Concerning Dapagliflozin and weightloss

[Angela64]

Interesting thread as when I went for my last review the DN, a new one I hadn't seen before, asked why I was taking insulin - as if I had decided to do it myself!! She put me on Dapagliflozin, though I was apprehensive after reading about all the potential side effects, and UTI's being common in 10% of cases! I was weaned off insulin over 3 weeks, and my blood sugars are more stable than before, but I use a CGM and the readings from sensor to sensor very unreliable. I changed to a new sensor on Sunday and already my average, with no diet change, is one whole unit higher (up from 6.8 to 7.8), and my time in range down from 100% to 89%! I prefer the CGM to finger-pricking, but wish it was more consistent when you change to a new sensor.
I have not changed my eating habits, but have lost 3.5 kgs in 6 weeks, probably due to peeing every hour now!

Is that a Libre CGM? They have become very unreliable and I’ve changed to Dexcom which you can calibrate which is useful.

 

[Angela64]

The prescription was sent before the annual blood test results arrived, as far as can work out as the surgery doesn't like to give out information since it became part of a group a couple of years ago now, so it is difficult to get access.

The policy does seem to be to put all type 2 diabetics on Dapagliflozin no matter how well they are doing, but I got no advice, or even a warning about Dapagliflozin and low carb eating. By making a series of adjustments, eating more carbs, spreading them through the day, not fasting for long periods, I feel fine most of the time, but I have to stick to the requirements, I can't decide to eat after morris practice because I'm running late or I go wobbly

I’ve written about my experience, I wasn’t forewarned about the Dapagliflozin and was just prescribed it without consultation and I follow a Low carb diet since diagnosis!

 

[Resurgam]

An interesting side effect.
I have the most dreadful cold and cough at the moment so I am feeling fragile and a couple of days ago I needed to eat something with carbs to raise my blood glucose, as I had not eaten much at dinner, and my husband saw me and was very rude - he is not used to seeing me eating crackers.
I know perfectly well that he's not firing on all cylinders these days - but I then spent the rest of the night awake and upset.
On reflection I am sure that the strength of my response was in part due to the negative experience I have had over the years with HCPs being nasty when I did not respond as they expected to their advice on losing weight - as in I didn't, plus I have Viking blood and a fearsome temper.

My hammer, axe and the Gras bayonet remain exactly where they are usually kept, my husband remains uninjured and oblivious to his suicidal error of judgement - after 47 years of marriage I'd have thought he'd have developed some sense of self preservation.

 

[MrsA2]

An interesting side effect.

Side effect of what? I, and several friends swear that spousal murderous thoughts are quite natural in later life. Those on hrt swear the thoughts go away while they are the medication but come straight back when off it.
Just saying...

 

[Davidden]

Is that a Libre CGM? They have become very unreliable and I’ve changed to Dexcom which you can calibrate which is useful.

Yes, sorry for the delay in replying. I changed to a new sensor on Monday this week, and my average is dropping on the new one - it wasn't bad on the old one! Not sure if my GP practice will support to Dexcom, I am due a review in about 6 weeks, so will ask then.
I was referred to a programme here called "Choose you", as I was concerned about exercise - various "ailments" make it difficult/impossible for me to do anything high impact/requiring 2 arms/too strenuous/etc. I opted for the online version and am now part of the Second Nature programme. I am using a treadmill at home for at least 10 minutes a day, but have not made any dietary changes, as I already (by their criteria!) follow a good one. I have lost 0.9 kg since starting (10 days ago on the preparation phase, and this week on the "reset" phase), and 4.5 kgs on Dapagliflozin in total, and will persevere - walking looks to be my only option, so need to get off my butt and get outdoors. The bulk of the programme appears to concentrate on food, and has not taught me anything new - today's "read" was about alcohol, and since I don't drink, not of much use!

 

[ChrisG90]

I started Dapagliflozin on 25th September 'to protect heart and kidneys' and have had to increase my intake of carbs as I was going wobbly mid afternoons but once I compensated for that I was feeling much better, but I noticed that I have not been eating as much and also that I have been losing weight.

Having tried to eat less in the past and just felt dismal and weak I am surprised at the reduction in appetite, but I am also seeing quite a drastic loss in weight.

I can't bring myself to get an actual weight - I think that I have been through too much trauma for not losing weight when other people were directing how I ought to eat, but I can set my scales to read one Kg when I step on them, but I have needed to reset them three times over the last fortnight - so I have lost at least 3Kg in 2 weeks.
I believe that is rather more than the suggested normal effect of the tablets.

There seems to be a big push to put diabetics on Dapagliflozin at the moment, so I wondered if anyone else has noticed weight loss to any great extent.

In the past I have struggled to lose weight except when eating low carb, and my weight and size have both reduced little by little since diagnosis, but I am wondering if the Dapagliflozin is somehow pushing the right buttons or overriding the settings I have struggled with all my adult life.

My husband has now lost 2 stone since May,! Weight loss tests carried out and all ok. I did read an article from a few years ago that said any weight loss with Dapagliflozin usually settles at about 6 months. He saw the Diabetic Consultant 3 weeks ago and was told weight loss is expected but if it continues to return to GP!

 

[Resurgam]

The coughing is getting quite bad.
I have decided not to take the Dapagliflozin until I feel better and start to eat properly again. The diuretic effect, and reduction in energy levels on top of a nasty cough and cold is more than I can deal with now - and I am not eating - the coffee from this morning is still sitting on the desk almost untouched.
I have tried several different cough mixtures and none have had much effect. I ache from coughing so hard and so long.

 

[Pipp]

Some horrible viruses about @Resurgum.
I would imagine needing to pee more frequently and coughing are not a good combination. Get well soon.

Is it safe to take breaks from Dapagliflozin? Do you need to titrate the dose gradually when you start?

I wasn’t offered Dapagliflozin at my review last week. I guess it is another postcode lottery?

 

[Resurgam]

Some horrible viruses about @Resurgum.
I would imagine needing to pee more frequently and coughing are not a good combination. Get well soon.

Is it safe to take breaks from Dapagliflozin? Do you need to titrate the dose gradually when you start?

I wasn’t offered Dapagliflozin at my review last week. I guess it is another postcode lottery?

Even with no Dapagliflozin today there have been a couple of close calls.

I think that continuing to take the tablets and not eating is a far more dangerous situation than stopping them - I really have zero appetite so I have an apple sitting untouched on the desk - that is a real red flag. I grew up in a house with an orchard, 120 apple trees and I have never been truely unable to eat an apple ever since - until now.

My nick name in my younger years was 'No Fear' - I didn't have to try to live up to it.

 

[Angela64]

Yes, sorry for the delay in replying. I changed to a new sensor on Monday this week, and my average is dropping on the new one - it wasn't bad on the old one! Not sure if my GP practice will support to Dexcom, I am due a review in about 6 weeks, so will ask then.
I was referred to a programme here called "Choose you", as I was concerned about exercise - various "ailments" make it difficult/impossible for me to do anything high impact/requiring 2 arms/too strenuous/etc. I opted for the online version and am now part of the Second Nature programme. I am using a treadmill at home for at least 10 minutes a day, but have not made any dietary changes, as I already (by their criteria!) follow a good one. I have lost 0.9 kg since starting (10 days ago on the preparation phase, and this week on the "reset" phase), and 4.5 kgs on Dapagliflozin in total, and will persevere - walking looks to be my only option, so need to get off my butt and get outdoors. The bulk of the programme appears to concentrate on food, and has not taught me anything new - today's "read" was about alcohol, and since I don't drink, not of much use!

I was diagnosed in 6/2021, I had the DiabetesUK training course which I found really good. I decide to follow a Low carb, high protein diet. I want to avoid taking insulin for as long as possible. Not everyone can do this diet as it might not be compatible with some medications mind.
I exercise, I swim usually, I have a X-trainer at home which can be good but generally I visit a Gym with Spa that has pools. I have bought myself some ‘kit’ some exercise bands and a ring, these are for Pilates and help with strength training. I do have some wrist and ankle weights, used sporadically.

 

[Angela64]

An interesting side effect.
I have the most dreadful cold and cough at the moment so I am feeling fragile and a couple of days ago I needed to eat something with carbs to raise my blood glucose, as I had not eaten much at dinner, and my husband saw me and was very rude - he is not used to seeing me eating crackers.
I know perfectly well that he's not firing on all cylinders these days - but I then spent the rest of the night awake and upset.
On reflection I am sure that the strength of my response was in part due to the negative experience I have had over the years with HCPs being nasty when I did not respond as they expected to their advice on losing weight - as in I didn't, plus I have Viking blood and a fearsome temper.

My hammer, axe and the Gras bayonet remain exactly where they are usually kept, my husband remains uninjured and oblivious to his suicidal error of judgement - after 47 years of marriage I'd have thought he'd have developed some sense of self preservation.

I am lucky that my husband is very supportive and helps when shopping by looking for the ‘carb’ values on things.
You can read below that I eat Low Carb so won’t repeat it.
I get SO angry with the so called professionals at my surgery critisising me when they know nowt about how I manage my T2D. You’ve been married same length of time we have but I’ve known mine since I was 17! You know we’d get less for murder )
Hubs is now diabetic too, he was heading that way for a while, I think its inherited from his parents but also exacerbated by his eating style. He eats what I have but more relaxed, that might change, who knows.

keep your spirits up xxx

 

[Resurgam]

@Angela64 My husband has completely forgotten the incident and I am learning in my 70s that some things don't need to be kept in mind. He's been warned about his blood glucose levels a coup[le of times and then forgotten about it - but I am definitely watching that on his behalf.
I think that I am getting over the cough - I checked my blood pressure and saw that my pulse rate is back to normal so I will probably restart the Dapagliflozin in the next few days.
Switching back to low carb eating has not been difficult and my pot of test strips arrived and I took a check of BG just now - 7.3, though I have not eaten or drunk anything but water all day and it is almost 21:00. People do worry about my ability to fast and remain calm about it, but when I don't eat carbs I don't feel hungry.