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Type 1 and GLP-1s

J

jules25

Member
Messages
6
Type of diabetes
Type 1
Treatment type
Pump
Has anyone had success getting pharm insurance approval for the above meds; Trulicity, Mounjaro, Ozempic, etc? I have been a Type 1 diabetic for 53 yrs and am on an insulin pump but still having so much trouble stabilizing my glucoses for the last 30 yrs. Pump helped but my glucoses still look like a seismograph report. Up, down, up down, no matter what i do. Exercise, good BMI, eat few carbs, etc. My insurance denied it!
My type 1 niece went on Mounjaro for her erratic glucoses and on pump too, her insurance approved and w/ no other changes, her A1c dropped fom 8.6 to 6.1%

She has been on for several yrs and doing amazing. There are articles and respected studies showing it IS beneficial to type 1 w/out much hypoglycemia. Pts need less insulin, lowers cardiac risks. Our system is slow to approve...FDA therefore insur. I am so frustrated. This is something that could help me control my glucose and therefore prolong my life.

Anyone had any luck as well? I am going to appeal my case and submitting clinical trial results that show it is safe and effective for type 1s, but just curious if it was approved for you, how did you do it? Thank you!
 
You mention that your BMI is good. Those meds are only cleared for people who are clinically obese. The FDA has not approved it for Type 1 diabetics. You are also contraindicated if you have ever had a DKA event.
 
Oldvatr said:
You mention that your BMI is good. Those meds are only cleared for people who are clinically obese. The FDA has not approved it for Type 1 diabetics. You are also contraindicated if you have ever had a DKA event.
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I know of patients here that have been prescribed it and are type 1s, on a pump and not overweight. It is for better glucose stabilization, so possibly using off label but their insurance is paying for it. I haven't been in DKA before but some of these patients I have referred to have been in DKA. Studies are showing this is safe and effective for T1s w/ little risk of hypoglycemia. these pts are trim as well.
 
jules25 said:
I know of patients here that have been prescribed it and are type 1s, on a pump and not overweight. It is for better glucose stabilization, so possibly using off label but their insurance is paying for it. I haven't been in DKA before but some of these patients I have referred to have been in DKA. Studies are showing this is safe and effective for T1s w/ little risk of hypoglycemia. these pts are trim as well.
Click to expand...
I am surprised insurance companies are supporting off label use since this makes them legally liable to class actions. You did not answer my point regarding BMI. this class of meds is capable of reducing body weight by 15% through mainly ketosis induced by chemicals. The treatment remains active for at least 5 days following the injection, and can linger for up to 5weeks. during that time there is no way of counteracting the med. It is a spanner in the gearbox of your metabolism. these meds carry a Black Box Warning or two so are not as safe as is claimed by the manufacturer.

It seems Victoza is the only member of this family to be be tested with T1D partcipants, and the results of that trial made the FDA remove it from treating T1D. No other trials have tested with T1D since. We have seen a couple of reports on this forum of users reporting euDKA while using one of these drugs. Going off label may be convenient, but it carries a risk.

www.medicalnewstoday.com

Ozempic: For weight loss, dosage, side effects, and more

Ozempic (semaglutide) is a prescription injection that helps manage blood sugar levels and lower risk of cardiovascular problems in adults with type 2 diabetes.
www.medicalnewstoday.com www.medicalnewstoday.com
 
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I am a type 2 diabetic and have been on Ozempic for a year or so and it’s worked well for me.
I am on the 0.25 dose and I’ve lost 20 lbs since being on it and lost inches as well.
 
jules25 said:
Studies are showing this is safe and effective for T1s w/ little risk of hypoglycemia. these pts are trim as well.
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Have you got a link? I would be interested to read them.
 
Oldvatr said:
diabetesjournals.org

751-P: Effect Of Once-Weekly Semaglutide on Weight Change and Metabolic Control in People with Type 1 Diabetes—Six-Months Results from the Real-World STEMT Trial

Introduction: the SUSTAIN trials have shown significant improvements in weight and HbA1c levels in people with type 2 diabetes, but the effect and safety o
diabetesjournals.org diabetesjournals.org
I found the Disclosures list to be enlightening.
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Yes, the advisory panel certainly seem to have some financial interest in the product...
 
Seems we should expect another group of patients to join the queue for these meds. Heart and Stroke risk is apparently significantly reduced by using these meds based on Liraglutide study results by Copenhagen Uni.

Another Off Label use that is not yet FDA approved but may soon be launched. NovoNordisk is going to be very busy. I suspect T2D folk will be pushed to the back of the queue.
 
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I have still not found any reputable study for a GLP-1 drug that mentions safety apart from blamd statements to that effect. The following report covers semaglutide trisl that comes close to it, but does NOT cover diabetes use and does not cover T1D use either. Those groupss were expressly excluded from the trial
pubmed.ncbi.nlm.nih.gov

Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial - PubMed

The STEP 5 trial assessed the efficacy and safety of once-weekly subcutaneous semaglutide 2.4 mg versus placebo (both plus behavioral intervention) for long-term treatment of adults with obesity, or overweight with at least one weight-related comorbidity, without diabetes. The co-primary...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov
Note also a similar Disclosures section that is also elightening And How!

I have found a copy an article on the trial, and it has a section labelled Safety and Tolerability. It at least identifies some events that occurred during the trial. Remember that these were healthy volunteers, and non diabetic. the report also mentions that some of the groups also developed T2D during the trial. The incidence of these events may or may not be significant when compared to the general populace. What steps to ensure safety that might apply to a similar trial involving diabetic people especially insulin users is not known, but we certainly do not know what long term effects may be happening and this trial is the longest duration that Semaglutide has been monitored.
www.nature.com

Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial - Nature Medicine

Results from the STEP 5 trial, testing semaglutide as an adjunct to behavioral interventions in adults with overweight or obesity, demonstrate sustained weight loss over a period of 104 weeks.
www.nature.com www.nature.com
 
Ubless someone can share evidence to the contrary, I think that the phrase "shows that it is safe" as stated in this thread is based either on anecdotal evidence or small cohort trials where nobody actually died, or had DKA event. I doubt that there were checks for malignant neoma ot thyroid issues, or even evidence of cardiovascular tests such as wave velocity tests or ultrasound checks on calcification of the arteries. I note also that off label use for weight loss is limited to 2 years, but diabetic use seems to be unlimited.
 
I am type 1, insulin resistant and treated with the t slim pump, g7 Dexcom, metformin and ozempic.
I've been on ozempic for 2 years and it's been the biggest most positive improvement in my diabetes in the 33 years I've had it. I lost weight too but remained the same weight over the past year. I found it a total game changer for me. My blood sugars improved, my insulin doses are lower. I don't have to bolus for a plain green salad ( for example) with no carbs, which I had to before ozempic.
My diabetes was hectic and brittle and ozempic has helped so much.
So I put up with the side effects.
For other medical reasons I have asked about the new drug in this family that could help with metabolism, but currently I am to be put on mounjaro when I've finished this prescription of ozempic. Looking forward to any improvements this will bring including hopefully less side effects
 
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