Dapaglifloxin - anyone had any experience with this?

magicmoose2

Newbie
Messages
3
Just commenced on this 3 days ago - this is my second time at giving it a go. I could not tolerate it last time but determined to give it another go. I was given no information on DKA from diabetic nurse or pharmacist but being a lurker on here I've read lots of interesting and helpful comments on this drug, so feel I know what signs to look out for.

Hello, magicmoose here - for some reason I am unable to log in with my real account so have created magicmoose2 until I can rectify the issue with the forum team.

An update on my experiences with Dapagliflozin! Commenced on 29/12/18 and reduced carb intake on 02/01/19 gradually saw numbers come tumbling down in the right direction. Started to feel unwell light headed / headache a week in so as advised here got my blood pressure checked and was deemed ok. Also purchased a BP monitor to check at home and BP was perfect, not too low or too high.

Headache passed, but then I started to feel ill - I'm not normally physically ill so I knew something was not right. Four days in after abdominal pain, lower back ache, cramps in legs, headache and general feeling of confusion I checked for ketones with a ketone stick, was at ++++ next day checked again when up and same ++++ BP fine and BG in 10's.

Decided to speak to duty DN who initially thought I had a virus and advised me to stop Dapagliflozin, if symptoms continued then it was a virus, if they disappeared then blame the drug. I then mentioned the ketones and she asked me to check again and she would call back. I checked still at ++++ and so given my symptoms she sent me to A&E. I fear had I not mentioned the ketones she would have just gone with the virus idea.

Triaged in A&E blood ketones at 3.6 of course doctors were confused as BG's fairly normal, at this point reading on BG monitor was 9.2. That morning I was struggling to eat, felt sick and was nodding off in the chair - not like me. I was also incredibly thirsty and was drinking loads of water, mouth was extremely dry. When I mentioned the drug and the connection to DKA the doctor did his research and started to treat me for that. Fluids administered, bloods taken, chest x-ray (breathing was a little fast) ECG done. Spent 5 hours in A&E before being moved to ward. Spent three hours on the ward and stayed for two nights until bloods improved.

Ketones continued to increase over the next few hours, but eventually started to go down. Back home, all symptoms gone within 24 hours, Dapagliflozin stopped. No ketones showing now on stick.

I'll be honest had I not used this forum to learn of DKA with Dapagliflozin, I might have dismissed it as a virus given the time of year.
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hello, magicmoose here - for some reason I am unable to log in with my real account so have created magicmoose2 until I can rectify the issue with the forum team.

An update on my experiences with Dapagliflozin! Commenced on 29/12/18 and reduced carb intake on 02/01/19 gradually saw numbers come tumbling down in the right direction. Started to feel unwell light headed / headache a week in so as advised here got my blood pressure checked and was deemed ok. Also purchased a BP monitor to check at home and BP was perfect, not too low or too high.

Headache passed, but then I started to feel ill - I'm not normally physically ill so I knew something was not right. Four days in after abdominal pain, lower back ache, cramps in legs, headache and general feeling of confusion I checked for ketones with a ketone stick, was at ++++ next day checked again when up and same ++++ BP fine and BG in 10's.

Decided to speak to duty DN who initially thought I had a virus and advised me to stop Dapagliflozin, if symptoms continued then it was a virus, if they disappeared then blame the drug. I then mentioned the ketones and she asked me to check again and she would call back. I checked still at ++++ and so given my symptoms she sent me to A&E. I fear had I not mentioned the ketones she would have just gone with the virus idea.

Triaged in A&E blood ketones at 3.6 of course doctors were confused as BG's fairly normal, at this point reading on BG monitor was 9.2. That morning I was struggling to eat, felt sick and was nodding off in the chair - not like me. I was also incredibly thirsty and was drinking loads of water, mouth was extremely dry. When I mentioned the drug and the connection to DKA the doctor did his research and started to treat me for that. Fluids administered, bloods taken, chest x-ray (breathing was a little fast) ECG done. Spent 5 hours in A&E before being moved to ward. Spent three hours on the ward and stayed for two nights until bloods improved.

Ketones continued to increase over the next few hours, but eventually started to go down. Back home, all symptoms gone within 24 hours, Dapagliflozin stopped. No ketones showing now on stick.

I'll be honest had I not used this forum to learn of DKA with Dapagliflozin, I might have dismissed it as a virus given the time of year.
Sorry you had this experience, and thank you for sharing it with us. I am glad you are recovered now. I am glad the Forum gave you the information you needed, and that you were able to use it so well. It is indeed worrying that this family of drugs can have such significant side effects, and yet the HCP's are not properly advised on what to look for, As you say, it occurs at a BGL below what is normally associated with DKA.

Well done for having a ketone capable meter with strips to hand. I admit that although I have a meter with that capability, I do not have any strips for it. I did use this med for a short while, and was not aware of these dangers since GP et al did not inform me or warn me. Thankfully, my severe UTI was enough for me to discontinue it witin a couple of weeks so it was not a problem for me.
 
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magicmoose2

Newbie
Messages
3
Well done for having a ketone capable meter with strips to hand. I admit that although I have a meter with that capability, I do not have any strips for it. I did use this med for a short while, and was not aware of these dangers since GP et al did not inform me or warn me. Thankfully, my severe UTI was enough for me to discontinue it witin a couple of weeks so it was not a problem for me.

I didn't, I only had the ketostix to check my pee. It was triage at A&E that checked ketones with a ketone monitor when I arrived.
 

Oldvatr

Expert
Messages
8,470
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I didn't, I only had the ketostix to check my pee. It was triage at A&E that checked ketones with a ketone monitor when I arrived.
So maybe a lesson for us both? However, ketostix and ketone test strips both have a shelf life, so not a get and forget item
 

DCUKMod

Master
Staff Member
Messages
14,298
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Hello, magicmoose here - for some reason I am unable to log in with my real account so have created magicmoose2 until I can rectify the issue with the forum team.

An update on my experiences with Dapagliflozin! Commenced on 29/12/18 and reduced carb intake on 02/01/19 gradually saw numbers come tumbling down in the right direction. Started to feel unwell light headed / headache a week in so as advised here got my blood pressure checked and was deemed ok. Also purchased a BP monitor to check at home and BP was perfect, not too low or too high.

Headache passed, but then I started to feel ill - I'm not normally physically ill so I knew something was not right. Four days in after abdominal pain, lower back ache, cramps in legs, headache and general feeling of confusion I checked for ketones with a ketone stick, was at ++++ next day checked again when up and same ++++ BP fine and BG in 10's.

Decided to speak to duty DN who initially thought I had a virus and advised me to stop Dapagliflozin, if symptoms continued then it was a virus, if they disappeared then blame the drug. I then mentioned the ketones and she asked me to check again and she would call back. I checked still at ++++ and so given my symptoms she sent me to A&E. I fear had I not mentioned the ketones she would have just gone with the virus idea.

Triaged in A&E blood ketones at 3.6 of course doctors were confused as BG's fairly normal, at this point reading on BG monitor was 9.2. That morning I was struggling to eat, felt sick and was nodding off in the chair - not like me. I was also incredibly thirsty and was drinking loads of water, mouth was extremely dry. When I mentioned the drug and the connection to DKA the doctor did his research and started to treat me for that. Fluids administered, bloods taken, chest x-ray (breathing was a little fast) ECG done. Spent 5 hours in A&E before being moved to ward. Spent three hours on the ward and stayed for two nights until bloods improved.

Ketones continued to increase over the next few hours, but eventually started to go down. Back home, all symptoms gone within 24 hours, Dapagliflozin stopped. No ketones showing now on stick.

I'll be honest had I not used this forum to learn of DKA with Dapagliflozin, I might have dismissed it as a virus given the time of year.

Magicmoose - please email [email protected] describing what you experience when you try to log in with your original account. In that PM, please also provide the email address you used when you signed up with your original account.

I'm sure we can sort it our.
 

gdmwelsh

Newbie
Messages
1
Type of diabetes
Type 2
Treatment type
Tablets (oral)
hi im also on Dapagliflozin last year my levels in blood were low but this year it created up so given these has well has metformin im just wondering did any men on here have same problem slight stinging after peeing and what did gp do had water sample come back clear from infections just wondering if its just side effects
 

LittleGreyCat

Well-Known Member
Messages
4,271
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
My last HbA1c was 7.9% (mainly due to comfort eating) and the surgery are suggesting that if it doesn't improve I should go on SGLT2 inhibitors.
Checking this area of the forum for information, and getting mixed results from this thread.

First thing - I thought the main DKA risk was due to the diagnosis being very high BGL then check for ketones.
If you are peeing out a lot of glucose then you can have the high ketones without the high BGL so the diagnosis can be delayed or missed.
Are any extra ketones just due to less glucose in the blood and the need to use ketones for energy - thus a drug induced keto diet?

Secondly, does anyone have a eGFR value below which this medication should be avoided?
I am currently on a gout medication which gets urate crystals out of joints and muscles and so increases the urates in the blood and thus gets them flushed out through the kidneys.
I'm a bit wary about having two drugs which both rely on extra work from the kidneys.

Edit: the reference which warns about DKA has the following paragraph about risk factors:
"
  • a low beta cell function reserve (eg, patients with type 2 diabetes who have low C-peptide levels, latent autoimmune diabetes in adults [LADA], or a history of pancreatitis)
"

Given this, did anyone have their C-peptide levels checked before being prescribed SGL2 inhibitors?
In my case - slim T2 - I suspect that I may not be producing a lot of insulin but apart from a private check for insulin resistance a good few years back I have never had any check on insulin production.
Think I will give this a separate thread.
 
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