I am on Rybelsus, the tablet form of Ozempic (semaglutide). I started a clinical trial (Ascend Plus) which involved a run in period of several weeks, first on the 3mg and then the 7mg of semaglutide. Then I was randomised into either 14mg or the placebo. Unfortunately I ended up on the placebo, and has since withdrawn from the trial and my GP surgery has prescribed Rybelsus 7mg after seeing my results from the real drug during the run in part of the trial.
My 7 day average BG has come down from 19.2mmol/L in late July to 6.5mmol/L mid/late November. Before this it was to high to record on my meter, so over 22mmol/L - I dread to think how high it got before I made changes.
I tried metformin at diagnosis and also late last year, but was unable to tolerate it at all. I was diagnised in 2018, so T2 officiallly for 7 years, and apart from a good drop in HbA1c at the start, off the rails due to depression and burnout. In between diagnosis and now, my weight went as high as 275lb, until it started to reduce gradually by about 9lb per year because of better portion control around 4 years ago. However my diet became very high carb, which was disastrous for my BG.
Nov. 2024: HbA1c - 126 / Weight - 235.4lb / BMI - 33.8
Dec. 2024: HbA1c - 112 / Weight - 232.8lb / BMI - 33.5 Some attempts at diet control.
Aug. 2025: HbA1c - 121 / Weight - 239.2lb / BMI - 34.3 Diet off the rails again.
Sept. 2025: HbA1c - 81 / Weight - 224.2lb / BMI - 31.9 Keto/VLC/IF, exercise, Ascend Plus trial.
I was diagnosed with NAFLD (fatty liver) in February this year after high serum alanine aminotransferase levels (ALT) and an ultrasound.
ALT 08/08/25 121 abnormal but expected - carb heavy diet
ALT 30/09/25 59 abnormal - after 6 weeks of keto/VLC and exercise and the Ascend Plus trial - semaglutide (Rybelsus)/placebo.
My cholesterol results have also come down.
I am going to have my HbA1c and full bloods tested again in February to see if the dosage of Rybelsus is enough - currently 7mg, and to see what the effect of the drug and my diet has been in other areas.
i am expecting a much lower figure than the HbA1c of 81 in September, as I use a CGM to monitor blood glucose continuously and this has consistently shown a big drop already. The semaglutide seems to make a difference in lowering my BG by 1.5 to 2 points. I have also found the dawn phenomenom much improved, with figures of around 8-9 on the placebo, now in the late 5s and low 6s. I also found improvements in my liver and cholesterol results and have lost 27lb over the last 16-17 weeks, mostly in the last 13 weeks.
I have also switched to a very low carb/keto way of eating plus daily exercise, and this has been very effective for reducing my weight and BG.
I am doing regular updates on my profile to document everything connected with the BG/weight/NAFLD/medication.