Question for diabetics

[KrisParr]

Started Ozempic 3 months ago. No weight loss at all, but A1C is down from 6.1 to 5.8  - I’ll take that.

[Rudynate]

On 2/23/2023 at 2:00 AM, augustus said:

I don't have diabetes yet but I was pre-diabetec.  The doctor told me to eat beans and it definitely helped me.  I buy kidney beans and wash off the sauce (especially if it's Goya).  Then I mashed them into a spread and add a little olive oil to give it some moisture, then refrigerate.  Then I spread it on whole wheat toast and a little mayo and it actually makes a pretty good sandwich.  You can add lettuce and tomatoes too.  It lowered my level to near normal.

Sounds tasty.  I might try it.

[Guest]

Hummus with veggies--a highly healthful snack

 

 

Edited July 2, 2023 by Unicorn

[ICTJOCK]

Well I haven't been diagnosed with diabetes and no medications,  but certainly have a family history of the disease on my father's side  (affecting mostly the women in the family,  but my Dad has been tested as being borderline).    His youngest sister has been on insulin since she was in her early 30's,  so I've grown up with the worry.  

I test every year and not even close to it,  but that doesn't eliminate the concern.    This disease (as shown with the discussions)  is not logical in terms of who gets it and why.     I talked about the "Importance of the Annual Physical"  in another thread and part of why I view this "annual talk"  as important for me is because of diabetes.     For "Cooper"  and all the other members here who have diabetes,  take care and best of wishes for health ahead.

[Guest]

6 hours ago, ICTJOCK said:

Well I haven't been diagnosed with diabetes and no medications,  but certainly have a family history of the disease on my father's side  (affecting mostly the women in the family,  but my Dad has been tested as being borderline).    His youngest sister has been on insulin since she was in her early 30's,  so I've grown up with the worry...

You don't mention whether the diabetes in your family is Type I or Type II. The two types are completely different with little in common other than both present with high blood sugars. All type I's require insulin, so if you know someone who's treated with anything other than insulin, you know that person has type II (some type II's also need insulin, but they're usually treated with other diabetes meds as well). Type II has a stronger genetic link, but the vast majority of Type II's are obese, and most of the rest are overweight. Anything can happen, of course, but you listed your BMI as 23 (6'1" and 175#), which is quite normal. If your family history is Type II, just make sure you get plenty of aerobic exercise, and your chance of getting DM-II will be quite low despite your family history. 

Type I is more complicated, and it seems to come on to those who carry certain HLA genes (protein markers on cell walls), when they get infected with the wrong virus at the wrong time. In those cases, in addition to attacking the virus, the victim's immune system also mistakenly attacks the cells which make insulin. If your family history is of type I, you may wish to be tested to see if you have the risky HLA genes (10 times more likely if you have those genes). 

Genetics of the HLA Region in the Prediction of Type 1 Diabetes - PMC

WWW.NCBI.NLM.NIH.GOV

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Type 1 diabetes (T1D) is one of the most widely studied complex genetic disorders, and the genes in HLA are reported to account for approximately 40% to 50% of...

 

"...The major genetic determinants of this disease are polymorphisms of class II HLA genes encoding DQ and DR. The DR-DQ haplotypes conferring the highest risk are DRB1*03:01-DQA1*05:01-DQB1*02:01 (abbreviated “DR3”) and DRB1*04:01/02/04/05/08-DQA1*03:01-DQB1*03:02/04 (or DQB1*02; abbreviated “DR4”)...".

[samhexum]

Jan 2022:  A1C  8.2, my Dr. put  me on Metformin.

May 2022: A1c 6.7, down 18 pounds.

Weight plateaued for a year, A1C remained 6.7-6.8.

May 2023:  Dr. put me on Ozempic.

Today:  Down 27 pounds since May, A1C 5.7!!!!

If you want to reach me, I'll be doing a photo shoot for the cover of Men's Health.

The only problem is that I'm in Medicare's coverage gap, and a refill is $750 for 3 months. My brother in law's doctor switched him to the medium pen, so he had an extra pen & a half he gave me and the Dr. had one sample left that he gave me.  I'm good through late Oct.  My pulmonologist is in the same building and I haven't seen him since before covid (I had an appt for 2 weeks after the 1st cases hit, but cancelled).  I'll make an appt with him soon, and stop in to see the endocrinologist that day, & maybe he'll have more samples.  Otherwise it's back to Metformin for 2 months (I have plenty on hand), & your appetite is supposed to go crazy when you stop Ozempic, so that should be fun.

[Guest]

On 8/28/2023 at 11:32 AM, samhexum said:

Jan 2022:  A1C  8.2, my Dr. put  me on Metformin.

May 2022: A1c 6.7, down 18 pounds.

Weight plateaued for a year, A1C remained 6.7-6.8.

May 2023:  Dr. put me on Ozempic.

Today:  Down 27 pounds since May, A1C 5.7!!!!

If you want to reach me, I'll be doing a photo shoot for the cover of Men's Health.

The only problem is that I'm in Medicare's coverage gap, and a refill is $750 for 3 months. My brother in law's doctor switched him to the medium pen, so he had an extra pen & a half he gave me and the Dr. had one sample left that he gave me.  I'm good through late Oct.  My pulmonologist is in the same building and I haven't seen him since before covid (I had an appt for 2 weeks after the 1st cases hit, but cancelled).  I'll make an appt with him soon, and stop in to see the endocrinologist that day, & maybe he'll have more samples.  Otherwise it's back to Metformin for 2 months (I have plenty on hand), & your appetite is supposed to go crazy when you stop Ozempic, so that should be fun.

Yikes! With your weight loss, you're probably due for a drug holiday. While it may intuitively feel as though having a "normal" Hgb A1c is "better" than having one in the diabetic or pre-diabetic range, this issue has been studied extensively, and there doesn't seem to be much, if any, benefit at lowering it below 7.0, and getting it under 6.5 leads to actually worse outcomes. National guidelines recommend the Hgb A1c goal of 7.0 for most people, higher for the elderly or frail. Please save your $750. 

6. Glycemic Targets: Standards of Care in Diabetes—2023 - PMC

WWW.NCBI.NLM.NIH.GOV

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The American Diabetes Association (ADA) “Standards of Care in Diabetes” includes the ADA’s current clinical practice recommendations and is intended to provide...

"Recommended glycemic targets for many nonpregnant adults are shown in Table 6.3. The recommendations include blood glucose levels that appear to correlate with achievement of an A1C of <7% (53 mmol/mol)."

The only people who should be on Ozempic-like meds with a Hgb A1c of under 7 (or maybe 6.5) are those who have established coronary artery disease. In that case, the Ozempic is used for cardiovascular prevention, not to lower blood sugars. 

Low HbA1c and Increased Mortality Risk-is Frailty a Confounding Factor? - PMC

WWW.NCBI.NLM.NIH.GOV

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Diabetes mellitus is increasingly becoming an older person disease due to the increased survival and aging of the population. Previous studies which showed benefits...

"... In a case control study of 16,585 mortality cases of type 2 diabetes matched for age and gender to a similar number of living controls, low HbA1c (<6.5%) values were associated with increased odds of all-cause mortality (OR 1.22, CI 1.11 to 1.34) in comparison to normal HbA1c levels (6.5% to 9%) after adjustment for study confounders after a median follow up of 3.7 years..."

Edited August 30, 2023 by Unicorn

[samhexum]

7 hours ago, Unicorn said:

Please save your $750. 

I was never going to pay that.

[+ Lucky]

On 6/18/2023 at 9:18 AM, Lucky said:

My Ozempic experience so far:

I started in February at the non-therapeutic dose of .25 weekly. In late March that was doubled to a .5 dose. I am still on that all these weeks later.

Ozempic has, to date, done nothing for me. My glucose has risen and I haven't lost any weight or seen a decreased appetite.

I will start this week on a dose of 1.0 and hope for better results. Just wanted to post this so people know that Ozempic does not always give great results.

UPDATE: Losing weight on Ozempic seems directly coordinated to exercise. My modestly active life here didn't quite cut it, but then I went on a vacation where I walked miles and climbed millions (it seemed) of steps. I lost weight!

Now I am back from a month in Thailand where again I walked miles and climbed stairs and my weight has dropped 55 pounds in 2 years.