Mounjaro with T1

Hi
I cannot help but i can welcome you and i hope you find what you are looking for...
These days i feel old fashioned as i have been successfully managing on MDI however my last hba1c of 39 is better than the 3 people i know who have pumps.

I wish you well

Tony

Hi,
Welcome to forum, I would suggest talking through your Basal doses or have a structured plan agreed with your consultant and/or DSN to reduce the daily dose if you start having excessive hypo episodes due to changes in your insulin sensitivity.
I know a couple of Type 1's who have used GLP-1 medication for weight issues but both of those people were on HCL Therapy and the pump handled the increased insulin sensitivity that came with the GLP-1 dose.
From talking to both of these people, they told me their TDD dramatically reduced (I can't give you a percentage figure as they never said) so your insulin usage will need to be closely monitored by your Diabetes Team.
Good luck with the weight loss and hopefully it will improve your quality of life.

Hi and welcome to the forum @Dogz111 . You might be interested in a thread I started on tirzepatide, which is the active ingredient in the brand name Mounjaro.

Its an interesting one - the hormone in Mounjaro that actually does the work is 'GLP-1', one of the 6 hormones affected by a T1 pancreas beta-cell deficiency.

Not seen much UK based investigation into this 'yet' other than Tim Street did a bit of analysis (article here).

It is used by 'Diabetes Nerd' (search on YouTube) who suggests it reduces the amount of insulin needed using micro-doses.

Not sure if any of that will help - might be worth a read as a place to start. I'll be interested to see what you find regarding the insulin management side.

Hope it works for you (just go steady and stay safe)

Hi, I don’t know what will work for you but would like to share my experience with both mounjaro and wegovy for weight loss. I switched to wegovy after the recent increase in the price of mounjaro. I am T1D for 50 years and now aged 68. I have been using both on and off for the past 12 months and have lost over 6 stone in weight. I had absolutely no help or support since the weight loss injections I was told “aren’t for type 1s”. I fund them myself. I had and continue to have good overall control and have always followed a healthy diet but over the years especially since my husband died I’ve piled on the weight. Due to my “good control” I have been unable to try a pump. I’m taking fiasp and levemir and have through my own trial and error been able to drastically reduce both. My advice would be to try if you feel you need to but be extremely vigilant with your levels. You will need to reduce your insulin but it all depends what your dose is now, how much food you can consume (I had absolutely no appetite and couldn’t face eating anything at first) and keeping lots of your go to hypo treatments to hand. I was lucky I think in that I managed it by myself with many years of knowledge and experience behind me. It sounds like you are getting yours from the gp or clinic. Would you be able to discuss with them or ask for help? On a personal level I’m so happy I persevered and am now at the weight I should be with a healthy appetite. Good luck to you.

Dogz111 said:

Hi Everyone,

New member!

After months of badgering the hospital, GP and diabetic nurse they have finally relented and agreed it’s ok for me to go on Mounjaro albeit privately. Whilst this is less than ideal, I think the benefits far outway the cost

I’m interested in anyone who has been on this journey and how it affected you especially with background insulin and carb ratios. I’m thinking I might just cut the background and bolus insulin amounts by 50% but was hoping for some perspective rather than just guessing. Whilst I know everyone is different, I’d be really interested in any thoughts

By way of background, I’ve been a T1 diabetic for 39 years and am well controlled with my last HBA1C of 44. My current BMI is 38 which I think is a factor of insulin resistance, due to weight and pangs of hunger do to insulin volumes. I’m currently on Triseba and Fiasp if that makes any difference

My ideal is to go on the omnipod but being well controlled alongside my insulin doses, this isn’t an option

Appreciate your thoughts

Click to expand...

I am in a similar situation but also have the female change of life affecting weight loss attempts.

I am awaiting Diabetics specialist approval but also aware of budget cuts being made.

You may find this site useful to see current practice among GPs. https://openprescribing.net/analyse...ZBB&denom=total_list_size&selectedTab=summary
It does allow you to select area and even drill down to individual GP practices.

I was unusual as I live half my life in Spain so also have a Spanish GP and she also happens to be a diabetes specialist at our local university hospital. She prescribed MJ, but I had to pay for it there. My UK GP argued that as a D specialist had prescribed, so could he and I get (at the moment) MJ on NHS. My UK D specialist concurred and even upped the dose to 10mg and further to 15mg if required. He also recommended I stop using Humalog and only Humulin I. Not been able to completely comply but have reduced from ~40 units/day to ~6.

But I need tight control using Libre and Juggluco! That is critical and it becomes much more difficult to maintain A1C and time in range as the weight comes off. Almost 20% now , Est.A1C 42, TiR over 80%. It can be done.

So it is possible to get MJ on NHS but requires commitment- a lot of it!

Also useful is NESTA.ORG The press releases are not too complex to read but the detailed financial analysis show that the NHS could save £15 Billion by allowing free script at primary care! Thats £Billion with a B!
So it may not be too long before the regulators are forced to change.
Unfortunately they are each trying to grab their own issue from the limited NHS pot and T1 is too often mistaken as no weight problem - it actually is same as non D : about 60% overweight or obese! Cost of that with resultant issues makes MJ cost small - but try proving it!

NESTA goes further to prove that the U.K. as a whole is wasting £150 Billion on overweight and obese! Political pressure will help but there will need a media campaign as well as by PWD.

In the US, there has been good trials of MJ for T1. Trump is starting to take note and demanding MJ price reductions.

Sorry for the long reply but we need to get working on this for the UK.

Bill_St said:

You may find this site useful to see current practice among GPs. https://openprescribing.net/analyse...ZBB&denom=total_list_size&selectedTab=summary
It does allow you to select area and even drill down to individual GP practices.

Click to expand...

Even the lowest region, London, is still prescribing 10,000 MJ pens in August but the sharp decline is noticeable at the end of a quite rapid rise.

Hi There, i spoke to my consultant about this and was told no as i had had DKA but i have put pounds on and now have a scary BMI my diabetic team seem its a no no for me but ive wanted to try but dont think i would be confident enough

Hi @Dogz111 - I'd be interested to see what you find.

In theory it should be beneficial as its one of the 6 hormones messed up by the 'Beta-cell delete' of T1.

Have a look at Diabetes Nerd on Youtube - she's been injecting Ozempic micro doses alongside insulin and found it decreased the insulin requirements

Hi @Dogz111
It's nice to hear about an open minded Endo (with regards to treatments) but have they given you a plan on insulin dose reduction?
I'll be interested to hear how you get on with the Mounjaro wrt insulin requirements, TIR and HbA1c

My short acting insulin has gone down from typical 25-30 units/day to 5-6, sometimes Zero! Still maintaining 20 units basal.

It is very interesting to see how much individual practices vary within a region.
Openprescribing does provide this analysis.

As an example, I provide the results for my own region. Corrected for the different list sizes, it gives the amount of weight loss drugs prescribed per 1000 patients so is a valid comparison. It shows variation from Zero to over 12 units per 1,000 patients in Oct.

Unfortunately it does not allow any distinction between T1D and T2D but while these figures are for all weight loss drugs, the vast majority are Mounjaro.

Also very interesting is the amounts prescribed over time. A very strong increase up to latest date Oct’25.

All of these practices refer to a limited number of specialists so the variation would seem to be due to individual doctors rather than the specialist teams. Different interpretations of national guidance perhaps but it would seem well worth having discussions with our specialists and asking for recommendations to be given to our doctors.

Try looking at your own regional and local usage …

Bill_St said:

It is very interesting to see how much individual practices vary within a region.
Openprescribing does provide this analysis.

As an example, I provide the results for my own region. Corrected for the different list sizes, it gives the amount of weight loss drugs prescribed per 1000 patients so is a valid comparison. It shows variation from Zero to over 12 units per 1,000 patients in Oct.

Unfortunately it does not allow any distinction between T1D and T2D but while these figures are for all weight loss drugs, the vast majority are Mounjaro.

Also very interesting is the amounts prescribed over time. A very strong increase up to latest date Oct’25.

All of these practices refer to a limited number of specialists so the variation would seem to be due to individual doctors rather than the specialist teams. Different interpretations of national guidance perhaps but it would seem well worth having discussions with our specialists and asking for recommendations to be given to our doctors.

Try looking at your own regional and local usage …

Click to expand...

Select Time Series option to see change over time.

chrisincontrol11 said:

Hi, I don’t know what will work for you but would like to share my experience with both mounjaro and wegovy for weight loss. I switched to wegovy after the recent increase in the price of mounjaro. I am T1D for 50 years and now aged 68. I have been using both on and off for the past 12 months and have lost over 6 stone in weight. I had absolutely no help or support since the weight loss injections I was told “aren’t for type 1s”. I fund them myself. I had and continue to have good overall control and have always followed a healthy diet but over the years especially since my husband died I’ve piled on the weight. Due to my “good control” I have been unable to try a pump. I’m taking fiasp and levemir and have through my own trial and error been able to drastically reduce both. My advice would be to try if you feel you need to but be extremely vigilant with your levels. You will need to reduce your insulin but it all depends what your dose is now, how much food you can consume (I had absolutely no appetite and couldn’t face eating anything at first) and keeping lots of your go to hypo treatments to hand. I was lucky I think in that I managed it by myself with many years of knowledge and experience behind me. It sounds like you are getting yours from the gp or clinic. Would you be able to discuss with them or ask for help? On a personal level I’m so happy I persevered and am now at the weight I should be with a healthy appetite. Good luck to you.

Click to expand...

I am interested in trying Monjaro or wegovy but not sure how to get hold of it. If you try and buy privately and state you are type 1 all the sites I have tried say they won’t prescribe. I am going to ask my endocrinologist but it’s unlikely he will approve it as my control is good and BMI less than 30. My main driver is completely unable to lose weight even on keto. I have high bp and want to bring weight down to come off Ramipril.

Edited by mods to remove forum rule breach