Weight loss on Victoza (Liraglutide)

[BrianSkye]

I've been using victoza for about 9 months now and it produced a dramatic reduction in most of my blood glucose readings but the reduction in HbA1c has so far been only about 1% point. However the last test was maybe 3-4 months ago. Checkups and clinics up here can be a little random.

Today I went to the Diabetes clinic and saw a new specialist who dropped the bombshell that I may be taken off the drug unless I show a significant weight loss which so far has not happened. I get the feeling that there is a hidden cost agenda here. I have only now realised that during the consultation she never asked what dose I had got up to and I never brought it up. It had been left to me to increase the dose until a good reduction in blood sugars had been achieved and I had never gone beyond the 1.2mg/day dose

I seem to have read that some people have not seen the weight loss effect until they have gone up to the 1.8mg dose. Can anyone please tell me of their weight loss experience versus dose please?

I have been given a follow up appointment 8 months away which gives me a certain leeway in achieving some weight loss and I would be very unhappy to be taken off this drug as it is the most effective I have ever been given. If I feel confident I plan to increase my dose myself to the higher level but I would appreciate some feedback... please

 

[benedict]

Hi Brian

I think the increase of your medication should only be done with the approval of your health team.

I know getting appointments with doctors can be difficult sometimes but I think another appointment to discuss this, or even a chance to talk to the doctor on the phone (if possible), is a better option than adjusting the dosage yourself.

Let us know how you get on.

Benedict

 

[BrianSkye]

Hi Benedict,
I'm afraid in the absence of any reply I went ahead and made the change up to 1.8mg on the 3rd Sept.
So far all that's happened is a further decrease in my blood sugar readings but nothing exceptionally (dangerously) low. My appetite is slightly reduced but nothing that's going to make any difference to my bad habits. I saw the dietitian yesterday for the first time since I was diagnosed in 2005! Without going into detail her initial advice is some changes to our chaotic mealtimes. My partner has different medical problems and needs to eat all he can, so there is some incompatibility as well. The dietitian wants me to come back for an hour's appointment in November and to bring my partner along in part to emphasize how important this is for my health.
I'm very disappointed in my diabetic clinic. There has been no consistency. First they are all enthusiastic and give me folders and charts to fill in for subsequent visits then I don't hear from them for 4 years. Suddenly it's all back on but every time I go I see a new expert who has different ideas for treatment. They also seem very dependent on the computer records to know anything about me but whenever we look at them there are test results omitted and visits to other specialists unrecorded. A person could get very despondent
I'll let you know if a leg falls off or whatever :roll:

Brian

 

[anna29]

Hi brian, With victoza being an expensive drug, they do have strict guidelines and results etc they look for before allowing patients to continue on this drug.
I had a productive weight loss of over 1.5 stone using victoza on my bodyframe and size being tiny except for my tummy [barrel shape and size] was putting too much pressure on my heart and upper respiratory.
Was up to the full dosage of 1.8 but with the weight loss success and significant on my upper body where it WAS needed, it has beeen agreed that I reduce the dosage to 1.2 and will stay on this indefinetely.
As benedict suggested it really would be in your best interest to return to the HCP before upping the dosage yourself, it is a GLP1 peptide drug after all...
Did you let the dietician know you had increased the dosage yourself?
Victoza can ONLY be successful with weight loss IF you actually do eat LESS and portion control SMALLER PORTIONS of food than in the past.
It acts as both an appetite suppressant/BG lowering with food sending a message to your stomach telling it is full - however if you are able to eat as normal as in the past before using victoza it cant and wont have this effect.
No signicant weightloss combined with your BG levels will be veiwed as victoza being unsuitable to continue with. This is probably why they suggested this to you.
Have been told with patients using victoza there HAS to be results specific with both weightloss and a decrease in high blood glucose levels to be allowed to continue on this drug.
Yes it IS highly expensive and cost effective to each patient also, hence the decision made as to who can/cant have this drug.
Anna.

 

[BrianSkye]

Thanks for the background info Anna. Gives me a lot to think about. No, I didn't tell the dietitian about the visit to the diabetic clinician or my change to the dosage. She actually knows nothing about my treatment regime at all, such is the level of communication here. I requested to see her independently following a visit to my GP.

I have spinal stenosis and other spinal problems that seriously limit my mobility and leave me in chronic pain the entire day. It's the major reason why I put on the last 2-3 stone. I already take high levels of painkillers and am on the list for an epidural nerve block and have been offered a laminectomy but the latter is being kept well in reserve because of its risks which are compounded by being diabetic. The upshot of my consultation was that the only thing I can now do to stabilise my condition is to lose weight. I'm sure you don't need to be told that this has been tried many times in the past but one more time won't hurt, particularly if it will qualify me for continued treatment with liraglutide which is the only treatment standing between me and insulin injections.

The only reason I felt happy to increase my dosage was that I had been given leave to do this by the previous consultant, as required, on my own initiative. I even have it in writing. It was never mentioned that there was an imperative to lose weight as part of the 'contract' for receiving it or indeed that I should be engaged in any specific weight loss program.

I am surprised that there is supposed to be this direct linkage between appetite suppression and BG reduction. I have had very little reduction in appetite though I think this is mediated by being rather depressed. Nevertheless this drug has made large reductions in my day to day BG levels and an initial 1% reduction (9.5=>8.5) in my first HbA1c result made 3-4 months ago. It's the most effective treatment I've ever received.

I will see if I can get a chat with my GP but the lack of cooperation between all these health care professionals is very dispiriting. The only way I can keep them all on track with my back condition is to keep writing to each of them with copies to the others.

I'll try and remember to post and let you know the result. Thanks again.

Brian

 

[Unbeliever]

I hope it all works out for you. I think this lack of cooperation between HCPs is universal unforunayely.

As we are all aware and as I am constantly told by friends "in the business" it is all abou money . The system seems designed to force hospitals GP pracices ec o compete instead of cooperating.
I often feel that his is something that needs addressing nore urgently than concerns over privatisation and competition from outsiders.

I am sure it would be mre cos effective in tthe long run - and more humane.

 

[BrianSkye]

Having now read the NICE guidelines at http://guideline.gov/content.aspx?id=25679 I have now decided to return to the 1.2mg dosage to avoid making unnecessary waves. Hopefully I will achieve the required weight loss and all will be well. At least it seems I have nearly 8 months to achieve this.

Reading the guidelines it seems that my BMI at 35.8 is marginal for the treatment with Victoza per se but another qualifier seems to be my back condition and its relation to weight. I must remember to keep a copy of this document handy at my next consulation. :wink:

I gain particular heart from this sentence: 'People with type 2 diabetes currently receiving liraglutide who do not meet the criteria specified above or who are receiving liraglutide 1.8 mg should have the option to continue their current treatment until they and (my emphasis) their clinicians consider it appropriate to stop'.