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T1, Dapagliflozin, weight loss, DKA risk

Discussion in 'Ask A Question' started by WJP1055, Jan 15, 2020.

  1. WJP1055

    WJP1055 Type 1 · Active Member

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    Morning fellow T1Ds. I don't write on here very often but I usually read selected articles on a regular basis. Since I've been suffering with back spasms, which are keeping off the golf course, I find that I have more than a little time to contemplate my current condition. I'm on Novorapid/Lantus and have followed a relatively low carb diet for 2 years but have only lost 1.5st, I'm currently 16st 7lb. I take two 500grm metformin tablets per day, one statin and an aspirin. My last HBA1C was 47 and my previous range has always been between 51 - 56, so that's a big tick. I've struggled to loose anymore weight despite being fairly active (golf 3 x pw = 15 miles of hill walking). I have asked my consultant about "dapagliflozin" which she says can help with weight loss but there is the possibility of risking DKA. So my question is has anybody tried this medication and did it have the desired effect, i.e. weight loss with little or no risk?
     
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  2. slip

    slip Type 1 · Well-Known Member

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    Hi @WJP1055 I see you're an old timer when it comes to T1D and it sounds as though you're doing pretty well! Sorry I've no idea regarding dapagliflozin but what I would like to ask is how many carbs is 'relatively low carb'? And what do you attribute to the recent drop in hba1c? (well done btw)
     
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  3. porl69

    porl69 Type 1 · Well-Known Member

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    Hi @WJP1055 Same here, I have no idea with dapaglifozin.

    AND well done on your latest A1C :)

    (edtited because new thread was created)
     
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    #3 porl69, Jan 15, 2020 at 12:36 PM
    Last edited by a moderator: Jan 17, 2020
  4. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    WJP1055 - as you may know the Flozins (there are a number of very similar meds), are much more commonly prescribed to T2s, looking to reduce their blood sugars, and maybe trim up a bit too.

    The risk of DKA is in a different form to the more usual T1 DKA, which, as I understand it is associated wit his high blood sugars, plus ketones. The risk with the Flozins, put in its simplest form, is that DKA can occur when the individual has perfectly normal, non elevated blood glucose. On that basis, it tends not to be indicated where a person is eating to a Keto or very low carb lifestyle. I haven't noticed if you mentioned how low carb you are.

    Obviously, if you are already living a reduced carb diet, and have great blood sugars, it is unlikely, as things currently stand, that you would experience DKA in the immediacy. Obviously, illness, stress and so on have the capacity to be a game changers.

    Were I in your shoes, having got myself into a good place, I (and I stress I express this for myself), I'd not be at all keen to bring another risk into the agenda, especially when considering how dreadful DKA can be.

    If your kidneys are in decent shape, did your Doc consider upping your Metformin a bit more. You don't appear to be on the max dosage, and Metformin can help some trim up, whether through appetite suppression, or improving insulin resistance, where there is any.

    Just finally, you state you take a daily aspirin; is there a particular reason for that?

    (edtited because new thread was created)
     
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    #4 DCUKMod, Jan 15, 2020 at 1:02 PM
    Last edited by a moderator: Jan 17, 2020
  5. WJP1055

    WJP1055 Type 1 · Active Member

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    I tend to have less than 100grms of carbs per day, eating mainly proteins and vegetables (excl potatoes and similar high carb options). This does exclude the few glasses of red wine I like to have each evening, The aspirin was prescribed approx. 10yrs ago to prevent heart attacks, although there is no history such illnesses in my family. I would like to loose weight to reduce the pressure on my lower back. Over the last 10 months I have suffered with a number of back spasms which are preventing me from exercising and causing some weight gain and thus exasperating my weight problem.

    (edtited because new thread was created)
     
    #5 WJP1055, Jan 17, 2020 at 2:46 PM
    Last edited by a moderator: Jan 17, 2020
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