Today I meet with Dr. Baker to discuss the results of my 72 hours of monitoring hell and debate the merits of Byetta (exenatide) in treating my recent onset Type 1 diabetes. In mice exenatide has increased the mass of B-Cells located in the pancreas improving their endogenous production of insulin; however trials in humans have been less conclusive. In addition to the preservation of beta cells exenatide delays the absorption of food and nutrients into the blood system similar to symilin. The side effects have been pretty severe though including massive weight loss, pancreatitis, increased hypoglycemia, nausea and diareah (sounds fun doesn't it!)
In order for Byetta to be an option for patients with Type 1 a glucose tolerance test must be performed. A couple weeks ago Dr. Baker had me down bottle after bottle of the homeless man version of McDonald's Orange Hi-C to find out if my body was still producing any insulin. Turns out I still have traces of C-Peptide in my blood when large amounts of glucose are consumed proving that I am still in the "honeymoon" phase of diabetes. This "honeymoon" phase is also the reason why I sometimes can't get my blood sugars high enough to work out, am able to enjoy pizza on occasion and encounter so many hypoglycemic moments - guess the only positive out of that is pizza.
According to Dr. Gitelman of UCSF ~
"It’s extremely important to conserve the endogenous insulin secretion that you still have during the honeymoon phase," Gitelman says. "Even when patients have to take insulin shots, if they can continue to make some of their own insulin, it’s much better for long-term outcomes. Those patients who continue to make their own insulin for longer periods of time have better blood sugar control, lower risk of hypoglycemia and lower risk for long-term complications. "It’s like the difference between riding a bike versus riding with training wheels. It’s very hard to fall over and do something wrong when some of your beta cells are functional."
So the question is will these training wheels help me or hurt me? I have alot of fears about introducing a new drug in my system when my main goal is conquering the Ironman; there's a good chance this drug could really interfere with that goal. Currently I only have 10% body fat so massive weight loss would be pretty unhealthy and if I am unable to absorb all the nutrients my body is ingesting workouts are going to be much less safe and my recovery will take much longer. While improving my body's natural production of insulin would be fantastic I'm not sure this is the best way to go about it. Some studies have suggested that intensive insulin therapy (i.e., pump therapy) also helps preserve insulin production in recent onset type 1 diabetics. Currently I believe my best course of action is to stay the course and not worry about a "miracle" drug - your thoughts?