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Dagpagliflozin and carbs

A

AmandaS

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Hi,I was diagnosed type 2 diabetic years ago but have had no real information from the drs/diabetic nurse.TBH at the time I was offered to go on a course but I was, and am, housebound so couldn't attend so was just left as that. I was advised to check lables for carbohydrates and then, 'of which sugars' and it had to be 5mg or under for me to be able to eat it.
When I was diagnosed it was all about reducing sugar but as the years have gone on as you know it's also about carbs. That as diabetics were should limit our carbs.
My blood suagr wasn't very well controlled and I was also diagnosed with an overactive thyroid so was reffered to an endocrinologist and diabetes specialist (Over the telephone.). He took me off two medications and started me on Mounjaro/Tirepatide (Which I'm really pleased about and in only four weeks, my Hba1c came down from 80, to 49.). I am also taking Metformin 1g modifid release, which I have been on since the start, and just before starting the Mounjaro I was started on Candestartan 8mg, and Dapagliflozin 10mg.
I was not informed, and there is nothing on the enclosed leaflet, but I read on another forum that you are not supposed to go low carb on Dapagliflozin? I googled and it said not too. However, I don't know how many carbs a day I should be having if that's the case? I'm really confussed what I should be eating! Any advice would be very welcome. I don't want to start eating too many carbs and my Hba1c go up again.
 
Hi KennyA, many thanks for your reply. I did some Googling this morning and it said that I should eat between 130-200g of carbs a day. I shall try and get in touch with the diabetes nurse at my local surgrey to just check. If and when I get an appointment, and with the outcome, I will come back to let you know. Thanks again.
 
The rare but potentially very serious side-effect is euglycemic DKA ie DKA at normal BG levels which may not be recognised quickly.

See 1.21 in @KennyA 's link. DKA should be mentioned on the PIL.
 
Dapaglflozin pushes the sugars into your urine so if you don't eat enough carbs you can get too low. If my daughter had meat and salad for dinner, she would be low and feel ill by morning. A carby pudding balances the meal for her.
 
Thanks so much emmakate. I tried to make an appointment with the diabetes nurse today but she wasn't available till the end of September. The receptionist was very nice and sent me a econsult to fill out and I now have a dr calling this Wednesday afternoon.
 
Ok, so, sopke to a dr earlier-left me so frustraited and annoyed, I might as well being talking to the speaking clock. She did expalin that Dapagliflozin takes excess sugar, passes it through your kidneys and flushes out with your wee. She said there is no risk of hypos from Dapagliflozin. Although she then said as I was also Mounjaro and taking metformin my blood sugar could go too low. I asked her how many carbs I should be eating a day, and she replied she wouldn't like to say as I'd have to talk to a dietitian about that. Then I said when I was first diagnosed as diabetic I was told to check food lables by finding the 'carbohydrates' section, and then, 'of which sugars.' If of which sugars is 5mg or under it's ok to eat. I explained that the emphasis is on carbs now days and how many carbs should I be looking out for (Found out on my own online, preferably 10g per 100g). She told me she didn't know anything about it and again said I'd need to ask a dietition! So I got nowhere. She did give me a link to a low carb diet on my local health providers page but it was a list of these food bad, these food good.
 
When I started Dap the surgery were concerned about my attempts to low carb, but satisfied that I could detect a hypo as I self fund Libre2+.
I don't think I have ever got close to a hypo, have been in low 4s, but this may be partially due to reduced kidney functionality.
I suspect that if my kidneys are slow to process, then they won't be able to shift massive amounts of sugar, however much I drink.
All you can do is test, test, test.
I am lucky to be able to use Libre2+ on a long term basis.
Carb counting combined with testing should give you some idea of how much carbohydrate your body needs to keep your BG within range.
 
I repeat that the greater danger, even if rare, is not hypos but DKA, and this is why you need to be careful not to go too low carb.

Please make yourself aware of the symptoms of DKA and equip yourself with Ketostix so that you can test your urine if you feel ill.
Remember with the flozins DKA can occur without very high BGs.

www.gov.uk

SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis

Test for raised ketones in patients with ketoacidosis symptoms, even if plasma glucose levels are near-normal.
www.gov.uk www.gov.uk
 
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