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Q about changing meds when HbA1c comes down

Bogs

Member
Messages
7
Type of diabetes
Type 2
Treatment type
Other
Hello.

I'm T2, diagnosed 2021. I was initially put on Metformin. This wasn't sufficient to get my levels under control. Dapaglifozin was then added in. Still not enough. I was then one of the 'lucky' ones and put on Mounjaro back in October 2024. It really has been life-changing and along with losing 6 stone my HbA1c has gone from sky high to 34, so into 'non diabetic' range. My blood pressure has gone from high to healthy and my NAFLD has reversed. All liver readings now normal.

And now the diabetes nurse at my surgery has said I need to come off all 3 medications, despite last month when I asked if I should reduce the Metformin/Dapa she said "absolutely not". I am really worried that if I come off all the medications (I certainly want to reduce them) then I will just go straight back to where I was before. My HbA1c is only so low because of the mounjaro. From all the reading I've done, I'd like to stay on a low dose of mounjaro for a good while, as that's what's working, and come off the metformin and dapa. But she says I have to come off them all. She said if I go back to where I was before I would then go back on the same combination of meds. Which not only seems daft and short-sighted, it really scares me - I don't want to go back to where I was before! But am I missing something? Is there a reason I'm not understanding as to why she thinks taking me off everything won't mean my HbA1c goes back up so high?

She says that I don't meet the criteria for the meds (all three) to be prescribed any more. I said, but that's because one of them (the mounjaro) is working so well. She just repeated that I don't qualify for the medications anymore. Is it really the case that I should come off them all, wait for things to get out of control again, and then go back on, yo-yo'ing like that? I have another medicated condition (unrelated) that took a similar process of trial and error with finding meds that worked, and now we've found the right meds for that, my blood readings are normal, but I haven't been taken off the meds because it's understood it's the medication that's making the results normal. I don't understand why this is different. If anyone is able to help or tell me about their experience with meds when they've come off or their HbA1c has come down I'd be really grateful.
 
Hi @Bogs and welcome to the forum and congratulations on your weight loss and diabetes control. I feel for you, this nurse is being so short sighted! I am on Rybelsus a similar drug to Mounjaro. I too have lost a shed load of weight and my HbA1cs are normal. At my review in May (with the surgery pharmacist) I was asked if I wanted to come off the Rybelsus, I said similar to you why tamper with what is working and have continued to take it.
To expect you to come off all three meds at once is shocking. Can you get a second opinion at the surgery?
 
Hi @Bogs and welcome to the forum and congratulations on your weight loss and diabetes control. I feel for you, this nurse is being so short sighted! I am on Rybelsus a similar drug to Mounjaro. I too have lost a shed load of weight and my HbA1cs are normal. At my review in May (with the surgery pharmacist) I was asked if I wanted to come off the Rybelsus, I said similar to you why tamper with what is working and have continued to take it.
To expect you to come off all three meds at once is shocking. Can you get a second opinion at the surgery?
I believe Nurses are not always right so seek second advice. They are only doing what the practice wants as it could be about saving cost !
 
Hi @Bogs and welcome to the forum and congratulations on your weight loss and diabetes control. I feel for you, this nurse is being so short sighted! I am on Rybelsus a similar drug to Mounjaro. I too have lost a shed load of weight and my HbA1cs are normal. At my review in May (with the surgery pharmacist) I was asked if I wanted to come off the Rybelsus, I said similar to you why tamper with what is working and have continued to take it.
To expect you to come off all three meds at once is shocking. Can you get a second opinion at the surgery?
Thank you for your reply. So I left a message with my GP. She has just text to say they will wean me down to 5mg of mounjaro while I wait for a referral she's put in for me to see the consultant diabetologist. I now have more questions! Like, how long will that be and what do I do about the Metformin and the Dapaglifozin. So, at least they aren't stopping the mounjaro overnight like the diabetes nurse said but I'm still confused and it still sounds like it's being stopped.
 
I believe Nurses are not always right so seek second advice. They are only doing what the practice wants as it could be about saving cost !
Thanks for your message. I'm sure it's about saving money. But that's short-sighted too because long-term T2 diabetes (and other obesity related conditions) were going to cost the NHS a lot more than the cost of the mounjaro and other meds. I really don't get it.
 
Thank you for your reply. So I left a message with my GP. She has just text to say they will wean me down to 5mg of mounjaro while I wait for a referral she's put in for me to see the consultant diabetologist. I now have more questions! Like, how long will that be and what do I do about the Metformin and the Dapaglifozin. So, at least they aren't stopping the mounjaro overnight like the diabetes nurse said but I'm still confused and it still sounds like it's being stopped.
If you can msg the GP again, maybe say out right that you want to stop the Met & Dap and ask how to go about it ie reduce them slowly or stop dead? Then ask how the weaning down of the Mounjaro will go. Or indeed ask if the Mounjaro dose could be left alone while you come off the other two meds? I think that’s what I’d do.
 
If you can msg the GP again, maybe say out right that you want to stop the Met & Dap and ask how to go about it ie reduce them slowly or stop dead? Then ask how the weaning down of the Mounjaro will go. Or indeed ask if the Mounjaro dose could be left alone while you come off the other two meds? I think that’s what I’d do.
Thanks Rachox. I tried to text back and it doesn't accept replies! But yes, I'm going to go back and ask what I'm meant to do. Not happy about it though. Really confusing and I don't really trust it's about what's best for me as an individual.
 
Pls chase it up til you get a plan everyone, especially you is happy with. Let us know how you get on @Bogs
 
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