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Nearly one year in… struggling

V

victronnix

Member
Messages
7
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I came off long lasting insulin recently as I was annoyed at not being able to get my weight down despite doing Keto. I am also on 10mg Empagloflozin.

I tried ozempic with the empagloflozin and I was severely ill for two weeks (bed ridden, severe diarrhoea and vomiting) so came off that.

I have revisited metformin (have been on 1g morning and 1g evening (2g a day) for about a month now and it doesn’t seem to do much for me at all.

My bloods are usually over 10 in the morning at the moment. I had got them down to between 6-7 last year on the Empagloflozin and insulin. The most insulin I took was 18ml in the morning.

So my questions are..

1 - Would 18ml of long lasting insulin cause weight gain/hinder weight loss? If it is only a small impact maybe I would be better going back onto the insulin rather than metformin.

2 - Do I need to give metformin longer to work?

3 - Apparently I should not do Keto with empagloflozin, as risk of ketoacidosis, so the nurse says low carbs, but any carbs seem send my blood sugar soaring even with the metformin.

4 - When I started taking Empagloflozin my blood sugars were immediately much lower. I was delighted! But then after a couple of weeks it seemed to be less effective.

I would appreciate any help or clarity with this as I struggle to find the right treatment. Thank you.
 
I can only speak from my experience.

I lost weight steadily whilst on insulin (Basal & Bolus). But understand that many people find it more difficult to lose weight when taking insulin.

Metformin did lower my blood sugars (but only a small amount). I reckon around 0.5 to 1 mmol on average. That was taking 1 to 2g per day.

A few years back I did Low carb / Keto for a period of about 6 months whilst taking Empagliflozin and had no issues.

Last year I went low carb / Keto (was still taking Empagliflozin) and I was hospitalised 2 weeks later with DKA. Hospital said it was due to the Empagliflozin.

I didn't recognise that it was DKA because my blood sugars were fine. I'd always thought it was high sugars -> check for ketones -> seek help. But apparently Empagliflozin can mean even though you develop DKA, blood sugars may still read as OK.

Know the symptoms of DKA and I think you should be ok to try low carb / keto. And if you have Ketone test strips that may give you more confidence.
 
I think the 2 posters above have pretty much covered it except for the question about how long Metformin takes to make a difference.

No personal experience of diabetes medications but I know from metformin takers that it takes around a week for it to build up in your bloodstream. And even then it works by discouraging your liver to dump so much glucose into your bloodstream - so has no effect on the glucose from digesting all the carbohydrates you eat.
 
Thank you everyone for your replies. I’ve asked for a dr or diabetes nurse to call me today from the surgery to decide what to do getting my blood sugar down has to be the priority.

I am hoping if I go back on the abasaglar that the smallish dose I need won’t hinder weight loss too much.. I don’t have much energy with these higher readings so that’s not going to help me lose weight either!

I am learning that this is all a balancing act!
 
I am a 45 year old lady and was diagnosed with type 2 last October. I stuck to the Dr Michael Moseley 800 cals a day diet (8 week blood sugar diet) for 2 months, whilst taking Metformin up until Christmas. Since Christmas I was on metformin plus empagliflozin, meanwhile gradually increasing my calorie intake, I now eat 1500-1800 a day on average and the nurse told me my HBA1C is now down from 87? to normal levels. Still on the metformin but hopefully I can come off that soon too. Due to other health issues I couldn't exercise much last year but the blood sugar diet book does give some good advice on that too, and now I'm 3 stone lighter than October, but more importantly feeling much better, sleeping better etc. My advice would be to try the blood sugar diet but speak to your diabetic nurse/doc to advise you are doing that as they'll probably say don't take empag. Write down what carbs and calories you eat in a day (I used 'Carbs and Cals Pocket Counter' book). Yes, it does have some weird food in the recipes, you will feel hungry for the first week but after that its ok. It does have some good recipes which I'm still using now e.g.courgetti (courgette made into ribbons in lieu of pasta), i now do half a portion of pasta and half courgetti. I hope that helps, good luck.
 
NicNak99 said:
I am a 45 year old lady and was diagnosed with type 2 last October. I stuck to the Dr Michael Moseley 800 cals a day diet (8 week blood sugar diet) for 2 months, whilst taking Metformin up until Christmas. Since Christmas I was on metformin plus empagliflozin, meanwhile gradually increasing my calorie intake, I now eat 1500-1800 a day on average and the nurse told me my HBA1C is now down from 87? to normal levels. Still on the metformin but hopefully I can come off that soon too. Due to other health issues I couldn't exercise much last year but the blood sugar diet book does give some good advice on that too, and now I'm 3 stone lighter than October, but more importantly feeling much better, sleeping better etc. My advice would be to try the blood sugar diet but speak to your diabetic nurse/doc to advise you are doing that as they'll probably say don't take empag. Write down what carbs and calories you eat in a day (I used 'Carbs and Cals Pocket Counter' book). Yes, it does have some weird food in the recipes, you will feel hungry for the first week but after that its ok. It does have some good recipes which I'm still using now e.g.courgetti (courgette made into ribbons in lieu of pasta), i now do half a portion of pasta and half courgetti. I hope that helps, good luck.
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Hi, I've just been encouraged (today) by my GP to give that Moseley 800 cal diet a try and I think I'm going to do it. How did you find it? I'm not going to follow it exactly, but will limit my calories to 800 (I hate lentil soup and that is one of the recommendations). Glad to hear you've had success on it.
 
KateTheGreat said:
Hi, I've just been encouraged (today) by my GP to give that Moseley 800 cal diet a try and I think I'm going to do it. How did you find it? I'm not going to follow it exactly, but will limit my calories to 800 (I hate lentil soup and that is one of the recommendations). Glad to hear you've had success on it.
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Not too bad, the soups were a bit boring as I'm not a huge fan of soup anyway, but other things like omelettes, using full fat mayo, replacing rice with quinoa I've kept since finishing the diet and managing to keep my weight steady now and my blood sugar in check. It is difficult in the first week as you will feel hungry, but after that you get used to it. I gave up alcohol too, never drank much anyway. Good luck with it.
 
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