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Medication

KirstyRobbie

Active Member
Messages
44
Location
North Somerset
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
hello ,

Has anyone tried or is anyone using “ Trulicity or ozempic ?”

My nurse has suggested me trialling one of the 2, as I’ve been doing low carb the last few weeks and my hba1c has only decreased from 56 to 50, and she isn’t very happy. Neither am I may I add. But since February I’ve had a hernia operation, been home schooling and had to shield in March, so I feel I haven’t done too badly, I’ve lost 7 kilos too.

After the reading the side effects of them both I have to say I’m terrified! I take 2 slow release sukkarto tablets at breakfast also each day.

Any advice, warnings or positives even?

Thank you
 
What sort of time frame are you talking about for the decrease in HbA1c? Looks like a decent drop in a few weeks and 50 is only just into the diabetic range. In your shoes I’d be looking to seek if the diet could be tweaked a bit - what’s the nurse’s reasoning?
 
KirstyRobbie said:
I’ve been doing low carb the last few weeks and my hba1c has only decreased from 56 to 50
Click to expand...
How low carb? If you would like to post a day's typical menus, we would all enjoy pointing out any items that could perhaps be swapped for lower carb ones without ruining your pleasure in eating. Many people here have managed to come off or avoid meds by diet. Personally I am happy to take the well-tested Metformin but beyond that I share your nervousness about other meds.
 
I think you have done really well and the results are clear in your fat loss and reduced hba1c. The next goal could be getting under the diabetes bar (48) and then under the pre diabetes one (42) so that you don't end up with complications.
Hopefully you are in a better position now to march on with the dietary tweaks you've made. It is a dietary disease so it makes sense to me that you should, regardless of medications, carry on with diet changes.
I know that trulicity is a medication which helps your body send out little amounts of insulin when you eat and only then so I think the idea is that your system isn't flooded with insulin. This might help you lower your hba1c a little but doesn't tackle the root cause of your diabetes which is insulin resistance causing excess fat around your liver and pancreas.
Reading side effects on medication packages is always scary (read the side effects of commonly used painkillers!) so not saying these meds are unsafe. Its just worth suggesting alternative strategies with your nurse or at least asking on average how many hb11c % points did patients like you drop by using the medication?
 
So you are almost out of the diabetic range? That's a substantial achievement in a few weeks and the progress should continue. I resist taking any drugs I don't have to, and falling A1c numbers would tell me I was already doing something right.
 
Thank you everyone, so I started low carb beginning of February, which was at the same time of being diagnosed with a para umlibical hernia and being told I had to have an emergency op, then obviously I was home schooling, so I my anxiety and stress was extremely high. She gave me glicizide to take as well but it was sending me into hypos so that was stopped after 10 days.

After my 8 week recovery I’ve also started hiit workouts and also on week 2 of couch to 5k and I was feeling so positive, but after the email from the nurse I feel so deflated now.

My typical day is,

Greek yogurt with berries, or nuts, occasionally ( although not a big egg lover) I have eggs and oven baked bacon or sausages with mushrooms.

Lunch salads with meats , tuna, or cheese.

Evening, stir fries, curry with no rice or a very small portion if I’ve done a lot of exercise that day, the same with pasta also.

I drink at leat 2 if not 3 litres of water, do a minimum of 10,000 steps a day too, always park the farthest away, always use the stairs etc.

I just feel so so lost!
 
Sounds like you’re doing well @KirstyRobbie - with an emergency op and the stress of home schooling, I’d say that’s a great drop in HbA1c as the op and stress won’t have helped your blood glucose levels. Food looks good too - keep at it and you’ll likely see more improvements.
 
If you are still eating grain and seeing your Hba1c falling you are doing very well and your nurse is expecting too much.
You have already had hypos on medication she prescribed - she could be dangerous.
 
Your nurse sounds a bit medication happy to me. Maybe she hasn’t had much experience of people using low carb or hasn’t really got any idea how much the stress of surgery/recovery and homeschooling push numbers up. Gliclazide at 56 seems a bit keen as well unless other things had failed.

Quite frankly you’ve done amazingly well under the circumstances and I’d be telling her I was happy with my results so far and will continue as I am for now and check again in 3 months time now the rest of life has settled more.
 
I also think you are doing well, even without all your other problems. With an HbA1c of 50 on diagnosis medication is unlikely to be offered, including Metformin, so I cannot understand why your nurse wants to increase your meds. I think she is wrong, personally. I can't tell you what to do, I'm not a medic, but if it were me, I would say "no", not at the moment.
 
Hi. You have done very well and your nurse is expecting too much. Just keep doing what your are doing. My last HBA1C was 56 and although I would like to see it go lower it's a balance of hypos with insulin versus higher HBA1C. My diabetes consultant also thinks it's OK. Personally I would stay off the Glutide meds which you are being offered as I can't see why you need them?
 
She said I was young at 34years to have a hba1c of 50 and she was hoping I would of got into the 40s so she suggested the injections, but I really do not like the sound of them at all and can not find anything positive.

I’d rather stay doing what I’m doing slowly gradually and safely, and bring the numbers down. Obviously if I was told I was in real danger or my life was at high risk I’d do it. But I just feel really under pressure now?!
 

Please don't feel under pressure. It is your choice whether to take medication or not. It can only be offered - not forced. I suggest you ask nurse for 3 months grace and carry on as you were.
 
Type 2 is typically (especially in the early years) a disease of high circulating insulin and insulin resistance. Adding more insulin to this is likely to increase resistance even if short term it reduces bgl.

Addressing (or ignoring) the underlying problem of insulin verses the measurable symptoms of blood glucose levels can make a big difference long term from all I’ve read.
 
KirstyRobbie said:
My nurse has suggested me trialling one of the 2, as I’ve been doing low carb the last few weeks and my hba1c has only decreased from 56 to 50, and she isn’t very happy.
Click to expand...

Have you been testing your levels with a blood glucose testing meter? That would tell you much more than an hba1c. Personally, in your position, I'd want to give the low carb a proper trial, and using a meter would allow you to target the carbs in your meals so that you know how much your body can tolerate.

And congrats on the weight loss. Weight gain is a side effect of high circulating insulin (T2s are insulin resistant so typically produce lots of it) and high blood sugars, so reducing your carb load should also help with weight loss.

Of course, there is one proviso on that. Weight loss can also be a symptom of T1 (low insulin) and in that case though low carb would help you make the most of the insulin you have, you would eventually need insulin. Hopefully your nurse will bear that possibility in mind and give you the tests you need (GAD and cpeptide) if your levels suddenly jump up.

But it sounds like you have an excellent routine in terms of diet and exercise.
 
What was your dose of gliclazide? The max daily dose is 320 mg, and the min dose is 40mg She should have started you on a low dose and increased it slowly if necessary, and with an HbA1c of 50 that should not be the case. I use 40 mg of Glic now, and I can drop 4 mmol/l on my meter after a meal, so it is quite effective. If she started you on a high dose, then no wonder you got hypo's.
 
If it were me. I would go very low carb of 10-25g a day and give it a month. I would get a BG meter and strips to home test. To see how I am going.
A food list.
https://www.ketogenic-diet-resource.com/support-files/kd-basics.pdf
A 20g carb, set menu. I would consider protein of about 60g a day for female and 90g for a male to lose weight.
https://sa.atkins.com/static/default/files/documents/pdf/mealplan/Atkins - Meal Plan_Week_onePhase one.pdf

I'm on Ozempic. Given you are losing weight now, you may not need it. Weight loss may help your BG levels. If you need it, I would google the latest double blind trials and metadata reviews. The warnings are from 2005 rat studies. In practice, these fears aren't being found in the human trials, any more than the control group.
 
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@KirstyRobbie the advice to get a glucometet (if you don’t already have one) is good advice - shout if you need some ideas about that.

On the food front, what you’re already doing looks fine and is working since your HbA1c dropped. However, if you wanted to tweak it further, the diet doctor website is brilliant, with foods/recipes and menus to suit all preferences: https://www.dietdoctor.com/ (no need to take any of the paid options, you can get what you need for free).

But if you try and avoid processed foods (meat, fish, eggs, some dairy) and stick to fresh sources of protein, with above ground veg, you can be pretty certain of minimal blood glucose impact.

Above all, any changes you make need to be sustainable for you. With time, most find this way of eating to be enjoyable.
 
Are you in the UK?

The NHS NICE guidelines suggest treating T2 with diet and exercise initially, and if that doesn’t work adding in a single drug (usually Metformin/Sukarto).

if that fails to bring numbers down then add in another drug and raise the target HbA1c to a level above your current HbA1c of 50.

Have a read of the attached link and compare it to your personal situation
https://pathways.nice.org.uk/pathwa...tes.xml&content=view-node:nodes-hba1c-targets

It looks to me as if your nurse is accelerating your drug therapy faster than the guidelines and not taking into account that you are making changes and improvements to diet and lifestyle that are clearly having a beneficial effect, and will continue to do so.

your weight loss is impressive. Well done.

and please feel free to show your nurse the NICE info and query her thinking.

it is entirely up to you whether you use any medications. She can advise, but not instruct.
 
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