Monday, September 11, 2006
Time for Exenatide
That's what my research both on my mother and on the drug, has revealed. I hope Mom's PCP agrees with me. I kind of think he will. In April of this year too few studies were out to indicate that it, too, is kind to the elderly, likely kinder than glipizide, especially to those with challenged kidneys. Now, those studies are out there all over the place. And, the timing is prime. Mom's fallen into that Type 2 Diabetic Gulf that renders her usual medication insufficient. After spending many hours over the last few days looking up everything available, I was finally reminded of exenatide (Byetta), looked up all the links I'd bookmarked in April, then pulled the same searches I did then which were not fruitful at that time. Now, there's information all over the place about exenatide and the elderly, exenatide and chronic renal failure, exenatide alone or with an oral med, exenatide and its effects on other meds...and, from my mother's body's point of view, it's all positive. There's even the possibility that her kidney functions will remain stable much longer through the use of exenatide and may even show some improvement. Hallelujah!
I expect that her PCP will probably recommended starting her on the minimum dosage, 5 mcg/twice per day, within an hour before breakfast and dinner, cut back her glipizide ER 10 mg to once a day (not sure whether morning or night would be better; I think, with Mom, it'll six of one and half a dozen of the other), keep her on both for awhile to see how exenatide affects her, then modify treatment according to what is revealed. I'd like to think that within some months we'll be able to get rid of the glipizide, but I'm taking a conservative position. As well, from sorting through what I've read and interpreting the entrails, so to speak, it's possible that under the influence of exenatide her bouncing blood pressure will settle down without further medication. That would be nice.
There was no reason in April to consider exenatide, since Mom's BG was under excellent control at that time, even though exenatide would most likely have been fine. Now, there's a reason. While it's true that there are, yet, no long term use studies available on the drug, well, you know, that's how it goes with drugs. I'm willing to take the risk; more importantly, I've talked to my mother about it and she's willing to take the risk, as well, especially, as she said, if it means the severe restrictions in diet, sleep and mandatory exercise over the last few weeks will be lifted.
So, despite my fears and frustration, I am, yet again, emerging from this health bump of my mother's with flying colors. I'm finally beginning to see a pattern: The more agonized and inadequate I feel just previous to working out one of her health problems, the more I apply myself to the problem, despite my fears, and the more deliriously satisfying is the solution. I still have two heavy duty days ahead of me, including her appointment. My assumption is that her PCP will agree with me, may have already easily come to the same conclusion over which I've been sweating. I'm prepared for the possibility of a lively debate. Both days are decidedly downhill days, though; treacherously steep, true, but they lead to a restful valley. I've always preferred the climb to the descent. I have, in fact, a literal history of falling on my face during steep hiking descents. But valleys are as exhilarating to me as summits, so I'm not complaining.
Well, I'm going to bed "early" tonight. I need some sleep.
Later.
I expect that her PCP will probably recommended starting her on the minimum dosage, 5 mcg/twice per day, within an hour before breakfast and dinner, cut back her glipizide ER 10 mg to once a day (not sure whether morning or night would be better; I think, with Mom, it'll six of one and half a dozen of the other), keep her on both for awhile to see how exenatide affects her, then modify treatment according to what is revealed. I'd like to think that within some months we'll be able to get rid of the glipizide, but I'm taking a conservative position. As well, from sorting through what I've read and interpreting the entrails, so to speak, it's possible that under the influence of exenatide her bouncing blood pressure will settle down without further medication. That would be nice.
There was no reason in April to consider exenatide, since Mom's BG was under excellent control at that time, even though exenatide would most likely have been fine. Now, there's a reason. While it's true that there are, yet, no long term use studies available on the drug, well, you know, that's how it goes with drugs. I'm willing to take the risk; more importantly, I've talked to my mother about it and she's willing to take the risk, as well, especially, as she said, if it means the severe restrictions in diet, sleep and mandatory exercise over the last few weeks will be lifted.
So, despite my fears and frustration, I am, yet again, emerging from this health bump of my mother's with flying colors. I'm finally beginning to see a pattern: The more agonized and inadequate I feel just previous to working out one of her health problems, the more I apply myself to the problem, despite my fears, and the more deliriously satisfying is the solution. I still have two heavy duty days ahead of me, including her appointment. My assumption is that her PCP will agree with me, may have already easily come to the same conclusion over which I've been sweating. I'm prepared for the possibility of a lively debate. Both days are decidedly downhill days, though; treacherously steep, true, but they lead to a restful valley. I've always preferred the climb to the descent. I have, in fact, a literal history of falling on my face during steep hiking descents. But valleys are as exhilarating to me as summits, so I'm not complaining.
Well, I'm going to bed "early" tonight. I need some sleep.
Later.
