Dapagliflozin

[Davidden]

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?

 

[JudiP]

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?

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?

 

[Davidden]

Hi, I’m type 2 on insulin.

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.