Ozempic

I am assuming you are Type 2 - you don't have it on your profile.

I am Type 2 and I am on Rybelsus, the tablet form of semaglutide, and I have seen a big reduction in HbA1c and in weight, but almost all of this was down to going low carb and exercising every day. I have lost almost 50lb now over around 7-8 months, logging all food and exercise and making sure I have a calorie deficit. My carbs come from some dairy (greek yoghurt and cheese) above ground vegetables, and nuts and a few berries. My blood sugar results are in my signature at the bottom of this post. My dose of Rybelus is the lower one of 7mg rather than the highest of 14mg (it takes a bigger dose in tablet form than injection because it is less bioavailable), so this would be equivalent to a 0.5mg dose of Ozempic I think.

Are you looking at what calorie intake you are eating, and how many carbs? Some things like milk can have a larger effect on carb intake than you think. I switched to almond milk as it is much lower in carbs and calories than dairy milk. If you are doing a lot of exercise it is possible you have put on a lot of muscle - have you gone down any clothes sizes - it is not always obvious on the scales when you are losing fat if you are putting on muscle as well.

I also find that using a CGM has been really helpful as it has helped me see how I respond to different foods, and what time of day it is better to eat them.

The exercise is also really important to improve the way your body handles the blood sugar. I am pretty strict with myself on diet and exercise, and keep the carbs to between 20 and around 40 to 60 per day.

Although these drugs can be helpful, they work differently for different people, and most of the weight loss is to do with diet as their main role is suppressing appetite and also improving your response to glucose to one more like someone without diabetes, so they are helpful but there is a lot of hard work to be done on diet.

I will also say that the heavier you are the easier it is to shift weight - I was getting an average of 1.8lb off per week at first, and now it is averaging around 1.4-1.5lb off per week, so things may depend on where you started. I have a link in my signature to my profile posts where you can see how things have gone over the last few months, and I will be doing my 4 weekly update on there next week.

mallins said:

Hi
Thanks for your reply. I have tried cutting my carbs to 50g a day but I was feeling really ill at that level. I had no energy at all and felt exhausted all the time. I have upped my carbs to between 130 150 a day but that might be too much for my body. I use a CGM and my sugars are usually within the limits set but usually towards the higher end. When I saw my diabetic nurse on Wednesday she was saying that they didn't want my sugars coming down too quickly as I might experience hypos. I think I will just need to plug on with the healthy eating. I have invested in the Zoe app and have been trying out some of their recipies. Obviously you cutting your carbs to between 40 and 60 has really worked well for you and you have achieved fantastic results. It does give me hope that if I just keep plugging away I might eventually get there before I pop my clogs!

Click to expand...

@Melgar has had experience of not tolerating low carb very well from what they have posted, perhaps they could join this discussion to talk about what has worked for them? Low carb diets are not for everyone, and there may be other members who could talk about their own experience with these issues.

On my own experience: I am also making sure I eat high fat and enough protein - fat is usually about 20% protein 10%carbs 70% fat in terms of calories. Definitions of what low carb looks like are are very varied - this might not look like low carb to some people.

What are the limits set for your CGM? I use the Dexcom One plus and I have set my limits on Clarity to between 3.9 and 7.8, so I can focus on keeping within a smaller range than the standard one set on the CGM. Setting this range has really helped me focus on lowing the variability of my blood sugars and staying within a healthy range 2 hours after food. I have lowered this gradually over several months as my blood sugar has come down.I aim for under 7.8 2 hours after meals and if I am being strict with myself no eating until under 6.0 - however most of the time I am just eating when hungry which works out a two meals and a snack per day with at least 12 hours of fasting and usually 18 hours between last meal in the evening and the first meal.

I try to make sure that the food I am eating will last me a long time in terms of needing my next meal and that has worked well at driving the blood sugar slowly downwards. This generally means enough protein and fat to keep me feeling OK for longer. Snacks tend to be fatty and or made up of protein, so nuts, boiled eggs, meat, or fish, pork scratchings, greek yoghurt etc.

If you are feeling exhausted it could be because you are not eating enough fat. Other low carb people may want to come in with ideas for low carb that helps with energy. Having said that it is not for everyone, people can react differently to different foods, what is important is what works for you.

I get my fats from seeds and nuts (almonds, pistachios and cashews), greek yoghurt, cheese, soft cheese, eggs, olive oil, avocados, butter, some 70% dark chocolate, pork scratchings, and moderately fatty meat and fish - not too fatty as I would struggle to eat it, but for example, chicken thigh meat rather than chicken breast, and 12% mince rather than the 5%. Oily fish such as salmon. I add butter to food sometimes to up my fats, but not excessively.

The pork scratchings and nuts are great for a high fat energy snack plus they always seem to bring my blood sugar down. Portion control is essential with these though.

I also make sure I am hydrated properly, and that I am getting enough fibre in my diet, and plenty of variety to avoid boredom

What does your food intake look like in a typical day?

I know people tend to up their fats when eating low carb to make sure they have fat as an energy source.
have you looked at the Diet Doctor site associated with this site? They have lots of good recipes for low carb eating.

On the hypo comments from the nurse - are you on any other diabetes meds apart from the Ozempic - I don't think there is a risk of hypos with semaglutide. Other members may wish to comment on their experience. The reson I am on the Rybelsus is that I refused medication that had a risk of hypos as I was keen to keep the low carb going..