Weight loss drug for type 2 diabetics

[lucylocket61]

https://www.theguardian.com/society...s-drug-made-available-nhs-semaglutide-obesity

I have been offered by my DN this to help my blood sugar levels. Given I have no appetite, and have to remember to eat or make myself eat, I am not sure how helpful it would be for me.

https://bnf.nice.org.uk/drug/semaglutide.html

Is the assumption that everyone needing to lose weight is someone who eats vast amounts? I cant fid any figures on its effect directly on blood glucose levels.

 

[ianf0ster]

Yes, their assumption is that all obese people eat far too much.
Otherwise they would be effectively abandoning the Calories In Calories Out model.

 

[Pipp]

https://www.theguardian.com/society...s-drug-made-available-nhs-semaglutide-obesity

I have been offered by my DN this to help my blood sugar levels. Given I have no appetite, and have to remember to eat or make myself eat, I am not sure how helpful it would be for me.

https://bnf.nice.org.uk/drug/semaglutide.html

Is the assumption that everyone needing to lose weight is someone who eats vast amounts? I cant fid any figures on its effect directly on blood glucose levels.

I have only had a quick glance at the research papers, but my understanding is that the drug helps alleviate insulin resistance.
Unfortunately, the way these things are reported in the media perpetuate the opinion that all people with obesity / high BMI eat too much. I try not to get too sensitive about this, and keep an open mind about new developments. Although would always read the original research papers rather than newspaper reports before making any decision to accept treatments.

 

[Living-by-the-beach]

https://www.theguardian.com/society...s-drug-made-available-nhs-semaglutide-obesity

I have been offered by my DN this to help my blood sugar levels. Given I have no appetite, and have to remember to eat or make myself eat, I am not sure how helpful it would be for me.

https://bnf.nice.org.uk/drug/semaglutide.html

Is the assumption that everyone needing to lose weight is someone who eats vast amounts? I cant find any figures on its effect directly on blood glucose levels.

I'm four weeks in and on my 5th dose of Semaglutide. It is not a tough drug to use but I sense I've got the very faint smell of stale diesel in my mouth all the time. I take weekly injections and the drug is known to lower one's weight. I plan on being on the drug for about 1 year to lose about 50lbs and get back to a BMI of low 20's. I think I'll get to my weight loss goal within 4-5 months but then dial back the dosages to wean off the drug. I walk / hike / 20-25 miles a week and I've had steady A1c for 8 years.

What is interesting is the parallel of losing weight on this drug, and most of the "Reality TV Weight Loss" shows where they ramp up extreme weight loss. 90+% of contestants most typically regain most of the lost weight post the competition. See here

https://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html


. There's one thing to losing weight then there's another to keeping the weight off. I am going to concentrate on titrating down for many months at lower dosages To give myself a permanent shot at putting T2DM completely in my rear-view mirror. The "Step" study said when you came off the Semaglutide you'd put the weight back on... We'll see.

There's a couple of dedicated websites for Ozempic / and Semaglutide out there. You can find them on Reddit. Losing weight when you've got insulin resistance is very very hard. & I'm not to proud to use a drug to help me fix my messed up endocrine system..

 

[Pipp]

Very interesting, thank you @Living-by-the-beach .
Please can you keep us informed of progress? Perhaps in a blogon here. I know that is a big thing to ask, but I think it would help folks to see an individual , long term perspective.

 

[Living-by-the-beach]

@Pipp

I'm on my 7th week (= 7th injection). I'm down 8lbs, from 226.8lbs. Nothing amazing but steady weight loss. I started with 0.25mg/week for two weeks then 0.385mg /week for two weeks and now three weeks at 0.5mg. I'm not in a rush to up my dose. The side effects at times are rough. Yet with my recent T2DM re-diagnosis (A1c at 6.5) I just want to fix what's wrong with me.

I've watched a couple of videos lately from Youtube.

This is a general talk about GLP-1 angonists / Trulicity / Ozempic /Wegovy etc

What was interesting in the above video was the mention of poor sleep for folks who are overweight. So I think the doctor was referencing disturbed sleep makes you hungry during the following day so you're over eating.

This next video came up with 3 points
The type of food
The size of food
The time of food.

3 minutes into the second video Dr Boz starts to explain timing food. What I've changed in the last week or so is having my food in the morning and a late lunch by 1-2pm and then off out for 3 mile walk. I find with the Ozempic (AKA Semaglutide) that I don't need to eat past lunch time and just have a couple cups of green tea in the evening. I'm working hard to get better sleep and then sleep through till the following morning. The point that Dr Boz makes is that to lowering one's insulin resistance, you'll lower your desire over time to over eat. Now that I've moved to 2pm to 8am fasting the Ozempic is helping me lose weight. Its no free lunch (its awkward as a drug) yet I am probably suffering from insulin resistance (and I am T2DM) sufferer..

Overall its going well. I hope that my weight loss (now that I'm doing IF in the evenings) so my health should really improve fast. On another plus benefit,I am now able to fit into some of my old cool looking jeans!

 

[Pipp]

The side effects at times are rough

Thanks, @Living-by-the-beach . Can you elaborate on the rough side effects, please?

 

[Living-by-the-beach]

Thanks, @Living-by-the-beach . Can you elaborate on the rough side effects, please?

Hi @Pipp

I've experienced nausea, soft stools, and constipation. Everyone's experience is different. One has to think of this as a genuine medicine. It is a medicine it is in one's system and it doesn't "Taste" nice.

I'm working on fasting from lunchtime onwards. That should lower my basal insulin rate. It is the lowering of excess of insulin that will allow me to lower my visceral fat. That should get my liver and pancreas working to non-T2DM level of functionality.

I'll keep you posted..

 

[NicoleC1971]

Yes, their assumption is that all obese people eat far too much.
Otherwise they would be effectively abandoning the Calories In Calories Out model.

Here are the common and very common side effects too some of which are 'useful' for weight loss:
Appetite decreased; burping; cholelithiasis; constipation; diarrhoea; dizziness; fatigue; gastrointestinal discomfort; gastrointestinal disorders; hypoglycaemia (in combination with insulin or sulfonylurea); nausea; vomiting; weight decreased
And yes the trial of this drug involved the control group being given the usual NHS weight management guides which are know not to be very successful so I am sure the intervention side who were given the drug did lose weight. The question is how much and were the side effects tolerable for the individual and do they want to be on these drugs for life as presumably the 'useful' side effects don't last unless you keep taking the tablets.
So they are broadening their market of a diabetes drug to a new category of patient to make more money. Given the side effects I'd be advising the low carb approach to reducing your appetite plus a bit more focus on the carb addiction part of the problem for those who struggle with eating less carbs but then that wouldn't make pharma any money and they wont' fund a trial so NICE can't promote it.

 

[zand]

The OP has been low carb for 10 years and doesn't need to reduce her appetite which is small anyway.

 

[Ronancastled]

Back in June my endo told me about some new wonder drug that exceeded Ozempic results for weight loss & BG normalisation. Said it was reported at the ADA 2021 conference.

 

[Katkit17]

Back in June my endo told me about some new wonder drug that exceeded Ozempic results for weight loss & BG normalisation. Said it was reported at the ADA 2021 conference.

5.5 stone is amazing! Well done you

 

[Ainsley.Rae25]

Hi! I had my first dose of trulicity 0.75mg yesterday. Have seen a massive change in my sugars already, and I'm already feeling full and not as hungry. Hope it works out for you.

 

[Oldvatr]

https://www.drugs.com/tips/semaglutide-patient-tips
The results claimed here seem to be a bit on the sensational side, so I would not necessarily accept them at face value. I have seen several reports that show the weight loss aspect but did not monitor sugar levels, so I am also at a loss as to who did those tests, and where they are reported.

I must reiterate the recent warning that the -glutides in general are associated with thyroid cancer, as had been evidenced by a poster on this site who has contracted that condition shortly after commencing treatment.

This seems to describe a trial for glucose, but please note thst the result reported is shown as Estimated, and was of the order of only 1.5 mmol/l drop post prandial, which is about the same as metformin.
https://pubmed.ncbi.nlm.nih.gov/28941314/

They also claim that the first phase insulin response is improved but there seems to be no test carried out to verify that (i.e. insulin clamp / IVGTT) and also they simultaneously claim that the drug slows gastric emptying, which again will actually prevent the first phase response which is a reaction to a step change in glucose levels and is not testable by oral methods. This trial was performed and paid for by the drug manufacturer, so it seems to be very poor quality evidence.

It is primarily being generally prescribed for weight loss / obesity cure, and the glucose lowering aspects are probably due to weight loss rather than any magic being done by the drug. The results quoted that I see are that post prandial levels dropped by an average of 1 mmol/; at the 1 hour mark, and took 5 hours to drop back to fasting level. The numbers show that at least one respondent has up to 1.4 mmol/l drop but the lower figure of 0,24 shows that some had hardly any improvement, They used Area Under the Curve technique to obsfurcate the result where a mathematical mean or average calculation may give a worse result.
https://pubmed.ncbi.nlm.nih.gov/28941314/#&gid=article-figures&pid=figure-1-uid-0

 

[Oldvatr]

This treatment seems to have a higher than normal risk of anaphylaxis and angiodema than other drugs. Make sure your first treatment is done at a medical centre, and allow 15 minutes after application before leaving.

 

[Sarah69]

Can I ask how you are losing weight please? I’m on this drug and I don’t think I’ve lost anything, I’m now going into my 4th month and on 1mg.