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Anyone on the Ascend Plus trial?

Are you sure? Its up to you but hold the tablet longer in your mouth and see if then it tastes bitter. If you look back in some posts some people thought it was the placebo then changed their minds. A good indicator is if you do a blood sugar test as if you are on the placebo you sugar will be higher. Good luck.
 
I’m nearly a month in on the 14mg .. I’m sure it’s the placebo as my appetite is back in the evenings , no hypos I was getting some low sugar symptoms but the pill is still bitter. My weight has stayed half a stone below my usual stable pre trial weight so I don’t know ‍. I think I’ll carry on with it anyway. I did wonder if there was a clue on the pill container. They must have a means of identification I wondered if it was the box on the label mine has an X in it
 
Poor you! It does sound as though maybe the trial isn't for you - I believe it isn't for everybody. If you ring them up, I'm sure they would be very sympathetic and advise you to stop. You gave it your best shot, but it wasn't for you!
 
I realised I was on the placebo, and stopped the trial, although I am continuing to fill in the questionaires.

My GP practice prescribed the Rybelsus to me after seeing what a difference it, combined with low carb and exercise, made to my BG and also in terms of weight loss and better liver results. 6 months on from starting the intial run in for Ascend Plus, I am still on the 7mg and have lost 42lb and brought my BG down a lot - I am due to have another HbA1c in a couple of weeks at the 3 month point from the GP practice prescribing Rybelsus and hope to see another drop in HbA1c and a further improvement in the liver results. At this point they may increase the dose to 14mg.
 
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I received my Ascend medication in the post on Saturday. Now I have it, I’m getting the jitters about the side effects. How bad is the nausea, does it wear off during the day? Is vomiting common? The reason I’m asking is, I have a small umbilical hernia and am a bit concerned that if I’m putting strain on my stomach through being sick it could make matters worse. I think I’m just a bit nervy
 
I think it affects people differently, I only get the sickly feeling if I eat or drink the wrong things.
 
Sweet things , some fizzy drinks and some spicy food. Like I said it affects people differently but if you google the medicine you can read the side effects and things to avoid. Good luck.
 
Hi, so started the trial on Nov 7th 2025, just had my Diabetic review, my levels have dropped from 48 to 46 HbA1c, I don't know exactly if i have lost weight but my tummy region feels not so bloated, I have had problems with going the loo, all or nothing basically but I can cope with that, I recently completed my questionnaire on line and then received my 6 months supply, the tablet does taste bitter so guessing I am on the medication rather than the placebo. When I eat my evening meals it feels like (when you put fuel in the car and it clicks as the tank is full) that's how I feel .. that did not happen before. So I am moving forward on a positive note, I don't expect to drop Kilo's fast, I just want to slowly but surely lose a few Kilo's (not time restraint) if I go out for meal I have a treat, but day to day be careful on my choices and lets see how this goes for the next five years ..
 
RAD123 said:
Sweet things , some fizzy drinks and some spicy food. Like I said it affects people differently but if you google the medicine you can read the side effects and things to avoid. Good luck.
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Same here especially the diet sugar free fizzy drinks, Savory snacks etc, interesting the pill is communicating with our brains to say no and find an alternative !!
 
It is a scary process I know, I felt the same however, after my results from my Diabetic health check came back I had dropped from 48 to 46 HbA1c, so that gave me a boost, I don't jump on the scales often but I do feel my tummy region is smaller .. who knows
 
I'm 30 days into the placebo/14mg process. I got on fine with the 3mg/7mg doses with no side effects that I could clearly blame on the meds. I lost about 3 kilos which I think is ideal for me. I didn't want a rapid weight loss, so around 1kg a month would suit me fine on an ongoing basis. My Libre glucose sensor showed I was within range 99% of the time, compared to sub-90 beforehand. I felt less desire to eat but enjoyed my food (smaller portions) and I developed a bit of a sweeter tooth which I could indulge without guilt. It was a great thing to be on over Xmas - I ate a little of everything I fancied but wasn't over-eating. I didn't detect a bitter taste to the pills and I didn't get the evil burps that others have mentioned.

I don't know if I'm on the placebo or not. My weight is slowly increasing and my glucose is back down to (just checked) 85% in range. My desire for food is back to pre run-in times. I can no longer eat whatever I want and get away with it. I haven't done the "bitter taste test" of my new pills so will try that tomorrow. The reason for not being entirely sure of what I'm on is that I had a stubborn chest infection for most of January which would have raised my glucose levels anyway.

I want to be on the real meds. I'll wait a bit to see if my glucose improves, post-infection, then I will talk to my GP. If I have no luck I'm prepared to pay for it privately (if I can), as I feel the health benefits will be worth it. I so enjoyed the temporary relief of anxiety/stress from being the "naughty patient" who can't control their blood glucose etc etc . I don't feel listened to when I try to give my analysis of what affects me and what doesn't. My GP surgery isn't interested in my Libre 2 data, which is a shame as many meds that they've tried me on (statins etc) raise my blood glucose, and I feel I'm not given the opportunity to properly weigh up the pros and cons if I report that side effect, and I rarely feel that I have any credibility despite my data. So these types of meds would give me an easy way to achieve more autonomy and reduce my contact with the NHS.
 
I have been on the placebo or 14mg for the last 6 months, my bloods and blood sugar have improved so much they have taken me off metformin. So if you feel you are on the placebo it will show on your next bloods and if you are putting weight back on and feel worse you are most likely on the placebo. So my advice is, your health is more important than anyone else's, so tell your diabetic nurse you want the real medication and I am sure they will prescribe it for you and come off the trial.
 
I'm now pretty sure I'm on the real thing, although the pills don't taste bitter. A month in and my appetite hasn't returned - I do sometimes feel hungry, but it does vary. I've learnt only to serve myself a small helping of any meal, rather than having to stop half way through! I have stopped feeling sick, thankfully, but at the other end I'm swinging between constipation and diarrhoea, which is a nuisance, but I gather not unexpected. I also have rather bad wind on occasion (sorry, TMI).

However, I am slowly but steadily losing weight, which pleases me enormously, especially as I am no longer "obese" but merely "overweight". I'm in no rush to reach my goal weight, but hope I will be able to do so.
 
Katy56 said:
Bristol/Bath area, will post after my appointment
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Hi @Katy56 how did your appointment go? I’m currently still on 7mg run in phase and it’s working quite well for me apart from some mild nausea and overwhelming fatigue…. BS right down and I have lost a few pounds. Not far off ideal weight. Don’t really want to increase this dose so interested to know if you managed to get it prescribed? If so who by. I’m near Bristol. Thanks v much!
 
Sadly, many practices, including mine, reserve semaglutide, whether oral or injectable, for those who "really, really need it", according to my GP. I think you have to be very seriously obese and/or have other life-threatening conditions before they'll even think of it. I am quite sure that if I found I was on the placebo (still not more than 80% certain that I'm not), I wouldn't be able to get it from my GP.... Alas....
 
I think the key here is that you should be talking about blood sugar control and not weight loss. If you are on the Ascend Plus trial it is for people with Type 2 diabetes. There are also more effective drugs for weight loss available through private prescription.

Rybelsus is not allowed to be prescribed for weight loss on the NHS, but it is prescribed for blood sugar control in type 2 diabetics, so you would not help your case by talking about weight loss, although that might happen, it also might not and is not a reason for them to prescribe the Rybelsus according to NICE guidelines, and also the use of Rybelsus for weight loss is off label.

The NHS is allowed to prescribe Wegovy (semaglutide) and Mounjaro (tirzepatide) for weight loss as far as I know, but it would be for people with a high BMI and with other co-morbidities, which rules many people out, and is subject to both the NICE and the local guidelines.

I was prescribed Rybelsus after requesting it at my GP practice on realising that I was on the placebo. Also pertinent to this is that I had tried Metformin and could not tolerate it, and that I would not be able to take any SGLT 2 inhibitor drugs as that would be the next line they would try, as I am on a low carb diet, and there can be a risk of DKA if you are low carb on SGLT2 inhibitor drugs. I was not prepared to up the carbs in my diet as the low carb approach was having a huge effect on both weight loss and bringing the blood sugar down.

I did the research and got ready to make my case with a list of reasons why I should be prescribed Rybelsus, but just looking at my results for blood sugar control (from my CGM) while I was on the run in and then the placebo was enough for them to prescribe the Rybelsus, and they are happy to carry on after my excellent HbA1c result this month after 3 months of the prescribed Rybelsus. See my signature for the results.

I have also lost weight, but this is mainly because of my low carb diet and exercise, and not really as much to do with the Rybelsus - the big effect the Rybelsus had was on my blood sugar, and in normalising my insulin response, and helping with the fatty liver.

It has been decided to keep me on the 7mg dose as this is working well to control the blood sugar numbers.
 
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I'm glad for you. Metformin seems to suit me very well and (I think) keeps my blood sugar under control; I don't test it at home or anything, and the GP only does once a year, but last year it was, "Keep on doing what you're doing". So they probably wouldn't prescribe Ryselsus on top, or even in addition - they wouldn't let me have the 1mg Metformin as it was so much more expensive than the 500mg.
 
You could be right - as you will see from my signature I had a very high HbA1c, and it came down dramatically with the run in for the Ascend Plus trial and with lifestyle changes (low carb and exercise, and has continued to fall dramatically after the prescription was made in November.

They are allowed to prescribe more than one drug for blood sugar control, but they will have guidelines about where the target HbA1c needs to be and would probably only be prescribing another drug if the the HbA1c was above the target number, unless there were other benefits to prescribing an additional drug. They will have the NICE guidelines, and perhaps local guidelines that they have to follow.
 
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