Jardiance newbie, low carb ideas please.

[Geminigirl]

Hi all,

My meds have recently been changed and Jardiance added a week ago. Started on 10mg per day along with a reduction in my Glimeperimide From 6 to 3mg per day and I have been trying to reduce my carbs a fair bit to try to fend off the likely side effects of Thrush and water infections.

I have actually lost 5lbs in weight and feel I am coping, although I feel an attack of Thrush may not be too far off I am drinking plenty of water and although the first two days I was having to pee on average every 90 mins, incl at night which was a pain, this has settled down, my BG readings have really gone down and I feel much less fatigued, so, so far so good.

I take it my waterworks have settled due to less glucose in my system? Anyway, I am getting really stuck on food ideas. I do love fruit, I have found Mango spikes me big time, are berries better at all?

If anyone could help with Breakfast ideas I would be grateful. I am bored silly with fruit and yogurt and can't face a cooked meal early in the day. Apart from a slice of toast at lunch (I have baked beans, Egg or Mackerel in tomato sauce) I am not having any other carbs apart form what may be in the veg or fruit I have. Considering I am the proverbial "carb queen" I am very pleased with that.

I have read on the forums about the risk of Ketoacidosis with this drug, I already get test strips and lancets on prescription due to the Glim, the DN also have me a vial of Ketostix incase I want to check Keytones. I am testing My BG a few times a day to see how it is going. I tested keytones today and am on "trace"

I am seeing the DN in two weeks time, so having Liver and Kidney function rechecked, then if all is well, giving it three months then another HBA1C to see if there is any progress.

Does anyone have positive experience with the Jardiance? I believe there was someone a few weeks ago, I am also aware of the warnings from some members. I really want this to work for me.

 

[ringi]

You have hit the nail on the head, the less glucose in your system, the less you will pee, and the less sugar in the pee to feed the thrush and water infections. Jardiance is a SGLT2 inhibitors, this is the only class of drugs the remove the glucose from your body, the other drugs “jush” push the glucose into different parts of your body. Unlike Glimeperimide , Jardiance creates no additional risk of Hypos.

(Maybe next time you see your GP, ask for a prescription for thrush treatment, so you can start it as soon as (or if) you get the symptoms without having to wait for an appointment. )

SGLT2 inhibitors are the new “up a coming” drug, every few weeks there is another paper published showing some benefit of them compared other diabetic drugs. I expect they will cost the NHS a lot in the short term, but greatly reduce the very costly complications of Type2.

If you commit to low carb, your BG may quickly come under control with the help of Jardiance, check your BG often and when it is normally under 7, talk to your doctor about reducing the Glimeperimide

For Breakfast, consider a hard boil egg with full-fat mayo, avocados, olives, full-fat cheese (soft or hard) or just a coffee with lots of cream and a little coconut oil.

There is no real increased risk of Ketoacidosis with Jardiance, however, it is possible to get Ketoacidosis while on Jardiance without your BG increasing a lot. Therefore read up on the symptoms of Ketoacidosis.

Ideally, you will always test positive on the Ketostix as they show you are burning fat, but should never be at the stop end on the sticks. Test with the Ketostix often so you know what is normal for you, if the readings go up a lot and you are feeling sick, go to A&E, tell them you are on Jardiance and wish to have a “blood gas test”, as you think you may have Ketoacidosis.

To greatly reduce the risk of Ketoacidosis, drink a lot of water, including if you are feeling ill. Drinking a lot of water also reduces the risk of thrush and water infections.

(The problem is if one someone turns out to be Type1 rather than type2, but has been given Jardiance, when their body stops producing insulin they will get Ketoacidosis without quick action. The Jardiance results in BG levels that are a lot lower then doctors expect in people with Ketoacidosis, hence delays someone going onto insulin.)

 

[Geminigirl]

Hi

You have hit the nail on the head, the less glucose in your system, the less you will pee, and the less sugar in the pee to feed the thrush and water infections. Jardiance is a SGLT2 inhibitors, this is the only class of drugs the remove the glucose from your body, the other drugs “jush” push the glucose into different parts of your body. Unlike Glimeperimide , Jardiance creates no additional risk of Hypos.

(Maybe next time you see your GP, ask for a prescription for thrush treatment, so you can start it as soon as (or if) you get the symptoms without having to wait for an appointment. )

SGLT2 inhibitors are the new “up a coming” drug, every few weeks there is another paper published showing some benefit of them compared other diabetic drugs. I expect they will cost the NHS a lot in the short term, but greatly reduce the very costly complications of Type2.

If you commit to low carb, your BG may quickly come under control with the help of Jardiance, check your BG often and when it is normally under 7, talk to your doctor about reducing the Glimeperimide

For Breakfast, consider a hard boil egg with full-fat mayo, avocados, olives, full-fat cheese (soft or hard) or just a coffee with lots of cream and a little coconut oil.

There is no real increased risk of Ketoacidosis with Jardiance, however, it is possible to get Ketoacidosis while on Jardiance without your BG increasing a lot. Therefore read up on the symptoms of Ketoacidosis.

Ideally, you will always test positive on the Ketostix as they show you are burning fat, but should never be at the stop end on the sticks. Test with the Ketostix often so you know what is normal for you, if the readings go up a lot and you are feeling sick, go to A&E, tell them you are on Jardiance and wish to have a “blood gas test”, as you think you may have Ketoacidosis.

To greatly reduce the risk of Ketoacidosis, drink a lot of water, including if you are feeling ill. Drinking a lot of water also reduces the risk of thrush and water infections.

(The problem is if one someone turns out to be Type1 rather than type2, but has been given Jardiance, when their body stops producing insulin they will get Ketoacidosis without quick action. The Jardiance results in BG levels that are a lot lower then doctors expect in people with Ketoacidosis, hence delays someone going onto insulin.)

Hi, thank you so much for your support. I have been feeling a bit off colour today but my BG has constantly been 9 or under so I think my system is adjusting. I was shocked before tea to find I was 5.3 and have to admit I panicked a bit because prior to these tablets I was constantly high teens so haven't seen this number for ages. Then I was worried because I was yet to have my Glimeperimide (with tea) so I did have one slice of toast from a small loaf with smoked mackerel fillets and tomatoes, mushrooms and melted cheese on top. Don't know if I did wrong with the toast!
I had live natural yogurt with berries for breakfast, a large green salad with lean Ham and Cheese for lunch. Have been drinking lots of water. I had a mid afternoon snack of Walnuts and Celery with a blob of crunchy peanut butter which I sired into some yogurt to make a sort of dip.
I have moved up one block on the Ketostix to 1.5, when I started this regime I was on negative. I will continue to test BG and as you advise, speak to my GP/DN if my readings stay low so perhaps the Glim can be reduced /stopped , I don't want to start carbing as a prevention of hypos.
My last HbA1C was horrendous & I do have about 4 stones to lose.
Thanks again.x

 

[ringi]

Your diet sounds great, keep it up and your BG will be much improved. Be careful with peanut butter, as unlike true nets, peanuts can often have lots of carbs, so check the label.

When I was on a drug like Glimeperimide, I decided to stop it myself without getting my GP's approval as soon as I started to get Hypos (BG below 4), when the nurse told me I must eat carbs between meals not to get Hypos, my mind was made up. But as I am not a GP, I can't advise you to stop taking a drug. Remember that it is not possible to get the dose of drugs like Glimeperimide correct unless you eat about the same amount of carbs at each meal and each day. So if you do "low carb" you must commit to it.

One way to check your process while on Jardiance is to get some of the glucose drip sticks to test your wee (as was used before BM meters). Ignore the scale(numbers) on the box as Jardiance makes the result invalid. But the drip sticks will tell you how much sugar Jardiance is removing from your body. Once you are off the Glimeperimide, if your wee contains no sugar, you know that your diet is controlling your diabetes not Jardiance, so time to book a GP appointment....

 

[ringi]

I forget to say, that unless you have high blood pressure you may need to increase your salt intake. A stock cube in a cup of hot water 2 times a day is enough. (It is very likely the food you are now eating have less salt then your body is used to, also our bodies need a little more salt on a low carb diet.)

 

[Geminigirl]

Thanks for all the advice.
Well, I have been on the Jardiance 10 days now and have lost 4lbs. The initial first few days of peeing a lot (sorry if tmi) has stopped and I am only getting up once during night which is fairly usual and maybe once or twice more during the day as norm.

My numbers have improved incredibly, they really have, so hand in hand with the low carbing something seems to be working.
Luckily I am Thrush and UTI free which I think is down to the low carbing thus far.
The only thing I have noticed and it was mentioned on the forum somewhere....is I have had two really nasty leg cramps at night which have left my calf muscle quite sore. It's is not mentioned as a potential side effect in the booklet I was given, nor in the huge leaflet with the tabs.
I wondered if it is due to flushing out certain things as well as the glucose so I have been taking a good multivitamin each day. One for the over 50's and it has potassium and all the other mineral type stuff in.

I am finding the low carb kerbs my appetite and my cravings have gone.

As advised, I am checking my keytones and these have settled on the mid range bar (there are three more above) so I assume that is okay and not to be concerned.

The only thing I think I have to watch is the Glimeperimide as I have been as low as 4.5 which I know is not a hypo but I didn't seem to feel any low glucose symptoms, hope I haven't lost my awareness as before I used to "feel it" on 5.5 or even 6! Due to the high numbers I was reading.

Also, my eyes have been a little "off", but this is settling down too.

Fingers crossed....

 

[Alison Campbell]

Re breakfast ideas: https://www.ditchthecarbs.com/23-easy-low-carb-breakfast-ideas/

 

[ringi]

Remember Jardiance plug low carb => A very low carb diet.
Therefore have a read of https://www.dietdoctor.com/low-carb/side-effects

leg cramps are often due to low magnesium levels - they don't always show up in a blood test. Slow-Mag is recommended by some of the leading low carb people for it. It could also be low levels of normal salt. As your body gets rid of what it does not need, increasing both could be a good option. A long soak in Epsom salts can also work, as the magnesium is absorbed by the skin.

I think you should be talking to your GP (with the next day or two) about reducing the dose of Glimeperimide, personly I don't like BG that are "always" below about 7 on drugs with a risk of Hypos, while people are starting low carb. The risk of having BG levels a little higher for a short time can be worth it, so as to get the low term benefits of low carb without Hypos being an issue.

(Glimeperimide can also slow down the removal of fat from the Liver.)

 

[Geminigirl]

Tha

Re breakfast ideas: https://www.ditchthecarbs.com/23-easy-low-carb-breakfast-ideas/[/Q
Thankyou. X

 

[Geminigirl]

Remember Jardiance plug low carb => A very low carb diet.
Therefore have a read of https://www.dietdoctor.com/low-carb/side-effects

leg cramps are often due to low magnesium levels - they don't always show up in a blood test. Slow-Mag is recommended by some of the leading low carb people for it. It could also be low levels of normal salt. As your body gets rid of what it does not need, increasing both could be a good option. A long soak in Epsom salts can also work, as the magnesium is absorbed by the skin.

I think you should be talking to your GP (with the next day or two) about reducing the dose of Glimeperimide, personly I don't like BG that are "always" below about 7 on drugs with a risk of Hypos, while people are starting low carb. The risk of having BG levels a little higher for a short time can be worth it, so as to get the low term benefits of low carb without Hypos being an issue.

(Glimeperimide can also slow down the removal of fat from the Liver.)

Thankyou. I am seeing doc on Monday. These cramps are horrid and my calf feels "bruised" my knees also ache! I talked to the pharmacist about it today, she said prob not to add salt to my food as I am on BP meds, but she also recommended, like you... an Oxo cube perhaps at night....will def try it. Can I ask, LADIES BITS ALERT HERE!!!! I have problems with my skin in the lady area so usually shower as I can't use anything scented in the bath, or use soap, I have Zerobase for that area for washing and during day. Would Epsom Salts burn do you think? Sorry if TMI.

I would hate to have to give up on these because of blooming cramp! Mind you, I have Fibro so it may just be that...always difficult to tell.

Thanks again for yr support, much appreciated and I am proud of myself for giving these a go as I have horrendous "new tablet" anxiety.

 

[ringi]

If I was you I would try taking Slow-Mag for a few days to see if it helps.

Do you have your own blood pressure monitor, as sometimes pressure monitor can drop fast with low carbs, and your BP meds will need to be reduced if it does.

 

[nolly53]

Are berries better at all?

If anyone could help with Breakfast ideas I would be grateful.

The best change I ever made was to breakfast - I have 2 poached eggs with a small slice of toast. On occasions I add some mushrooms, tomatoes and/or bacon fried in one cal spray.

Berries are great - if you check out bags of frozen berries at the supermarket you will see that the sugar and carb content is low. I have them with Greek Yoghurt.

Thanks for your post about Jardiance. I am about to start and have been snooping around to see what experience everyone else is having.

 

[SockFiddler]

Hey, happy Jardiance user with lots of positive stuff to report here (I tend to call it "GlucoPee").

Like you (and lots of others) I was really, really anxious before I started taking it back in June. I couldn't tolerate Metformin at all, so was put onto Jardiance 25mg. The first couple of weeks were really, really tough, I have to admit, but complicated by the fact that I can barely walk and, at the time was living in a house with an upstairs bathroom. So having to pee 11 times a day meant having to deal with the stairs 22 times a day. With hindsight, I realise I was a little pee-phobic for a while. I Also started LCHF at the same time as the new drugs, so I can't honestly say which action caused which particular side effect.

Now I'm happily in a bungalow (no stairs!), and have resumed a more responsible management regime (the house moved knocked me off my diabetes perch for a bit), am taking my GlucoPee properly (daily, at the same time every day) and feeling much, much better.

It's worth noting that, while I was in my Poor Management Hinterland (which included a very indulgent Xmas and New Year as well as a fully catered week's holiday where I further indulged regardless of carbs), I was still taking the meds (Though a little haphazardly) and my HbA1c (taken on 29th Jan, so all my misbehaving is still within range to affect the result) had still fallen by 7 points. My weight and my blood pressure had both massively improved, too.

I'm not planning to take this drug forever, but I am happy to stay on it while I'm getting used to the LCHF habit, getting my FBG under control and otherwise trying to smarten myself up. Jardiance does also contribute to weight loss and (though I've not found any actual documentation to prove it) I believe from my experience help to get and keep you in a state of ketosis (where your body is happily looking for fat as its primary energy source).

This keto conclusion comes simply from the fact that there's no way I'm eating below 80g carbs / day, AND I'm eating loads of meat (protein) and yet I dropped into ketosis last Friday - just 5 days into my new LCHF regime. According to this site's info and other posters, ketosis shouldn't be possible with my daily carb consumption and high amounts of protein should kick me out, too.

LCHF will require a little more salt intake, particularly with the Jardiance as you'll feel much thirstier than normal (so will pee out more salt than usual) plus you're eating far less salt-rich foods. @ringi told me about the stock cube drink trick last year and I swear by it now.

I'm still a little wary of taking this drug long-term, especially as it's so new there have been very few studies done on its long-term impacts and effects. But, for now, the benefits to my health, weight and BG have been immediate and substantial. DKA is a factor, and ketones in your urine are not indicative of you having DKA. However, if you suffer any of the other symptoms you should seek medical attention immediately: I've turned it into a little phrase so that, if I can remember what each word stands for, I at least know I'm not confused!

Very (Vomiting / nausea)
Bad (Bad breath)
Boys (Breathing, gasping for air, almost like a fish out of water)
Head (Heart is racing)
To (Thirst - unquenchable)
Cells (Confusion)

Also, everything @ringi said is perfect.

Oh, and about lady parts... Yeah, don't use salts! Lady bits don't need a lot of scrubbing and washing to stay clean and you might find that being too aggressively hygienic ends up leaving you (ironically) vulnerable to thrush and other such infections. But that's a further effect of LCHF (as also already noted). Jardiance will increase the chances of that taking hold, but LCHF will mitigate it by reducing the amount of sugar there is to pee out.

Oh, last thought: I've had two "hypo-ish" events. It's worth bearing in mind that everyone will tell you that T2s can't have hypos, but do remember that we can have moments when our BG falls far below what we're used to it being. Jardiance can make that more likely, so it's worth getting yourself through the Hypo Awareness Program and buying some glucose to keep in your testing kit just in case.

 

[Geminigirl]

Hi all and thanks.
I have been taking the mineral supplements and the cramps have stopped.
I have now lost 10 lbs and no thrush or water infections so far, though I am being careful to drink lots.
My levels are really good now, it is remarkable though I find if I don't have a little carb at lunch I am fairly low by tea time and I don't seem to feel it dropping so I am testing regularly till I have next HBA1C in March. Hoping I can then drop the Glimeperimide totally.
I have made sure I have plenty of test strips (luckily GP is happy to provide!) and I have glucotabs with me, specially when I go out.
However, I am not feeling "quite right" and my Fibromyalgia seems much worse, my back is a real sod and despite my pain meds I am in a lot of pain. Not sure if the Jardiance is having an effect? I don't want to jump on that being the cause as I have this pain a lot anyway.
I really want to be positive but gosh it is hard sometimes!

 

[SockFiddler]

I had the same, actually (I have some fairly serious back issues), but, apparently, it's because those of us with weaker / compromised spines will be more sensitive to weight changes, particularly around our tummies (where most of us T2's carry our weight). As we embrace LCHF / a generally healthier lifestyle, that weight starts to shift - often at a faster rate than our muscles / spines can adapt to.

It makes sense - we gained our weight very slowly and have been carrying it for a long time. Our muscles have learned how to keep us balanced and upright in a certain way, and now we're changing both our body shape and how we carry our weight (and where that weight is). I found that, after about 3 months, my spine was a much better shape anyway (I had severe lower lumbar stenosis, on top of other things, which has now straightened out) - but the muscles are slow to adapt to your new way of moving and standing; just like any other muscle, you'll have to build them up and strengthen them a little.

My advice is to invest in your bed (a good mattress!) so you can rest comfortably while your muscles catch up to your new shape, don't push yourself too hard on your pain days, and only take pain killers when you've finished whatever you're doing - DON'T take them to be able to carry on - that's when you start pushing yourself (and your back) far beyond what you're able to currently do and risk serious damage.

If it's really inhibiting things you need to get done, perhaps try talking to your GP for a physio referral? I also found (very) gentle yoga, and building "Rest-Days" (where I ignore housework, keep food prep and moving about to a minimum and advertise to everyone that I'm going to be lying down) into my schedule to be especially valuable. It doesn't take long - I think 3 months for the initial sharp aches and then 6 for the residual to abate - but, particularly if you've got spinal issues already, you need to take that pain seriously. Now that I write this, I realise that I didn't need a rest day for the whole of January - I started LCHF in August, so it really does improve quickly if you let it.

Good luck, keep posting, don't be afraid to ask for help.

Sock xx

Oh, and: Pain will spike your BG levels, be warned, and sometimes in advance of a new bout of pain coming on. Don't take this as failure but as your body responding appropriately (if inconveniently) to things that go wrong.

 

[ringi]

Jardiance does also contribute to weight loss and (though I've not found any actual documentation to prove it) I believe from my experience help to get and keep you in a state of ketosis (where your body is happily looking for fat as its primary energy source).

Low levels of Ketones was tested for and found in one of the studies of Jardiance, but as most doctors and researchers don't think it is important, it is not talked about.

 

[kokhongw]

These are the main features of SGLT2 inhibitors. They significantly reduce the glucose re-absorption levels by our kidneys. So the more glucose/carbs intake, the more glucose excreted.
http://www.diabetesincontrol.com/diabetes-2017-part-1/