From insulin to empagliflozin & glicazide

[imp]

Hi everyone,

I'd like some feedback on this as I am not sure if there is a necessity for the change or if it is really a better option.
I was diagnosed with Type 2 ten years ago. Initially was put on Metformin XR, then on insulin when I got pregnant, had my babies, breastfeeding, and I decided to continue on insulin & Metformin XR after my kids were weaned off.
Recently, a new endocrinologist decided that I needn't be on insulin and prescribed empagliflozin, glicazide, & Metformin XR, citing 'simplifying my life' as the reason for it.

I've been on it for two weeks (the second week was on reduced dosage because I experienced severe side effects and wanted to go back to my previous treatment). But doc said no, but to go on reduced dosage. My last HbA1c (6.5) had been an improvement from the previous HbA1c (6.8) before the change in treatment, so I am wondering if being on empa & glic was necessary or it is indeed better than being on insulin (healthwise). Would appreciate some feedback, tq.

 

[Daibell]

Can you let us know what your BMI is and whether you have excess weight? if so then a low-carb diet will help solve the problem if you are not already low-carbing. I would think low doses of the various tablets was worhthit to avoid the insulin hassle but that assume the tablets work for you.

 

[Oldvatr]

For a T2D, if you are still producing your own internal insulin, then adding in exogenous insulin seems a bit counterintuitive. The extra insulin is more like a sledgehammer forcing glucose to be stored as body fat, and this can lead to insulin resistance developing that makes the doses less effective. If you are able to stop the external insulin and find a way of controlling your blood glucose by other strategies, then this is possible. What you will need to do is cut back on the carbohydrate in your diet, so you need less insulin to handle it. This is the way most of us here go, since crbs directly relate t glucose in the blood. Dropping carbs drops insulin demand and gives control.

Adding in the other oral meds will allow you to have a higher intake of carbs than maybe you actually need, so if you do go lower carb, be prepared to reduce the dose of these meds as you gain control. Some insulin users with T2D have managed to come off all meds altogether by using the diet approach which is an indication of a healthy pathway, It does mean that you will have to maintain the low carb diet to keep control, so some use the other oral meds to cover a higher carb intake to suit them. I am one such T2D who uses an oral med at a low dose to help me keep a diet regime with some simple pleasures like toast going and I do not need to be too strict with myself. That is my choice but I have avoided insulin treatment and reduced my orals to a minimum now. I am also at a healthy BMI now and lost my belly fat.

 

[imp]

Thank you Diabell & Oldvatr. My BMI is normal 23.5. I'm at my average weight of 62kg at 163cm. I don't take a lot of carbs, but maybe I should try and cut down on rice (although I am already eating a small portion). The thing is, this new medication is making me hungry and I feel the need to eat. Kind of defeats the purpose of managing my food intake. ‍
Yeah, I heard about some T2D not needing to rely on meds anymore, but was wondering if it were all true.

 

[Andydragon]

Thank you Diabell & Oldvatr. My BMI is normal 23.5. I'm at my average weight of 62kg at 163cm. I don't take a lot of carbs, but maybe I should try and cut down on rice (although I am already eating a small portion). The thing is, this new medication is making me hungry and I feel the need to eat. Kind of defeats the purpose of managing my food intake. ‍
Yeah, I heard about some T2D not needing to rely on meds anymore, but was wondering if it were all true.

Well yes it can be true. I went from bydureon, Metformin and dapaflaglozin to no drugs at all and hba1c in the normal range (38 to 40) although that is just below UK prediabetic but is still normal and therefore (as of Thursday) officially in remission

Others on here I'm sure have gone from insulin to nothing, but dont know off the top of my head who, so it is doable

Not guaranteed though, but for many it does do a lot

 

[imp]

Well yes it can be true. I went from bydureon, Metformin and dapaflaglozin to no drugs at all and hba1c in the normal range (38 to 40) although that is just below UK prediabetic but is still normal and therefore (as of Thursday) officially in remission

Others on here I'm sure have gone from insulin to nothing, but dont know off the top of my head who, so it is doable

Not guaranteed though, but for many it does do a lot

Oh wow! Tq Andydragon, for sharing. And congratulations! This gives me hope.