wasn't just the nausea but the burning forehead and headaches and not being able to move. I know I should consult my doc beforehand but I just wanted a day off from being so ill so I skipped two doses, one before dinner yesterday and one before breakfest today.
 
On Byetta 5 mcg twice a day and Metformin 1000 mg in the AM and 500 in the PM, my blood sugars typically ran in the high 100's and low 200's. Once in awhile I would hit the low 100's. I didn't take anything last night. No Metformin. No Byetta. And this morning I just took the Metformin 1000 mg. Before breakfest my BG was 238, which is maybe 10-20 more than usual. Two hours after eating, my blood sugar shot up to 433. That's higher than it used to be with NO MEDS WHATSOEVER! That could be contributed by the amount of food I ate for breakfest. On this Byetta I have had NO appetite and what I do eat, I throw up usually. My body has been starving. So when I didn't take a dose, I ate 1 1/2 bowls of cereal (multi-grain cheerios). It felt so good to have something in my body that didn't come back up. I'm not sorry I ate so much for that reason.
 
My question is . . . does this mean the Metformin isn't working? Should I ask my doctor to switch me to a different med all together?
 
Also, I love Byetta. I love the weight loss and I love my blood sugars (when I was on the 10 mcg my blood sugars were almost perfect!) but I just can't handle the nausea anymore. I have no social life and I'm trying to find a job but I'm scared because I'm so sick. It's hard to even job hunt because I always feel so horrible. And if I DID get a job, how could I do it? I can barely get out of bed most of the time. The few times I've attempted to meet up with friends, I end up being the wet blanket and holding my pounding temples the whole time, and going home to lay down because I can't sit up anymore. I've kept a food journal to log what I ate, the meds/doses, where I took the Byetta shot, how long before I ate, etc etc. Anything that could be related to the nausea. I've tried chewing sugar free Tums, eating snacks throughout the day so my tummy doesn't go empty, drinking chamomile tea to settle the queasiness. Nothing seems to work. And I can't seem to find any patterns to help me understand what makes me sick and what doesn't, other than not taking the Byetta! In the past two weeks there have only been 3 days that I felt well enough to function. I just can't go on like this.
 
So if I can't take Byetta anymore and the Metformin isn't working, is there other medicine that will help? Or should I keep plugging along and deal with the nausea, hoping it will go away? Thanks so much for listening. I'm so confused as to what to do.
2

Hi Lex,

Im sorry you're having such a hard time with Byetta, but if you're still violently ill to the point of being nearly bed ridden after two weeks on 5mcg, perhaps Byetta just isn't for you.  There are lots of powerful oral meds that you can and should begin taking (eg. Avandia, Glipizide, Starlix, etc.) that can do wonders with pulling your BS back into a normal range.  If that doesn't do it there is always the once a day shot of Lantus insulin.  This is no big deal in that you don't even feel the shot and one shot supplies you a constant base dose of insulin all day long from which your oral meds can work.  This might be a much better route for you than the suffering you are going through with Byetta.

Talk to your Endocrinologist and tell him specifically about how sick you have been and what your numbers have been doing.

scool Warren

It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.

3
Well, I did some "experimenting". Sunday I took only the Metformin. Today I only took the Byetta, instead of doing both. Havoc on my blood sugars I know but I figure after years of neglecting my diabetes, two days won't kill me. And since I started the meds at roughly the same time, it was hard to say what was making me sick.

I felt fine both days! Today I have the slightest slightest headache and nausea that comes and goes, but a few sips of chamomile tea and few bites of sugar free jello and I was fine again. I just called the doc office and left a message explaining everything so I'm waiting for a call back. I think I was getting so sick because of the combo of the two meds. Metformin causes diarrhea and Byetta causes constipation . . . so maybe my digestive system was all whack? Is that possible?

I also asked if I could reschedule my appointment. I'm supposed to go back August 1st but I have so many questions. I wrote them all down!

Also I know my mom started on Metformin and got really sick and it didn't do anything for her blood sugars. She switched to Glipizde and her blood sugars are beautiful now! I get jealous, hehe. When we went camping she had smores and her blood sugars were still in the normal range. Lucky girl.
4

Lex,

Glipizide and Metformin are two very different types of meds.  The metformin basically works to break down your insulin resistence and make you more sensitive to insulin while the Glipizide prods your pancreas to release more insulin.  If I take to much glipizide with my Byetta, I acutally can go to low, its that effective!

scool Warren

It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.

5
I'm actually thinking that I might by MODY, which means that I'm not insulin resistent, right? It would mean that I produce insulin but not enough. Which would also explain why I reacted to insulin shots years ago and would go too low all the time. And, furthermore, why Metformin doesn't seem to be working too much. Because if I'm insulin resistent, would insulin shots work without something like Metformin to help me use the insulin????

The doc just called and said, yes, I do need to come in for an appointment sooner. But when the receptionist looked to book me one, couldn't find one any sooner! So what was the point of that??? I asked for a phone consultation and the receptionist said she would have the doc call me. Two minutes later I got a call saying to come in tomorrow. Haha, I'm just kinda laughing about that.

I have a whole page full of questions to ask. I'm so glad for places like this. I never would have known about MODY or the different types of type 2's. I can't remember ever being so excited to go for a doc appointment before . . . not only to figure this all out, but to see if I lost a little more weight!
6

LOLOL I've never been excited about a doctors appointment.  Yes, Lex, you are insulin resistent.  The metformin is the first drug usually prescribed for this and it is specifically to make you more sensitive to the insulin you are already producing.  This coupled with the Byetta and you have a very nice combination.  Metformin seems to be one of those drugs, however, that seems to quit working sooner or later in type 2 diabetics.  So if your numbers were really high on just the metformin, thats not surprising.

Tell your doctor you would like a drug like "glipizide" to augment the byetta and help pull your numbers down farther. Eventually, if you can move to the 10mcg dose of Byetta, you might be able to get rid of this extra drug alltogether, but for now, we aren't even going to think about a stronger dose of Byetta as you have been having such a tough time!  Let us know what the doctor says and lets get your numbers into a zone that will make you smile after each finger stick!

scool Warren

It's not that some people have willpower and some don't. It's that some people are ready to change and others are not. - James Gordon, M.D.
What some call health, if purchased by perpetual anxiety about diet, isn't much better than tedious disease. - George Dennison Prentice

I can only please one person per day, today is not your day...tomorrow doesn't look good either.

7
Saw the doc today. My a1c went from 13 in April to 10 in June. And that was just from taking 500 mg of Metformin ONCE a day. I expect my next one to be even lower.

We have taken me off of Metformin. The combination of Byetta and Metformin was the cause of all my sickness. Tomorrow I start Amaryl 1 mg before breakfest and we'll increase from there. I'm continuing the Byetta at 5 mcg.

I heard Amaryl actually causes your beta cells to burn out faster? Is that true?