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Sulfonyurea, byetta or any other meds that help insulin sensitivity and weight loss?

Discussion in 'Type 1 Diabetes' started by megan, Oct 1, 2020.

  1. megan

    megan Type 1 · Well-Known Member

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    This week I had my diabetic consultant and team on a speaker phone consultation. The line wasn't completely clear so I didn't grasp a couple of words.
    But I had asked, again, why clarythromycin may have made my insulin requirements by a third in 7 days and was there another medication that did this other than an antibiotic.
    That appears to be a no although I don't agree. But I am just the patient.
    So disregarding what is written in my letter to my team earlier this year, which had been distributed to all concerned for their opinions... this dr continued on the line of why is it I want to lose weight. Mmmmmm
    Healthy BMI
    Reduce risk of multiple diabetic complications with improved blood sugars. Did I really need to explain that??
    So then he said there's a group of drugs he's not keen to prescribe because there's increased risk of DKA.
    Would that not be the type of medication I was asking about? I think I've proven having avoided SEVERE hypos on the two occasions I had clarythromycin that I watch my health carefully and perhaps this drug could be a game changer for me. Would this be the category of SULFONYUREA ?

    He'd mentioned metformin briefly ( which in my letter and in my records I've been on for years max dose)
    He mentioned byetta ( which in my letter states I tried but it made me very sick)

    So I came off the phone a bit deflated. I write to my nurse straight away to ask her to clarify this name of meds that I didn't catch the word for. Nothing back yet.

    Anyone else with any experiences or knowledge of these meds? Or others I don't know about?
    I know that sometimes a medication proves useful even if used for a different purpose to it's initial intention.

    Oh and I did have to answer this dr with ' no 500-800 Cals a day on my 16:8 program is not sustainable for me long term' ( I'd done it for about a month and then continued with 16:8 and more Cals since then
     
  2. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    https://www.diabetes.co.uk/diabetes-medication/

    Metformin is the one which increases insulin sensitivity and can help reduce appetite and weight.

    Edit: most of the rest seem to stimulate the pancreas to produce more insulin (which can lead to weight gain). One down side might be eventually burning out your pancreas.
     
  3. Rokaab

    Rokaab Type 1 · Well-Known Member

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    Though given that @megan is Type 1, megans pancreas will not be doing much insulin producing anyways unless newly diagnosed (in which case it might be erratic at best)
     
  4. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    Yes, missed that.
    However I am a bit confused because I didn't think sulphonylurea and other such drugs were appropriate for a T1 beyond the honeymoon period.
     
  5. Daibell

    Daibell LADA · Master

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    Hi. First forget Calories and think Carbs. 'Calories' have no use for us; sorry. If you are T1 you should be on the Basal/Bolus (MDI) insulin regime per NICE Guidelines if you are in the UK. Some of us do have Metformin even with the insulin. It helps a very small amount, does no harm and has some other benefits. You should not have Sulfonylureas such as Gliclazide with insulin as the insulin does the job of providing the insulin you need. Byetta is best avoided even if overweight as it has some side effects (it's a weight reducing drug). If you do have excess weight then keep the carbs low enough for the weight to come down. Most antibiotics do increase blood sugar and a decent medics would know that. In summary when on insulin you wouldn't normally have any other diabetes tablets other than possibly Metformin. Weight is normally controlled by Carb intake but people's metabolisms vary so some will find it harder.
     
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  6. megan

    megan Type 1 · Well-Known Member

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    Thanks for the reply's. I've been type 1 for about 30 years. I've been on metformin for years. I've tried byetta.
    I've done no carb and low carb and it's said now it's recognised that my body reacts with ketogenesis and so I can end up taking almost as much insulin for a green salad as I do a sandwich so it doesn't work for me. It actually makes things more erratic. So I continued to gain weight. Believe me I've tried everything.
    I did DAFNE years ago and am on an insulin pump
    And the issue with those antibiotics was that it made my blood sugars drop drastically so much so I had to reduce my insulin by a third for that week
     
  7. ziggy_w

    ziggy_w Type 2 · Well-Known Member

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    Hello @megan,

    Sorry, I'm a T2, so won't specifically comment on your situation. Just chimming in to suggest that maybe the medication your doctor was referring to is an SGLT2 inhibitor. SGLT2 inhibitors lower the threshold at which sugar is spilled through the kidneys and these sugars therefore end up in your urine). This class of medication can help a little by lowering insulin requirements, but as you've noted they are associated with ketoacidosis (or specifically with euglycemic ketoacidosis -- lowish blood sugars with high levels of ketones).
     
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  8. megan

    megan Type 1 · Well-Known Member

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    Hi yes that is correct. My nurse has just got back to me. I have asked if I could be allowed to trial a very low dose. It's that or byetta. And I'd already shown I was able to follow a 500-800 calorie a day diet with no carbs
     
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