Folder Discuss Byetta & Victoza: Pen Needle Guidelines for Byetta


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 From:  Mark_in_MO
 To:  ALL
677.1 

In the past, the basic guidelines for pen needles used with Byetta was to use the "Mini" pen needles (5mm) for children and very thin/muscular people (or as someone said for those who are not very "fluffy"); and to use the "Short" pen needles (8mm) for pretty much everyone else.

My endocrinologist faxed in a new prescription for pen needles for use with my Byetta, and he prescribed the "Mini 5mm" instead of the "Short 8mm" needles. I am waiting for a return call from his office to see if this was an intentional change or an error.

However, while waiting, I looked through the BD Diabetes.com website, and there is a new statement listed by the Needle Prescribing Guidelines for the "Mini 5mm"needles that says: Prescribe the Mini for "Patients who use Exenatide".

Is this a new guideline that anyone using Byetta should be using the 5mm Mini needles rather than the 8mm Short needles? Has anyone else been directed to switch from the 8mm to the 5mm needles?

I will let you know what the endocrinologist advises.

Mark in Missouri

Type II Diabetes (2000)
Byetta 10 (Jan, 2006)
Metformin 1000mg-2x daily

EDITED: 6 Apr 2009 by DIABETES_DOC

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 From:  Mark_in_MO
 To:  ALL
677.2 

Additional information - By the way, I have seen the endocrinologist for about 5 months (I have an appointment for later this month) so he could not base the change in needle length on any weight loss.

While I have lost about 70-75 pounds since starting Byetta, I am not "very thin/muscular" - rather I am somewhere between "fluffy" and "muscular" - basically I still have about 30-40 pounds more to lose.

Mark in Missouri

Type II Diabetes (2000)
Byetta 10 (Jan, 2006)
Metformin 1000mg-2x daily

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 From:  Mark_in_MO
 To:  ALL
677.3 

Got a response back from my endocrinologist - the change in my pen needle prescription from the Short 8mm to the Mini 5mm was apparently a mis-communication in the doctor's ofice.

However, they said it should not hurt to use the 5mm needles since I have lost some weight. Just recommended that I watch to make sure that I do not experience any leakage from the injection site after removing the needle, I may try the Mini needles when I inject into my thigh, which (due to a lot of cycling) has lost most of the fat and is reasonably muscular (still not thin).

I will ask about the change to the BD needle prescribing guideline next week when I see my endo.

Mark in Missouri

Type II Diabetes (2000)
Byetta 10 (Jan, 2006)
Metformin 1000mg-2x daily

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 From:  toneylee in VA (TONEYLEE)
 To:  Mark_in_MO   6 Apr 2009
677.4 In reply to 677.3 
Mark: This is very interesting (and initially startling) and important for us to know--especially if we are advising "fluffy" people getting poor Byetta results to switch to longer needles. I'll be wanting to know what the endo has to say. Thanks!
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 From:  Geri in Co:Victoza(3-10) (GERI)
 To:  Mark_in_MO   7 Apr 2009
677.5 In reply to 677.3 
Due to a change in insurance I had to get all new prescriptions for my new mail order company and when I got my syringes for my insulin I discovered that I got 12.7mm needles instead of my regular 8mm syringes. I was going to ask the endo when I go in a couple of weeks if there were longer needles for the spit too. I haven't gained anymore weight, other than the 10 lbs from the emotional distress from my knee fiasco, but I was wondering if it would help the spit work better. I'll let you know what he says.
Geri in Co:Byetta(3-06),Glucophage XR, Glucotrol XL, NPH
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 From:  Jan (JANICE)
 To:  ALL
677.6 

This is interesting. I have always been on the 5 mm needles. I am still fluffy around my stomach.

I was, until I read here, pulling out the needle and seeing drops on the end. Now I leave it in and turn the dial and then rotate the neddle a bit in my skin and no drops.

I so hate needles that I kind of hope we don't hear we should be using longer ones.

Jan in NY, Byetta 5 (as of May 17, 08) 500 metiformin 2x a day & other meds
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 From:  Mark_in_MO
 To:  ALL
677.7 

Well, I thought I posted this message once, but it appears that it got lost in the shuffle as I was installing a new PC today.

I met with my endocrinologist yesterday, and I have a correction: The prescription for the "Mini" 5mm needles was NOT an error (the nurse miscommunicated his message to me) - what the endo actually said was he prescribes the 5mm pen needles for all his Byetta patients. I got started on the 8mm "Short" needles when I was going to a different end. The endo said due to the tiny amounts of Byetta being injected, he wants patients to use the smallest needle so they get all of the drug possible, and leave as little in the needle as possible. When you consider that a drop of water is 1 milliliter, and our injection of Byetta is 1/10th of that amount - I guess the shortest needle makes sense.

As a reminder, the BD website (needle manufacturer) recommends the use of the 5mm Mini for all exenetide (Byetta) users. The endo said there was no problem with me using up my existing supply of 8mm needles, but wants me to continue with the 5mm needles. I have been using the short needles in the morning when I inject in my thigh and the 8mm needles in the evening when I inject in my abdomen. I have noticed that when I inject with the short needles in the thigh I get less pain than with the longer needles, have had fewer "bleeders", and seem to be getting more effect from the Byetta - I have been getting better appetite suppression during the day and my BG numbers have been down a bit as well (while eating the same diet). So maybe getting a little more Byetta is a good hing - or perhaps it is all in my head...who knows?

Anyway, I guess we should revise the standard recommendation of the 5mm needle for the small/thin person and the 8mm for pretty much all the rest (including the fluffy ones!). FYI - the endo says he never prescribes the 12.7mm needles for anyone to use with Byetta. I hope this info has some value. Can someone else check with their endo to confirm?

Thanks,

Mark in Missouri

Type II Diabetes (2000)
Byetta 10 (Jan, 2006)
Metformin 1000mg-2x daily

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 From:  Geri in Co:Victoza(3-10) (GERI)
 To:  Mark_in_MO   17 Apr 2009
677.8 In reply to 677.7 
I see my endo next week so I will ask him and see what he says.
Geri in Co:Byetta(3-06),Glucophage XR, Glucotrol XL, NPH
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 From:  Geri in Co:Victoza(3-10) (GERI)
 To:  Mark_in_MO   30 Apr 2009
677.9 In reply to 677.7 

My endo had not heard about only using the 5mm needles and told me to call the hotline and ask. Instead I looked it up on the website and it says that we can use 3 different sizes on the Byetta pen.

1) 31 guage x 3/16" - 5mm
2) 31 guage x 5/16" - 8mm
3) 29 guage x 1/2" - 12.7mm

Hope this helps all of us.

Geri in Co:Byetta(3-06),Glucophage XR, Glucotrol XL, NPH
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 From:  Mark_in_MO
 To:  Geri in Co:Victoza(3-10) (GERI)   30 Apr 2009
677.10 In reply to 677.9 

Geri,

You are correct - The Byetta website shows you can use all three pen needle sizes. The BD website (pen needle manufacturer) also says you can use all three sizes, but further states that the 5mm Short needle is the one recommended for use with exenatide (Byetta). I think everyone is OK using whatever they currently have been using, but should still check with their Endo Dr. the next time the see them (regular appt - this is NOT worth a special appt). What my Endo says does make sense - since we are injecting such very small amounts of medication, the shorter the needle, the more medication we get into our system.

Thanks,

Mark in Missouri

Type II Diabetes (2000)
Byetta 10 (Jan, 2006)
Metformin 1000mg-2x daily

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 From:  mel (MEL95)
 To:  Jan (JANICE)   30 Apr 2009
677.11 In reply to 677.6 

I am new to Byetta and am having a little trouble getting over my needle phobia. It took me 1/2 an hour to try to inject myself this morning and couldn't do it.I went to the endocrinologist yesterday. Is there something that could help me overcome my needle phobia. My blood glucose readings have been really well. My endocrinologist wants me to use the Byetta mostly for the weight loss.

 

 

DX with diabetes 2007, Meniere's Disease in 2002, and a low back injury in 2001.

Metformin -500mg X2 , omerprazole 20mg X2 + other medicines

Mel LeVan

EDITED: 30 Apr 2009 by MEL95

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 From:  Jan (JANICE)
 To:  mel (MEL95)   1 May 2009
677.12 In reply to 677.11 

Mel:

I do feel for you. I was the way you discribe just sticking my finger for the bg test!

So I figured doing Byetta would be no big deal since I had gotten over the finger stick thing.

Honestly it was at first. But just like sticking my fingers, the more I did it the less upset I was.

Take a few deep cleansing breaths, breath in deeply and breath out slowly thru your mouth. Just get yourself in a calm state. It will it better and easier.

I do hope Byetta works for you in regards to losing weight but please understand it does not do that for everyone. I and some others lost quite a bit the first few months and then slowed right down. The main reason to take Byetta is to achieve better bg numbers.

Jan in NY, Byetta 5 (as of May 17, 08) 500 metiformin 2x a day & other meds
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 From:  Steve in FL (SKEET4ME)
 To:  ALL
677.13 

I just had to reply to this one..."fluffy"?? you guys are too funny.

I have always used the 5mm needle and never gave it any thought until this post. In the beginning when I was getting use to giving myself the shot, I would count to 7 like they said to do and then I would sometimes notice a small drop on the end of the needle. Turning the needle while still in was just too much for me at the time, but I found if I counted to 10 instead of 7 there never is a drop on the needle after I take it out.

Leaking form the site? No, can't say I have ever had an issue with that with the 5mm. Only time I have ever had a problem is when I hit a capillary and then I just bruise a little.

Hope you have all been doing well!

Steve in FL
Met (1000x2)
Byetta 10x2
Go Jaguars!

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 From:  Jan (JANICE)
 To:  Steve in FL (SKEET4ME)   unread
677.14 In reply to 677.13 

I had a magnet once of a big cat that said "Im not fat, I'm fluffy"

I do the 10 second time and there was still a drop at the end of the neelde so I do now roatate it while still in and no more drops.

Have a couple of bruises right now - at least less of them than when I first started.

Jan in NY, Byetta 5 (as of May 17, 08) 500 metiformin 2x a day & other meds
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 From:  Sue (SUEFIRST50)
 To:  Jan (JANICE)   2 May 2009
677.15 In reply to 677.14 
I also rotate the pen while the needle is still in and I leave it in for a count of 30 (a fast count) and sometimes I still see a little drop on the needle. I thought I had conquered this problem by making sure the needle was screwed on really tight but for some reason lately I am seeing that little drop at the end of the needle after I remove it. Someone suggested turning the knob to set it for next shot while still in but I read that isn't a good idea because there can be a backflow of blood when you do that and it would contaminate the pen.
Susan in NY Byetta 5 mcg x 2, Glipizide 5 mg X2, Metformin 1000 mg X2, Metoprolol 100 mg, HCTZ 12.5 mg, Lisinopril 20 mg, Zetia 10 mg, Omeprazole 40 mg
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 From:  Jan (JANICE)
 To:  Sue (SUEFIRST50)   3 May 2009
677.16 In reply to 677.15 
I have been rotaing the pen while it's still in the skin. Been doing that at least a month now with no back flow.
Jan in NY, Byetta 5 (as of May 17, 08) 500 metiformin 2x a day & other meds
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 From:  Geri in Co:Victoza(3-10) (GERI)
 To:  Jan (JANICE)   3 May 2009
677.17 In reply to 677.16 
I've been doing the reset for just about the whole 3 years now, I was told to by the hotline. I just hold down the plunger while removing the needle so there is no back flow. I also twist the needle before doing the reset. More complicated but it works for me.
Geri in Co:Byetta(3-06),Glucophage XR, Glucotrol XL, NPH
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 From:  mel (MEL95)
 To:  Jan (JANICE)   4 May 2009
677.18 In reply to 677.12 

Dear Jan,

Thank you for the advice on getting over the needle phobia. What I did was had my husband inject me two times so I could feel what it felt like and then this morning I injected myself. I am experiencing a little nausea and dizziness with it. I have dizzy spells anyway with my Meniere's. So i am use to that..

I just wanted to say thank you :-) :-)

 


Mel in OH, Byetta 5mg (since 5/2/09), and other meds

Mel LeVan
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 From:  Jan (JANICE)
 To:  mel (MEL95)   4 May 2009
677.19 In reply to 677.18 

Mel:

Your're welcome and really it does get better. When I first had to do the finger sticks I had to have my husband do it too.

The first time, well probably the first 5 or 6 times, I did the Byetta shot I was dizzy for a few mintues. Now it's nothing - no problem at all even if I have to restick a few times cause I feel some pain. There should be no pain, so do it gently and if it does hurt you have probably hit a capillary and just pull out and try again.

Jan in NY, Byetta 5 (as of May 17, 08) 500 metiformin 2x a day & other meds
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 From:  mel (MEL95)
 To:  Jan (JANICE)   5 May 2009
677.20 In reply to 677.19 

Jan,

For the finger sticks I had no problem. When I got my meter, the nurse did a blood sugar on me and I was fine after that. I think my problem with the Byetta was I can see the needle and in doing a bg I don't.

Today, I've had a little nausea and dizziness and I know that it will be better as soon as my body gets use to the Byetta. We will see if it helps me at all in the weight arena...

Many thanks...

 

 


Mel from OH - Byetta(5/2/09), Metformin 500mg X2 and other meds

Mel LeVan
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