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dapagliflozin and raised blood glucose

S

sparky2000

Member
Messages
5
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi all,

After a few years on Metformin I became fairly intolerant of it and it has been recently swapped for dapagliflozin.

My blood glucose on metformin was usually around 6 ish. It rose to about 12 after a three month break. I have just started on Dapagliflozin this week and after three days on dapagliflozin my blood glucose has shot up to a morning fasting 15 and even higher this afternoon.

As it’s a Friday I am going to give it the weekend to see if it settles down before contacting the practice nurse but has anyone else seen a similar rise in starting dapagliflozin?
 
As an update to the above…

After starting on dapagliflozin and my blood glucose shooting up to nearly 20 it dropped back down to around 10 to 12 which is around the same as it was three months after dropping metformin and before starting dapagliflozin.

So after two weeks on dapagliflozin it doesn’t seem to be that effective for me. I do notice an increased thirst and more frequent visits to the loo!

I will get the holiday out of the way and have a word with the diabetic nurse but I would be interested in your experiences in starting with dapagliflozin and it’s effectiveness for you.

Sparky
 
Welcome to the forum. I’m sorry no one has replied but I guess everyone is otherwise engaged at the moment!
I’m afraid I don’t have experience of Dapagliflozine, but thought I’d ask what your diet is like normally? You may be able to adjust your diet to help reduce your sugar levels?

Edit for typo
 
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Hi Rachox, Thanks for the welcom.

I would say my diet is usually pretty good and not too carb heavy. I was diagnosed about ten years ago and went through the usual diet changes and a few changes of meds to get me where I am now so I think diet is being managed ok. At least our diabetic nurse didn’t raise any issues at my last review.

Sitaglyptin, metformin and diet brought my fasting glucose down to about six to seven (weight about 11st 5, so ok for a male my size). The metformin was stopped for three months as really struggled with upset stomach and bowel and it was swapped out for dapagliflozin.

After the three month break my glucose was up to about 12 which was about as I expected. Once I started on dapagliflozin it seemed to shoot up to 14 with occasional daytime readings reaching almost 20. Although it’s still early days I haven’t seen a fasting glucose reading lower than about 10.5. It does seem to be having an effect on other things as I am always thirsty now and need more frequent trips to the loo.

Its still early days but rather than wait for my three month HbA1c reading I probably need a conversation with the practice nurse, but I was just wonder what experiences other had when starting out with dapagliflozin in case I am expected too much too soon.
 
From what I know Metformin doesn’t affect blood glucose levels directly, what it does is reduce the amount of sugar your liver chucks into your blood stream, so stopping it could account for your fasting levels being higher as your liver likes to predict you getting up and ‘helps’ with more glucose. It called dawn phenomenon.
I’m not sure of all of effects of dapagliflozin but it’s basic mode of working is to make your kidneys pee out more sugar, hence the more peeing and therefore increased thirst you are experiencing. Again I don’t have experience of this drug.
In the meantime, could you tell us a typical days eating (not Xmas eating!), we may be able to help with a few tweaks, those pesky carbs often lurk where we least expect it.
 
Not sure how much this helps but I found Dapagliflozin Great for my Bloods Sugars. I was taking it in conjunction with Metformin, I only stopped it due to the repeat UTI's. Hope you get it sorted soon.
 
I got put on these back in September and only negative is I've had 2 kidney infections and definitely learned to keep drinking fluids ill be having my bloods checked to see if my hba1c have dropped but also diet for me plays a big part carbs at mo is a big no no as I'm less active being non weight bearing due to charcot.
 
I was put on Dapagliflozin when first diagnosed.
GP was very insistent I drank plenty of water, at least 2 litres a day.
And to be meticulous about hygiene to prevent uti.
Changed to low carb diet, plenty of exercise and 3 months later hba1c had dropped from 87 to 38.
Had no problems with the Dapagliflozin, but I did drink 2 litres plus a day.
Meds stopped after 3 months.
 
Update 2…..

After developing a raging thirst and many, many visits to the loo I saw the diabetic nurse and after a finger prick test (25 three hours after toast for breakfasts!) she felt I wasn’t responding to dapagliflozin well.

So now I am startling on gliclazide along with my usual sitagliptin. The nurse did suggest that this may not work as she suspects my insulin stores my be depleted and the next step would be referral to check this.

I haven’t seen any bg improvement yet but it’s only been a couple of days Fingers crossed that this and cutting down carbs a bit will help.
 
sparky2000 said:
Update 2…..

After developing a raging thirst and many, many visits to the loo I saw the diabetic nurse and after a finger prick test (25 three hours after toast for breakfasts!) she felt I wasn’t responding to dapagliflozin well.

So now I am startling on gliclazide along with my usual sitagliptin. The nurse did suggest that this may not work as she suspects my insulin stores my be depleted and the next step would be referral to check this.

I haven’t seen any bg improvement yet but it’s only been a couple of days Fingers crossed that this and cutting down carbs a bit will help.
Click to expand...
What do you eat each day? Perhaps you could you post your food intake each day and members might be able to help that way.
 
sparky2000 said:
she suspects my insulin stores my be depleted and the next step would be referral to check this.
Click to expand...
I would push for a referral to see how much insulin you produce, a C-peptide test.
I'm not sure what she meant by 'depleted insulin stores' (insulin is not a stored thing, it's produced on the spot as needed), but if you're not producing enough you may have a different type of diabetes.
Did she test for ketones when you were at 25?

Do you check blood glucose at home? What are your fasting levels like, and what kind of numbers do you see after a low carb meal instead of toast?

Should you develop any of the following symptoms with high BG: belly ache, nausea, vomiting, a funny smell to your breath, often described as fruity or pear drops, or a funny way of breathing, seek medical advice right away.
 
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Thanks for the replie, they are very helpful.

No problem with ketones, it was 0.2 when she took the bg test of 25. No signs of any acidosis symptoms either.

Fasting bg today was 12. It went up to 19 two hours after two slices of toast. After a lunch of a tin of cream of chicken soup, no extra carbs, it was still 18.

When I was taking metformin my fasting bg was between 5 and 7 so it was effective with my current diet at the time. Sadly I became very intolerant of it, hence the changes. I will be pushing for a referral and although I don’t have a carb heavy diet I will explore cutting back more.
 
sparky2000 said:
two slices of toast. After a lunch of a tin of cream of chicken soup, no extra carbs,
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Either of those would be way too many carbs for me, giving me high levels too.

Try eggs of greek yoghurt for breakfast and protein and green veg or salad instead of the soup, a tin of tuna perhaps
 
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