Screening for Byetta

The metabolic syndrome components in childhood and adolescence, and prehypertension and hypertension in adulthood are felt to be components that will go into a lifelong struggle with weight gain and poor health. Hypertension 2006 7;48(1):33-9.

The main finding in this study is that adults with prehypertension and hypertension had higher levels of each of the metabolic syndrome components (elevation of both the upper and lower blood pressure values, abnormal triglycerides, glucose/insulin resistance, and lower levels of HDL-cholesterol) in childhood and adolescence.

This metabolic syndrome identifies the likelihood that the individual will likely respond to treatment with Byetta and to reverse the abnormal weight and the three associated conditions of cardiovascular disease, diabetes and Alzheimer’s disease.

The prevalence of individual metabolic syndrome components in adulthood and children was significantly related to hypertensive status. Both prehypertensives and hypertensives had more adiposity in childhood. This is why we look to wave form measurements as the most sensitive check in the blood vessels with the CVProfiler in the office when beginning our search for the metabolic syndrome.

With this simple test we can screen to who may respond to Byetta.

New Theory of Weight Gain

Over 30 years ago, when I was a fellow in endocrinology and metabolism at the University of California San Francisco, I was involved in a study of a 300 pound woman who was almost 5 feet tall. We kept her on the clinical research unit and monitored her daily diet. We found that when we gave the calories that were ideal to stabilize her weight, she actually gained 8 pounds in two weeks.

She then underwent a gastric bypass and began to lose weight steadily. It became clear to me at that time that perhaps some people ate excessively and therefore gained weight, but others would gain weight with even restricted calories .

A similar study in the New York Times Magazine of August 13. carried the research of another physician in roughly the same time period. For us traditional ideas about weight gain were incomplete. We later learned that genes are very important to weight loss as we have discovered while using Byetta. It is clear that a patient needs to either have diabetes or at least the metabolic syndrome before Byetta will work. It is a gene changing medication.

The third component of obesity was discussed in the New York Times article. It seems that microorganisms inhabit our gastrointestinal tract and assume an extraordinary array of functions. These bacteria and viruses extract calories from the food and help store those calories in cells for later use.

The research involved in these data has not yet gone to the point were we know how to take advantage of this knowledge but we do know that antibiotics can change this microflora release for a short period of time. The flora then goes back to what it was before. It seems that certain gut proteins allow fat deposition to increase in the rest of the body. Certain viruses are known to also play a role in addition to bacteria.

For us here at EMMC, it seems that we are inadvertently having some impact on this new metabolic understanding by using all the supporting medications for people taking Byetta. As various vitamins, minerals and amino acids are added to the patient’s program to sustain the weight loss from Byetta, we seem have started some great weight loss. Serendipity is a good thing.