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Dapagliflozin

Davidden

Well-Known Member
Messages
56
Just back from my diabetic review and the diabetic nurse, one I haven't seen before, asked me why I was on insulin! She said I didn't appear to have the markers that would lead to prescription in the UK - I was put on it in 2020 in Peru to get my blood sugars down for surgery, and been on it since - and, despite annual reviews in the UK since 2021 which never mentioned this she wants to wean me off insulin! My age (73) is a major factor, according to her, and she feels that gradually reducing my insulin and starting me on Dapagliflozin, which apparently makes you pee out excess sugar, and so also aids weight loss (??).
I avoid obvious carbs wherever possible (pasta, bread, rice, potatoes - and have used sweeteners, currently Bolivian Stevia, for years) but do eat a lot of fruit (but now I have to cut back on!), which of course means fructose, and though my cholesterol levels are not that high, I have also been told to reduce my cheese eating - nuts and/or cheese are my preferred snacks instead of sweets, crisps, etc. My HbA1c is down to 65, which she was reasonably happy with.
We had a discussion about the Libre 2 sensors, as I am convinced that 4 of the past 5 (one fell off within 12 hours, but included in the count!) have been faulty, with 2 reading excessively high, and 2 excessively low - I am now showing 22 "lows" in the past 90 days from just 2 sensors (first and last of the 4), and am 100% certain I have never had a hypo! She said she has heard a lot of complaints about the accuracy of the sensors, but no decision has yet been made to consider changing! My current average blood glucose on the meter is 6.0 over the last 7 days, which I know is b*llocks!
Just wondered if any Type 2's on insulin, have had similar review experiences?
 
Hi, I’m type 2 on insulin. I’m interested in two areas of your letter. Firstly I was put on Dapagliflozin a while ago then taken off due to my having previously had several UTIs. One area of the warning for this medication was regarding a possible flesh eating disease occurring. I was rather alarmed about that. I do sometimes wish I had been kept on it though because it apparently protects the kidneys.
My other interest is about the sensors. I have had Freestyle Libre sensors for a while, currently using the Freestyle Libre 2. I have had several occasions when they have come off a few days before the expiry date , but my previous one gave the most ridiculous readings throughout - mostly far lower than those recorded on my Accuchek finger pricker. I am about to complain about that but I’ve noticed the current sensor is also not very accurate. I loved using the sensors at first and felt it was so much easier to control my diabetes but now I have lost confidence in them. I wi see why they seem less reliable now?
 
JudiP said:
Hi, I’m type 2 on insulin.
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Thanks for the response - Dapagliflozin seems to be used a lot to prevent/combat heart failure and kidney disease, neither of which I have ever had problems with (I have a full body CT scan every 3 months - next one on September 2 - as they are monitoring me for cancer metastasis), and other than age related minor issues (none with heart or kidneys!) mine are clear, so was surprised this DN proposed such drastic changes to my regime. I actually saw a GP a month ago, supposedly as part of my review process, and he seemed happy with everything! I have a friend who was put on Dapagliflozin for heart problems (he actually had cardiac arrest, and was kept alive by someone who happened to be there and used CPR guided by a YouTube video!) and he complained of side effects, and says not to rely on it for weight loss!
Until a couple of months ago I had no issues with the Freestyle Libre 2 sensors - yes, I had the occasional freak reading, but fingerprick checks prevented me being concerned. I have never had a "real" hypo (so probably wouldn't really know if I had one!), but am now up to 15 in the past 7 days according to the sensor (fingerpricks showing an average of 6 points higher than the sensor), and my average glucose is showing 5.5 for the past 7 days, probably 3 or 4 less than I would expect it to be. I had the one fall off, and very high readings during the recent hot spell, but it is still quite warm now. I did buy a pack of sensor covers from Amazon, and though they are not perfect - tend to curl up at the edges (though so far not the current one) - they do hold the sensor in place.
 
Picked up my Dapagliflozin today, but am not going to take it till after my CT scan next week - don't fancy having to look for loos all the time if it works as well as a diuretic as they say! I also had a chat with the pharmacist as I was concerned about a few things, not least the reports of UTI's in 10% of users, fungal infections in 1% of users, and the risk of Fournier's Gangrene (necrotising fasciitis) - rare but not unknown! Since I have never had any problems I wondered if it was a risk worth taking - headaches, dizziness, etc. I can accept, but risk of a serious urinary infection may be a step too far for me! The pharmacist assured me that the meds are used widely, and she felt the risks were minimal, so will give it a go from next week, while reducing my insulin dose.
 
Thought an update was needed. I started taking the Dapagliflozin on September 1st and so far no side effects - I always drink a lot of water (only that, coffee and a glass of milk a day, no other liquids), so haven't really noticed much of a change in my peeing frequency yet. I started reducing my insulin as instructed, and my blood sugars do appear to have decreased a little, and stabilised, currently down to 40 units once a day, from 50. Last Friday the nurse called me to see how I was doing, and I told her that I had only started the new meds on the Tuesday. She said that progress sounded positive, and she would call me again in 2 weeks, by which time she hoped I had stopped the insulin! In fact she has taken it off my repeat prescription list already! That means reducing the dose from 40 units a day to nil in just 10 days now! She had told me to reduce it by 2 to 3 units a day every 3 days originally, so quite a drastic reduction speed up. I will persevere and see how it goes.
 
Good day. I’ve been on Dapagliflozin 10 mg for a year now, and besides the expense (as it is pricey), I am happy with it, as it reduced my Metformin from 500 mg twice a day to just once a day. I don’t recall any side effects and likely experienced an improvement, seeing that I reduced the Metformin.

Naturally our cases are not the same, as my need to move to Dapagliflozin was because of my kidney health (which has also improved over the past year), as it’s more kidney friendly than Metformin, which I am aiming to come off all together.

Let us know how it works out for you and any side effects, if any, you can advise on. All the best.
 
I see you are in Eswatini, so can imagine healthcare costs can be high. I visited Manzini many years ago as my (then) father-in-law was head of Coca Cola. Lovely country.
We are fortunate here in the UK as healthcare is free (for the most part) and especially diabetic treatment, otherwise many of us couldn't afford it either. Good luck on your journey with Diabetes.
 
Just back from my latest review, or follow-up. I have been on Dapagliflozin for 18 days now, and have reduced my daily insulin from 50 units to 10! My glucose levels have reduced considerably, and stabilised a good deal, with no big spikes after food (still low carb, though, for now) - been in range (apart from what I think was a compression low!) for 2 weeks now. I have lost 2.5kgs in the 18 days, not a huge amount, but positive. The DN doesn't need to see me for 3 months, then will arrange blood and urine tests to make sure all is well. By then, well in 5 days time, I should be off the insulin completely! As my waking CGM readings are much lower than before I have done some finger sticking, and they are usually about 2 higher (which I understand is an acceptable variation between blood and the sensor), compared to up to 5 before, so am really happy with how things are going, despite my initial concerns.
Still early days on the new meds, but so far it is looking promising, glad the insulin is going, no side effects and feeling same as always!
 
Davidden said:
I see you are in Eswatini, so can imagine healthcare costs can be high. I visited Manzini many years ago
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Wow, I’ve been on this forum for 2 years now, and you’re the first person who knows my country and even visited my home town (Manzini) where I grew-up. I am honoured. Not many people know about our beautiful, small Kingdom, nestled between South Africa and the southern pit of Mozambique.

Indeed, medication is not free in my country, with exception to ARVs, which is free, and Metformin is subsidised, so quite affordable. Special drugs like Dapagliflozin, are unfortunately not. When I can find it, I do buy a generic version that sells at 3 times less.

Thanks. It’s awesome to know you.
 
Davidden said:
. I have been on Dapagliflozin for 18 days now, and have reduced my daily insulin from 50 units to 10!
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This is truly awesome news. Congratulations. Have you experienced any side effects? I have read that it increases urination and can cause bladder infections in a small percentage of people.

Personally, in support of my kidney health, I consume as much water as I can every day, which results in frequent urination, so I cannot link it to Dapagliflozin, and likewise, I believe that my water intake reduces my risk of a bladder infection. So personally, I do not recall any side effect it has had on me.
 
I am now completely insulin-free (so maybe I am in the wrong forum!), and my blood sugars are much lower and more stabilised, and I have been "in-range" 100% the past 7 days. Yes, I do drink more water, and have to pee more than usual, and it is usually an instant need rather than being able to think about it! No other noticeable side effects, so am quite pleased with the results so far.
 
helenb1979 said:
I have just had this added to my medication. I can wee for England so I don't think I will notice the difference
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I have always drunk a lot of water, other than coffee I do not drink anything else, and at my age the bladder is not so forgiving as it used to be anyway, but what I do find now is that if I stand up - I have to wee - and if I am sitting and feel the need, it is an urgent need. Generally an hour is the longest I can manage, when not asleep, without having to go! Remains to be seen how I will cope on a longer journey.
 
Going on holiday in a month. A 4 hour car journey. Thats going to be at least 2 stops
 
Davidden said:
if I stand up - I have to wee - and if I am sitting and feel the need, it is an urgent need.
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Wow, that’s me to a T. I am only 57 and have been worried about it getting worse the older I get.

The urgency does worry me, as it’s getting more difficult to hold it, especially after sitting for a while.
helenb1979 said:
A 4 hour car journey.
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It seems like we all have to plan ahead. I usually drink as much as I can in the morning after brushing my teeth, but when I need to travel far, I drink a small cup at most.

The worse is when you fly. It takes over an hour (sometimes over 2 hours when there’s a delay) from boarding to stable flight, when the seat belt sign goes off (with zero access to toilets). As a result of the urgent need I experience, I am now very careful not to drink before flight, which sadly, is counterproductive for my kidney health.
 
I have been going along merrily since stopping insulin a couple weeks ago, with my blood sugars - per my CGM - almost all within range, no bad spikes, no lows, and my 7 day average of 7.8. All looking good, you might think! A few minutes ago my reading was 4.9 (it has, in fact, been hovering around there, or slightly lower, for 30 minutes!) - it is 3 and a half hours since my evening meal (cheese omelette, banana sliced in Greek yoghurt, and a glass of milk), and 2 hours since I ate an apple, but I have not had my usual post-prandial "spike" tonight. I decided to do a fingerprick - and with the CGM still reading 4.9, that read 13.0! That is 8.1 units higher than the CGM, which is ridiculous. I am 11 days into the current sensor, and have not had a reading as low as 4.9 in those 11 days, but I also have not had a CGM reading as high as 13 during that time either. Makes me wonder if using a CGM is lulling me into a false sense of security, but do not really want to go back to sticking a needle in my finger several times a day! (CGM went up to 5.2, but has gone back down to 5.1, almost 20 minutes after my fingerprick reading!)
 
Did you wash your hands first? Could sugars from the apple still have been on your fingers?

If it can’t be contamination then I’d check a couple of times tomorrow, and if still out then contact abbot for a replacement sensor.
 
Lakeslover said:
Did you wash your hands first? Could sugars from the apple still have been on your fingers?
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Washed my hands at least twice since apple - Dapagliflozin makes me pee a lot!! Just checked now - CGM 6.5, slowly rising, Fingerprick 8.4, which is acceptable variance. Sensor change due on Sunday morning so will see how it goes.
 
Hi everyone. Nice to hear from you and glad about your progress.

I have no experience with CGMs but have read various posts in this forum related to false readings. It be worth while having it checked out.

Davidden said:
cheese omelette, banana sliced in Greek yoghurt, and a glass of milk
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How reap was that banana? I avoid bananas from both a sugar and kidney perspective.
 
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