Coming off trulicity

[kerina]

Hi I have been on trulicity for the last 14 months. My a1c was 111 to start and came down to 44. I did suffer all the usual side effects but persevered and also lost 16kg.
My daily blood sugar readings were good but have overall jumped up 2 points. The lowest being 7 and the highest I get is 9.7.
I have continued a low carb diet and I take 2000mg of metformin. It has been 3 weeks off trulicity, do you think it will settle down again?

 

[SimonCrox]

That is an impressive HbA1c reduction - well done.
But if you are doing the same as before (diet plus metformin) except have stopped one agent (trulicity) and your glucose levels have risen, then they are unlikely to go back down again unless you do something such as restart trulicity or start something else such as a gliptin or SGLT-2.
best wishes

 

[bulkbiker]

Hi I have been on trulicity for the last 14 months. My a1c was 111 to start and came down to 44. I did suffer all the usual side effects but persevered and also lost 16kg.
My daily blood sugar readings were good but have overall jumped up 2 points. The lowest being 7 and the highest I get is 9.7.
I have continued a low carb diet and I take 2000mg of metformin. It has been 3 weeks off trulicity, do you think it will settle down again?

When you say low carb... do you have an idea about how low carb you are?
It may be that cutting carbs a bit more may help bring your numbers down a bit?

 

[kerina]

When you say low carb... do you have an idea about how low carb you are?
It may be that cutting carbs a bit more may help bring your numbers down a bit?

Hi, I don't count carbs but have cut out pasta, bread, rice and all processed foods. I have very limited root veg and mainly eat eggs, fish cheese and chicken. Salad veg and greens.

 

[kerina]

That is an impressive HbA1c reduction - well done.
But if you are doing the same as before (diet plus metformin) except have stopped one agent (trulicity) and your glucose levels have risen, then they are unlikely to go back down again unless you do something such as restart trulicity or start something else such as a gliptin or SGLT-2.
best wishes

Thankyou. I am just so disappointed as didn't want to go back on trulicity as it's quite a brutal drug. I was just hoping that my numbers would settle down again. No spikes so thinking my diet is ok but higher than it should be to start.

 

[DCUKMod]

How long have you been off Trulicity, @kerina ? Sometimes when we make a change, it can take a little while for our body to adjust to it. Don't lets forget that a finger prick test is a real snapshot of what's going on.

If you feel your numbers are staying up too long, then in your shoes, I'd ask for another A1c test (at least 6 weeks after the last), to assess that.

If your A1c has gone up by a modest amount, then you could consider if there's anything else you could do to impact it, rather than pick up the additional meds.

If, at that stage your numbers have drifted up more than both you and your Doc would like, then a tweak of meds could be a good idea.

Bearing in mind there are over 400 options for treating T2, it could be your Doc would try you on something else. To be clear, the 400 number is meds and combinations of meds, so not 400 different tablets or injections.

Whatever you do though - don't panic!

 

[kerina]

How long have you been off Trulicity, @kerina ? Sometimes when we make a change, it can take a little while for our body to adjust to it. Don't lets forget that a finger prick test is a real snapshot of what's going on.

If you feel your numbers are staying up too long, then in your shoes, I'd ask for another A1c test (at least 6 weeks after the last), to assess that.

If your A1c has gone up by a modest amount, then you could consider if there's anything else you could do to impact it, rather than pick up the additional meds.

If, at that stage your numbers have drifted up more than both you and your Doc would like, then a tweak of meds could be a good idea.

Bearing in mind there are over 400 options for treating T2, it could be your Doc would try you on something else. To be clear, the 400 number is meds and combinations of meds, so not 400 different tablets or injections.

Whatever you do though - don't panic!

Thankyou, I'm trying not to panic too much. It has only been 3 weeks that I have been off trulicity so maybe things will take time to adjust. My a1c of 44 was last month and my doctor wants to retest in January.

 

[DCUKMod]

Thankyou, I'm trying not to panic too much. It has only been 3 weeks that I have been off trulicity so maybe things will take time to adjust. My a1c of 44 was last month and my doctor wants to retest in January.

I would suggest, if you think things are changing you could be justified an earlier test to avoid anything too drastic happening, in terms of your A1c.

Whilst 3 months is a pretty routine time gap between A1cs, the results are very much skewed to recent weeks. I know of one very well respected GP who repeats A1cs after 4-6 weeks for newly diagnosed folks, managing with diet and exercise, as that's enough to begin to show the impact of dietary changes.

The worst thing that could happen is your GP could refuse, then you are in the position you are now- test in January.