Victoza- weight gain-hypoglycemia

[rehab1171]

Hello, I use Victoza to control my hypoglycemia episodes, so I am not diabetic I come from the other side. I have too much insulin and slow release of glucose from liver. I can easily get down to 2.3- 1.8 measured by Freestyle Libre. I use Victoza but I put 18 kg in 6 months approx. which increased back inflammation and pain. On keto or low carb diet or IF my glucose is down to 1.8 over several days, longest I tried was a week then I gave up I was just in bed. If I take moderate carbs as advised by my doctor glucose jumps to 15 before carshing and all within an hour or two. My doctor is basically giving up on me and my weight, performance at work and backpain are deteriorating with time. So any help on diet would be highly appreciated. Thanks ( and yes I have seen several doctors in several countries - This is the only one that at least tried hard to help).Also experience of how to control weight gain with Victoza is appreciated. Thanks.

 

[Goonergal]

I’m confused. Why would you be using a blood glucose lowering medication to treat hypos?

 

[zand]

I thought Victoza was meant to help you to reduce your BGs and therefore help with weight loss. As you a) don't need to lower BGs and b) are gaining unwanted weight, I would question why this has been prescribed. All drugs have possible side effects and I wouldn't want to risk developing anymore of those through taking a drug that was already harming me.

Are you taking any other medication at all? If not, I would follow a low carb diet and monitor my BGs before and 2 hours after eating. Better still, use a Libre for a couple of weeks to see if you can spot any patterns which might shed a little more light on things for you.

 

[Deleted member 527103]

Have you checked the Libre readings? If not, it is very likely that your levels do not fluctuate as much as you think
It is renowned to be unreliable at high and low readings.
In addition, all CGMs experience compression lows when pressure is applied. If your lows occurred whilst you were lying on your arm, this is more likely to explain them than a real low
This is why those of us with Type 1 are strongly recommended to test a high or low with a finger prick before treating.

Libre is a fantastic piece of kit but only if you understand its limitations and don't think of unchecked readings below 4 or above 9 as gospel.

 

[rehab1171]

I’m confused. Why would you be using a blood glucose lowering medication to treat hypos?

My doctor thinks that if I avoid the spike up of glucose after a meal there will be no hypos. He says Victoza doesn't cause hypos by itself it only avoid spikes. I get spikes if I eat while grain or fruits or legumes. I f I don't eat them I am continuously in a hypo level.

 

[rehab1171]

Have you checked the Libre readings? If not, it is very likely that your levels do not fluctuate as much as you think
It is renowned to be unreliable at high and low readings.
In addition, all CGMs experience compression lows when pressure is applied. If your lows occurred whilst you were lying on your arm, this is more likely to explain them than a real low
This is why those of us with Type 1 are strongly recommended to test a high or low with a finger prick before treating.

Libre is a fantastic piece of kit but only if you understand its limitations and don't think of unchecked readings below 4 or above 9 as gospel.

 

[rehab1171]

Thank you for the tips. Indeed I noticed if I check while laying in bed is lower than if I sit down. I will pay attention to that next time.

 

[rehab1171]

I thought Victoza was meant to help you to reduce your BGs and therefore help with weight loss. As you a) don't need to lower BGs and b) are gaining unwanted weight, I would question why this has been prescribed. All drugs have possible side effects and I wouldn't want to risk developing anymore of those through taking a drug that was already harming me.

Are you taking any other medication at all? If not, I would follow a low carb diet and monitor my BGs before and 2 hours after eating. Better still, use a Libre for a couple of weeks to see if you can spot any patterns which might shed a little more light on things for you.

 

[rehab1171]

Yes, I questioned it too but my doctor thinks it will stabilize it accompanied by a moderate carb diet. As I said, low carb diet puts me in extended hypos. I take Glucobay, it is ment to slow down the digestion of carbs , also to avoid spikes of insulin. My doc says I have a delayed response of insulin that is why I first gets a spike, but once insulin is out it is out too much that it crashes all available glucose to dangerous hypos. So in theory all matches but my weight gains, mood swings, back inflammation and some cognitive disfuction ( memory, depression) make me question and I am like very much loosing hope. So I reach out here to see what other users and diabetic people can say from their experience.

 

[rehab1171]

Have you checked the Libre readings? If not, it is very likely that your levels do not fluctuate as much as you think
It is renowned to be unreliable at high and low readings.
In addition, all CGMs experience compression lows when pressure is applied. If your lows occurred whilst you were lying on your arm, this is more likely to explain them than a real low
This is why those of us with Type 1 are strongly recommended to test a high or low with a finger prick before treating.

Libre is a fantastic piece of kit but only if you understand its limitations and don't think of unchecked readings below 4 or above 9 as gospel.

 

[rehab1171]

Thank you also for mentioning that it is unreliable below 4 ( which is most of my time). I will double-check with Blood glucose measurements. This could be the reason of weight gain, since Libre is piping most of my time especially at night I eat to stop the hypos even when I feel ok and not hungry. Is my doc advice. I have the alarm set at 3.2

 

[Daibell]

I think there is some confusion here and I'm not convinced by the Drs input. Victoza is targeted at those who have excessive weight and insulin resistance and need to reduce weight and BS. Normally weight gain itself is caused by too many carbs. I don't understand why you have been prescribed Victoza but I guess it's to help reduce your weight but in turn it will reduce your BS causing hypos. Perhaps you have one of the less common forms of diabetes? Has the possibility of having Reactive Hypoglycemia been considered?

 

[Oldvatr]

Victoza belongs in a family of medications that mimic the effect of the enzyme that the pancreas produces in response to a glucose spike. It pretends to be GLP-1 which is the enzyme that triggers the beta cells to output more insulin regardless of what your blood glucose levels are actually doing. So for someone who has too much insulin then this seems to be counter-productive.

The main problem connes if you have high blood sugars at any time since the combination of high glucose and high insulin at the same time triggers fat burning to happen, and hence weight loss. but the fst burning produces ketones in the blood as a byproduct, and these can build up and cause a serious condition known as ketoacidosis, which requires hospital treatment. If you read the side effects for this med, you will see ketones and fruity breath being listed as a common side effect, These are signs or ketosis starting to build up. The leaflet does not mention DKA but we have reports in the forum of this occuring in some users.

I suspect that dehydration plays a part in this, expecially if vomiting occurs. These meds are associated strongly with nausea so that too is a common side effect. stay well hydrated.

 

[rehab1171]

I think there is some confusion here and I'm not convinced by the Drs input. Victoza is targeted at those who have excessive weight and insulin resistance and need to reduce weight and BS. Normally weight gain itself is caused by too many carbs. I don't understand why you have been prescribed Victoza but I guess it's to help reduce your weight but in turn it will reduce your BS causing hypos. Perhaps you have one of the less common forms of diabetes? Has the possibility of having Reactive Hypoglycemia been considered?

 

[rehab1171]

When I was prescribed Victoza I was in my ideal weight. I put weight only after using Victoza and frequent eating in response to the hypo' alarm by Libre. I am confused too.

 

[rehab1171]

Victoza belongs in a family of medications that mimic the effect of the enzyme that the pancreas produces in response to a glucose spike. It pretends to be GLP-1 which is the enzyme that triggers the beta cells to output more insulin regardless of what your blood glucose levels are actually doing. So for someone who has too much insulin then this seems to be counter-productive.

The main problem connes if you have high blood sugars at any time since the combination of high glucose and high insulin at the same time triggers fat burning to happen, and hence weight loss. but the fst burning produces ketones in the blood as a byproduct, and these can build up and cause a serious condition known as ketoacidosis, which requires hospital treatment. If you read the side effects for this med, you will see ketones and fruity breath being listed as a common side effect, These are signs or ketosis starting to build up. The leaflet does not mention DKA but we have reports in the forum of this occuring in some users.

I suspect that dehydration plays a part in this, expecially if vomiting occurs. These meds are associated strongly with nausea so that too is a common side effect. stay well hydrated.

 

[rehab1171]

I thought high insulin and high glucose cause fat storage and weight gain and that the weight loss associated with Victoza was for the loss of appetite it induces. May be I am wrong?
Yes, I see that the prescription of Victoza in my case is weird. Everyone who commented on my post pointed out to that too. I will have to go back to my doc and revise the use of Victoza especially giving its side effects.

 

[Oldvatr]

I thought high insulin and high glucose cause fat storage and weight gain and that the weight loss associated with Victoza was for the loss of appetite it induces. May be I am wrong?
Yes, I see that the prescription of Victoza in my case is weird. Everyone who commented on my post pointed out to that too. I will have to go back to my doc and revise the use of Victoza especially giving its side effects.

While insulin is increasing, yes, fat geta stored. When insulin decreases then fat gets burnt if leptin levels are low. Leptin levels drop when weight is lost or during fasting. The reports I have seeen of possible DKA when using a Glutide medication occurs at median glucose levels of around 10 to 15 mmol/l so it depends on what you consider 'high'. The DKA that may be associiated with Ozempic is termed Euglycemic DKA which is different from the usual diabetic ketoacidosis and occurs as a result of fat burning while glucose levels are not at either extreme. I think that being T2D may be a factor since insulin resistance may play a part. There has been recent research that showed that having both high insulin and glucose together also affects Leptin and Gtrhlin and triggers fat burning as a last ditch survival trigger to protect in the presence of extreme insulin resistance.

I think that if these meds induced ketosis by the low sugar route, it would be mentioned in the guidelines but there are statements that hypos only occur in conjunction with other medications that also can cause hypos on their own

 

[Lamont D]

I wish I had seen this post first but it wasn't in my alerts!

The only drug I know that has a spike lowering effect but doesn't cause weight gain rtf is the one I clinically trialed, but the downside is, too many carbs still triggers a hypo, but not as severe!
the best treatment is not to spike at all and that means a ketogenic balanced diet designed by you, for you that improved your health with no hypos!
Yes, no hypos!
yes good health, clear minded and no symptoms.
It can be done.

(mod edit to comply with forum ethos)

 

[Oldvatr]

I thought high insulin and high glucose cause fat storage and weight gain and that the weight loss associated with Victoza was for the loss of appetite it induces. May be I am wrong?
Yes, I see that the prescription of Victoza in my case is weird. Everyone who commented on my post pointed out to that too. I will have to go back to my doc and revise the use of Victoza especially giving its side effects.

Actually, thinking about that what I wrote, I am not entirely happy with it myself. I can see it taking effect with very high sugar levels, and high insulin, which is a condition one step away from diabetic coma, so really is the option of last resort as it were. But it does not explain what may be happening in connection with this medication, which occurs at not particularluy high glucose levels. So something else is going on.

The timing of the injecion is not connected to eating or fasting. It is not dependant on any particular diet or nutrient. It does not need a glucose hit to start it off (as a sulfonyl med does) and it overrides the GLP-1 pathway forcing an insulin response regardless of glucose level. It is stated that hypos do not occur so the ketosis is not related to glucose (unlike dietary ketosis). So there may be some thing associated with insulin being pumped out willy nilly due to the GLP=1 clamp, but without there being food under digestion or triggering the normal GLP=1 enzyme or the lipase generated enzymes either. Maybe this combination of insulin with glucose already in the blood and not having the normal enzyme handshaking going on, then that is causing the fat burning. But then this status is actually a normal stage for a T2D with hyperinsulinenia, and we do not seem to get DKA from that condition. All I can think of is that there is some mechanism that both the SGLT-2 meds and the GLP-1 meds is upsetting that either stops the body getting rid of ketones or overrides the Krebs Cycle to force fat burning (as I said, weight loss appears to be more than just glycogen and seems to involve lipids too).

I think the thing that worries me is that a drug like Gliclazide (which I am using) also increases insulin output but is not associated with DKA like the others I mentioned above. But it is also limited in scope and passes out of the system in a matter of hours so any effect from it is transitory, The binding of the GLP-1 receptors is an override that I suspect has a longer half life, which is why the inections are weekly, so once in the body, it may be not be easy to control it. But the SGLT-2 meds are also daily pills and they can cause DKA, so still not explaining it. Dunno, its above my paygrade.

All I know is that I have had the experience of extended periods with glucose levels above what my meter can read (>32mmol/l) and I know my pancreas is still producing insulin . At the time I was maxed out on the Gliclazide, so thrashing my pancreas without DKA. It is not simply high insulin or high glucose or low carbs. But ketones and fruity breath are listed as common side effects of the gliptin meds. Its there for a reason since my gliclazide does not have this side effect, nor any causation of DKA (unless the pancreas output is faulty) but does list hypoland as a probable destination.