Dapagliflozin

[Nometype1andproud]

Hello folks I've been prescribed this to try and counteract insulin resistance and crazy weight gain. I cannot tolerate metformin and hba1c shot up from 65 to 77 and 2 stone weight gain in last year.

Any success stories?

 

[TypeZero.]

Hello folks I've been prescribed this to try and counteract insulin resistance and crazy weight gain. I cannot tolerate metformin and hba1c shot up from 65 to 77 and 2 stone weight gain in last year.

Any success stories?

I never used anything apart from insulin but have been doing tonnes of research.

Dapagliflozin may cause urinary tract infections because the glucose concentrations of your urine increases so watch out for that.

 

[lessci]

I'm a type 2, on Dapagliflozin, @TypeZero is right, drink, drink and drink some more, at 1st you'll never be away from the loo, but your body does get used to being more hydrated, 6 years & not one dose of thrush (you watch me get one now ), it can also cause (rare in t2) DKA with no symptoms especially if you follow a low carb way of eating

 

[TypeZero.]

I'm a type 2, on Dapagliflozin, @TypeZero is right, drink, drink and drink some more, at 1st you'll never be away from the loo, but your body does get used to being more hydrated, 6 years & not one dose of thrush (you watch me get one now ), it can also cause (rare in t2) DKA with no symptoms especially if you follow a low carb way of eating

Did you lose any weight since you’re technically urinating the sugar out?

Also do you take it before every meal or like once a day

 

[NicoleC1971]

If you have double diabetes i.e. both insulin resistant AND needing to inject insulin then I'd have thought some of the dietary advice offered to the classic insulin resistant type 2s would be appropriate i.e. to reduce carbs (and bolus obviously). Did your team mention this as an option?
This drug works by getting you to pee out some of your glucose (developed from observing how untreated type 1s excrete glucose!) but if you imagine how high your glucose goes when you do not inject insulin and even when not eating I think the doctors are expecting too much from this drug and as has been pointed out it comes with side effects.
If you can turn off the glucose tap by eating a little less bread, pasta, rice and avoiding sugar that might be a lot more effective than just the drug by itself. Sorry that I don't have any type 1 experience with this class of drug other than a type 2 friend who took it and managed to shed a little weight but not much.

 

[lessci]

Did you lose any weight since you’re technically urinating the sugar out?

Also do you take it before every meal or like once a day

I take 1 10mg tablet once a day (first thing for me, but I don't think it matters when you take it) When I was just on that and metformin I was losing, but they've put me back on the gliclazide too, which prods your pancreas to make more insulin, that kind of counteracts it (but I've not put any back on which is a bonus, the 1st time they had me on the glic I gained almost 2 stone in a month without changing any of my eating habits), it is a bit of an appetite suppressant too, but I can eat when I'm not hungry!

 

[Nometype1andproud]

If you have double diabetes i.e. both insulin resistant AND needing to inject insulin then I'd have thought some of the dietary advice offered to the classic insulin resistant type 2s would be appropriate i.e. to reduce carbs (and bolus obviously). Did your team mention this as an option?
This drug works by getting you to pee out some of your glucose (developed from observing how untreated type 1s excrete glucose!) but if you imagine how high your glucose goes when you do not inject insulin and even when not eating I think the doctors are expecting too much from this drug and as has been pointed out it comes with side effects.
If you can turn off the glucose tap by eating a little less bread, pasta, rice and avoiding sugar that might be a lot more effective than just the drug by itself. Sorry that I don't have any type 1 experience with this class of drug other than a type 2 friend who took it and managed to shed a little weight but not much.

I'm on an insulin pump, I carb count 24/7 due to being on the pump so am well aware of my carb sensitivity. I was merely after other peoples experience of this particular medication due to my current position. Thank you for your reply though

 

[Nometype1andproud]

I never used anything apart from insulin but have been doing tonnes of research.

Dapagliflozin may cause urinary tract infections because the glucose concentrations of your urine increases so watch out for that.

Yes, I had the list of negatives given to me today by my consultant . Increased uti’s, thrush and increased risk of dka hence why I was after positive stories

 

[lucylocket61]

I'm on an insulin pump, I carb count 24/7 due to being on the pump so am well aware of my carb sensitivity. I was merely after other peoples experience of this particular medication due to my current position. Thank you for your reply though

the point is surely that if you reduce your carb intake you reduce the sugar levels in your blood and may not need additional meds to deal with those levels? You can adjust your insulin to compensate for lower carb levels. That is what one of my T1 friends does.

 

[NicoleC1971]

I'm on an insulin pump, I carb count 24/7 due to being on the pump so am well aware of my carb sensitivity. I was merely after other peoples experience of this particular medication due to my current position. Thank you for your reply though

Also on a pump and carb count (but lazily) to avoid weight gain and creeping up of insulin needs. I hate carb counting so my lazy approach is to avoid them as much as possible! Just something you may want to consider and if you do take the sglt2 inhibitor type drug I'd be interested to know how you get on!

 

[Nometype1andproud]

the point is surely that if you reduce your carb intake you reduce the sugar levels in your blood and may not need additional meds to deal with those levels? You can adjust your insulin to compensate for lower carb levels. That is what one of my T1 friends does.

I'm resistant to the insulin I'm taking in whatever amount I need I'm needing increasing amounts to what I used to need regardless of the number of carbs the problem still exists. I'm on a pump so it's very refined anyway I don't and never have been carb heavy as I am very sensitive to carbs already this will help me against the resistance which is why I was interested in peoples replies on that particular medication.

 

[Nometype1andproud]

Also on a pump and carb count (but lazily) to avoid weight gain and creeping up of insulin needs. I hate carb counting so my lazy approach is to avoid them as much as possible! Just something you may want to consider and if you do take the sglt2 inhibitor type drug I'd be interested to know how you get on!

I don't have a particularly carb heavy diet to begin with and since improving my hba1c I am healthier on paper but a **** sight bigger and now the resistance I have a max 200g carb a day at my most

 

[NicoleC1971]

I don't have a particularly carb heavy diet to begin with and since improving my hba1c I am healthier on paper but a **** sight bigger and now the resistance I have a max 200g carb a day at my most

So the average diet has about 240g a day so you're right to say your diet isn't carb heavy but is higher than what I'd eat as a low carber (about 90g a day max.) and yet you're needing more insulin to cover it which then needs you needing more and more. A good analogy is the clothes are the carbs your insulin/you is trying to stuff into an overfilled suitcase (your cells). Some people have less room in their cells than others and others can use huge amounts of insulin but simply get fatter without being insulin resistant. As a type 1 you are obviously very aware of what you eat plus the amounts of insulin you're injecting.
I am not trying to get you to eat a lower carb diet or criticise what you are doing but just trying to open your mind to the idea that eating more protein and fat but less carbs may help you reduce your insulin resistance better than drugs alone. The hba1c is only 1 part of your results because if you're insulin resistant and having to take more insulin then this is linked to cardiovascular risk and not just from the weight gain.

 

[Nometype1andproud]

So the average diet has about 240g a day so you're right to say your diet isn't carb heavy but is higher than what I'd eat as a low carber (about 90g a day max.) and yet you're needing more insulin to cover it which then needs you needing more and more. A good analogy is the clothes are the carbs your insulin/you is trying to stuff into an overfilled suitcase (your cells). Some people have less room in their cells than others and others can use huge amounts of insulin but simply get fatter without being insulin resistant. As a type 1 you are obviously very aware of what you eat plus the amounts of insulin you're injecting.
I am not trying to get you to eat a lower carb diet or criticise what you are doing but just trying to open your mind to the idea that eating more protein and fat but less carbs may help you reduce your insulin resistance better than drugs alone. The hba1c is only 1 part of your results because if you're insulin resistant and having to take more insulin then this is linked to cardiovascular risk and not just from the weight gain.

I appreciate your reply however being type 1 for 12 years and having low carbed on and off I didn't post a thread to ask advice about dietry advice. My post was merely aimed at other type 1’s who have been prescribed this drug and the success of it for them.

 

[Fenn]

I was taken off this drug years ago because my keytones kept going high, I have been referred to a consultant who has put me back on them, maybe two months in, I have to be honest, I haven’t checked my keystones although have been given urine test strips, The first time I loved the drug, made a lovely difference to my bg and I was dropping weight, I didn’t really need to lose any but never hurts when you’ve always been big.

This time around I have just had a heart operation with lung complications so have been too unwell to notice what affect it’s had, I have never had an infection downstairs. I do pee more but not so it’s a problem.

Not sure how much use this has been sorry, good luck.


Edit I’ve just noticed my signature says jardinace, this time it’s called Foxiga but I believe it’s the same or very similar

 

[Nometype1andproud]

Thanks for replying! I will only be on a small dose due to being type 1 but do have a lot of weight to shift so am willing to give it a go.

Sorry to hear you have been so poorly wishing you a speedy recovery.

 

[TypeZero.]

Thanks for replying! I will only be on a small dose due to being type 1 but do have a lot of weight to shift so am willing to give it a go.

Sorry to hear you have been so poorly wishing you a speedy recovery.

Do let us know if your basal decreases and by how much

Thanks

 

[Nometype1andproud]

Do let us know if your basal decreases and by how much

Thanks

Will do!

 

[Nometype1andproud]

Just an update for every one since starting on these tablets I have lost roughly a lb a week but more importantly I am around 85% in target range! I have reduced my basal rate slightly too and hardly need any corrections nowadays

 

[Oldvatr]

The FDA in the USA does not allow the use of this drug with T1D, but NICE apparently does in the UK.
https://www.nice.org.uk/guidance/ta597/chapter/1-Recommendations

Note that the risk of DKA is significantly higher for T1D, and it can occur at any bgl level above 10 mmol/l but still be below 20 mmol/l which is where the usual insulin-deficient DKA is diagnosed in A&E. Make sure A&E staff are made aware that you are taking this medication if needing assistance.

Note that incorrect or missed doses of insulin can make matters worse. Best to not take Dapagliflozin near bedtime.

Keep well hydrated since this medication increases your fluid excretions, and be especially aware if also taking a water tablet such as furosemide. Observe sick day guidance if necessary.

Edit to add: I note you are a pump user. One of my T1D friends suffers blockages in the cannula, and kinks in the tubes that stop the flow of insulin without informing him. Also mis-siting the canula can be problematic. These send him to A*E quite regularly, and the Forxiga could make this worse by speeding up the DKA.