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Dapaglifloxin - anyone had any experience with this?
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<blockquote data-quote="LittleGreyCat" data-source="post: 2659135" data-attributes="member: 6467"><p>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.</p><p>Checking this area of the forum for information, and getting mixed results from this thread.</p><p></p><p>First thing - I thought the main DKA risk was due to the diagnosis being very high BGL then check for ketones.</p><p>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.</p><p>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?</p><p></p><p>Secondly, does anyone have a eGFR value below which this medication should be avoided?</p><p>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.</p><p>I'm a bit wary about having two drugs which both rely on extra work from the kidneys.</p><p></p><p>Edit: the reference which warns about DKA has the following paragraph about risk factors:</p><p>"</p><ul> <li data-xf-list-type="ul">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)</li> </ul><p>"</p><p></p><p>Given this, did anyone have their C-peptide levels checked before being prescribed SGL2 inhibitors?</p><p>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.</p><p>Think I will give this a separate thread.</p></blockquote><p></p>
[QUOTE="LittleGreyCat, post: 2659135, member: 6467"] 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: " [LIST] [*]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) [/LIST] " 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. [/QUOTE]
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