Medication question

[Maggie75]

Hi everyone,

I'm T2, was at DN today to discuss how to deal with my diabetes which I have not been managing well at all, she has prescribed me Dapagliflozin 10mg tablets, one a day. I did ask her if these cause hypos which she has assured me they do not, she has touted it as an absolute wonder drug for diabetes, heart and kidneys. Is anyone taking this medication and can you confirm this? The reason I'm asking is I intend to go back to low carb eating which really helped me before and I don't want to take any chances with hypos. Also how often do you need to replace monitors and strips? I've still got my monitor from when I was diagnosed in Nov/20 and the strips (obviously I haven't been testing regularly), should I replace these now? I know I'll need to get back to testing to see what is spiking me food wise. Thanks for any advice on this.

Maggie

 

[EllieM]

Hi @Maggie75
dapagliflozin has a lot of good points but it also has some negatives.

In particular you need to be careful when going on a low carb diet if taking it, as it can cause diabetic ketoacidosis in these cicumstances.

https://www.pinnaclepractices.co.nz/assets/Position_Statement_on_Ketogenic_or_Very-Low-Carbohydrate_Diets_and_the_Use_of_SGLT2-inhibitors_in_Adults_with_Type_2_Diabetes.pdf

In New Zealand they recommend against a keto diet and suggest you discuss with a dietician before doing a low carb diet.

Please be careful.

 

[EllieM]

Also how often do you need to replace monitors and strips? I've still got my monitor from when I was diagnosed in Nov/20 and the strips (obviously I haven't been testing regularly), should I replace these now? I know I'll need to get back to testing to see what is spiking me food wise. Thanks for any advice on this.

At a guess your monitor will still work but your strips will need replacing. Check the use by date on the strips.

 

[Maggie75]

Thanks so much for the reply and advice on this, having read the pamphlet for side effects I'm very unsure about this medication, I've never seen side effects like that on any medicine. I think I'll just go back to the alogliptin and low carb for now. The possible weight loss effects of the new meds aren't worth the potential side effects. I'll order some more strips for meter as well. Thanks again.

Maggie

 

[andrewk75]

I have just been prescribed Forxiga and am wondering the same thing. I am taking Metformin and statins and I mentioned to the nurse that I was trying to reduce my carbs and she didn't say not to. After I read the info leaflet I had concerns as well, but it is virtually impossible to speak to anyone nowadays. I haven't picked up mine yet as I was only prescribed yesterday.

The worry about the potential side effects and even the way the drug works are causing me a lot of anxiety, as I like to go for walks and that can be an issue if you need to pee more often.

 

[Sooze]

I take Forxiga , metformin 1000mg morning and night and 20 units humilin I at night and never had a hypo but spend lots of time in loo but upside is you’re peeing out calories . The more carbs you eat the more you pee ( I’m my experience ) . Good luck

 

[andrewk75]

I take Forxiga , metformin 1000mg morning and night and 20 units humilin I at night and never had a hypo but spend lots of time in loo but upside is you’re peeing out calories . The more carbs you eat the more you pee ( I’m my experience ) . Good luck

That's reassuring I guess I will start taking them and see what happens. I am aware that a lot of people gave problems with Metformin which I gave been OK with, so hopefully this will be OK too. I will try and reduce my carbs a bit to try and reduce time spent in the loo.

 

[lovinglife]

Please anyone on the SGLT2 medications such as the Forxiga be careful with doing very low carb or keto, there is an increased chance that you could develop DKA The current advice is not to low carb whilst in these meds

https://www.pinnaclepractices.co.nz/assets/Position_Statement_on_Ketogenic_or_Very-Low-Carbohydrate_Diets_and_the_Use_of_SGLT2-inhibitors_in_Adults_with_Type_2_Diabetes.pdf

Edited to add the word very which I didn’t realise I’d missed out

 

[andrewk75]

Please anyone on the SGLT2 medications such as the Forxiga be careful with doing low carb or keto, there is an increased chance that you could develop DKA The current advice is not to low carb whilst in these meds

https://www.pinnaclepractices.co.nz/assets/Position_Statement_on_Ketogenic_or_Very-Low-Carbohydrate_Diets_and_the_Use_of_SGLT2-inhibitors_in_Adults_with_Type_2_Diabetes.pdf

It's a pity that the information leaflets don't really mention this aspect. I had originally planned to try and reduce carbs significantly (not that I have had much success in the past) but am now looking at a much smaller reduction just in case. Reading between the lines of the info I could find suggested a drastic reduction might not be good.
The thing is everyone reacts differently, so difficult to know what is best.

I have literally just started the meds, first tablet this morning, so will see what happens over the next few days.

 

[lovinglife]

I think it would be best to err on the side of caution @andrewk75

 

[MissMuffett]

I’m on Forxiga and keto diet. It has helped bring my BG numbers down from in the mid teens to 5s and 6s. The week of my birthday (and on holiday) I ate birthday cake and had afternoon tea and got thrush. Now I don’t have any side effects with very low carb and I drink plenty of water.

 

[newbie72]

hi everyone, i started on Dapagliflozin 10mg tablets, one tablet per day, only last week so very early days. I am also taking 2000mg Metformin per day and have been since T2 diagnois in early December 23. Metoformin took a while to settle down but felt i was getting somewhere in terms of managing (or getting used to side effects) Since taking Dapagliflozin, i have been suffering really bad daytime nausea and overwhelming fatigue. Hopefully things will settle down, I hadn't appreciated the low carb effect with this particular medication, that is interesting (not that i have been doing keto, but i have been really trying to limit bad carbs of course)