Question for diabetics

[CJK]

On 1/25/2023 at 9:53 AM, craigville beach said:

my heart doctor required me to drop Glipizide, he says it is very bad for your heart.   I take Jardiance, and Basaglar with a weekly shot of Trulicity. 

I took Trulicity before the latest Ozempic craze. (The two are similar.) My though at the time was, "Of course you will lose weight on these drugs. Projectile vomiting will do that." 

Metformin caused me a different world of hurt. There were days when I had to change my pants eight times. Although I did learn the best way to get smells out of clothes is to launder them in vinegar before laundering them in detergent. 

After being on and off Farxiga and Jardiance (back and forth a few times) I am now solely using insulin. It is proven, has few side effects and works. I take 10 units of long acting (Levemir) a day and short acting (Humalog) as needed. I am extremely careful with my diet, but given my kidney and cardiac dietary restrictions, the diabetic restrictions are third.

I worked with a dietician for about six months, concentrating on what I can eat, not what I cannot. Although the list is pretty short, I have been able to avoid needing the short acting insulin most days. Pasta, rice, potatoes, whole grains, spinach, corn, legumes, cold cuts and most processed foods are gone. Cabbage is a great substitute for just about everything. Sticking to plain vegetables and lean fish, chicken or beef is pretty easy when the alternative is dialysis or death. Believe it or not, cake and ice cream are okay occasionally. 

When I was in the hospital a couple weeks ago (two mild heart attacks and a heart procedure) the dietician came to my room after the procedure. He explained he was required to see patients after the procedure, but I was one of the very few patients with whom he knew he did not really need to discuss diet. We talked about other crap just so he could say he had been to see me. 

[Danny-Darko]

3 hours ago, sniper said:

If I'm taking metformin for PRE-diabetes and my A1c is holding at 5.4, how long before I talk about going off it? I never got over 5.9 in the first place...

Congrats and keep up the good work! Simple answer though is, ask your doctor. He would know best what's right for you. I'm diabetic type 2 and after 55lbs weight loss and dietary modifications my last A1c a few days ago was 5.3. I've been on Jardiance and Ozempic after years of being on Metformin. My doctor was very happy with my results, but in my case I'm under no illusions of being off meds. Your case is different. Consult your doctor and best of luck to you! 

 

[Danny-Darko]

2 hours ago, CJK said:

I took Trulicity before the latest Ozempic craze. (The two are similar.) My though at the time was, "Of course you will lose weight on these drugs. Projectile vomiting will do that." 

Metformin caused me a different world of hurt. There were days when I had to change my pants eight times. Although I did learn the best way to get smells out of clothes is to launder them in vinegar before laundering them in detergent. 

After being on and off Farxiga and Jardiance (back and forth a few times) I am now solely using insulin. It is proven, has few side effects and works. I take 10 units of long acting (Levemir) a day and short acting (Humalog) as needed. I am extremely careful with my diet, but given my kidney and cardiac dietary restrictions, the diabetic restrictions are third.

I worked with a dietician for about six months, concentrating on what I can eat, not what I cannot. Although the list is pretty short, I have been able to avoid needing the short acting insulin most days. Pasta, rice, potatoes, whole grains, spinach, corn, legumes, cold cuts and most processed foods are gone. Cabbage is a great substitute for just about everything. Sticking to plain vegetables and lean fish, chicken or beef is pretty easy when the alternative is dialysis or death. Believe it or not, cake and ice cream are okay occasionally. 

When I was in the hospital a couple weeks ago (two mild heart attacks and a heart procedure) the dietician came to my room after the procedure. He explained he was required to see patients after the procedure, but I was one of the very few patients with whom he knew he did not really need to discuss diet. We talked about other crap just so he could say he had been to see me. 

My doctor wanted to put me on Trulicity but my insurance finally agreed to Ozempic. I had been told that Trulicity has less side effects. It took me awhile but I finally adjusted to my dose of Ozempic. I found a way to control nausea with sipping natural ginger tea. As far as my laundry, I wash my underwear in hot water with detergent and chlorine bleach tablets as normal and then I add baking soda to the final rinse.  That's what's worked for me. 

[Bargara Leatherboy]

Wow what timing - I am in Australia Type 2 and finally got my script of Ozempic filled today.  It went into short supply last year and I have not had any since August.  I find it works really well.

 

In the meantime I took myself off Metformin - and watched my numbers very carefully - I found even after being on it for years that I spent half my time on the toilet - or in pain or needing to find a toilet pretty fast.  

 

And the numbers were not improving - nor was my weight - so gave it up.

 

Since then I have exercised more - gentle walking, bike riding and swimming, and watched what I eat and by avoiding carbs I am doing really well.

 

HB1ac was 8.8 then it starting hitting the 6's like 6.2 and then went to 5.8 and most recently being 5.5.

 

So I take Ozempic, Glipizade and thats it - I do use digestive enzymes and fibre every day to assist.

 

I had an uncle who did not look after himself and he had both feet amputated - so the message is look out for yourself and be careful.

 

Many medical people are very caring - but they only get fed the information from the pharmaceutical companies who's best interest is that we take more and more drugs, so thats not the best place to get your information.

 

Its your body - your life - do you own research 

 

 

[Guest]

1 hour ago, Bargara Leatherboy said:

...So I take Ozempic, Glipizade and thats it - I do use digestive enzymes and fibre every day to assist.

...

I recommend very strongly that you do not take glipizide with a Hgb A1c of under 6.5%, and especially with a Hgb A1c of 5.5%. This is associated with an increased mortality rate. Ozempic is at least safe to take, but only if you need it for weight loss. No guidelines recommend treating to a Hgb A1c of less than 6.5%, let alone 5.5%. And using glipizide in this situation is dangerous (scientific reference is higher up in the string). 

[CJK]

14 minutes ago, Bargara Leatherboy said:

...And the numbers were not improving - nor was my weight - so gave it up....

Sorry ahead of time for the long post, but let me throw this out there...

I have been to hell and back health-wise between 2016 and just recently in large part because of misdiagnosis. Unfortunately, many of the things posted on this thread were part of that hell. Maybe this will help someone ask what could be the right doc-questions for his case....

In 2016, something just was not right. The doc thought I was pre-diabetic. Despite taking diet and exercise steps, my weight started to increase. By 2018 I was over 260lbs and went into the hospital for the first of many times. We will call this Hospital A. It is a university teaching hospital known worldwide for a government health agency headquartered on campus. (he-hem). I was told to stop eating cakes, cookies, potato chips and soda and put on metformin. We (me, my sister, two friends) explained I did not eat these things. The doc, very condescendingly, said I needed to read labels because everything has labels. We explained I shopped at a farmers' market, cooking fresh veggies and plain proteins. The doc snapped, "What about bread? Bread comes in a bag with a label, or do you bake your own?" When I answered truthfully, I have baked my own since I was twelve, he thought I was being smart with him and never came back.

A few weeks later my Internist admitted me to Hospital B for something else that was complicated and required expertise only available there. This is a huge community hospital which also supports two medical schools. The docs there threw lots of diabetes drugs my way and diuretics (Lasix) to get some fluid out. Once again, I explained my weight made no sense given my diet but was not believed. They were satisfied when we pumped put enough water to get me to 230, even though I could not put on shoes because my feet were too swollen from liquid. I was in Hospital B five times total over the next year, including for bypass surgery (hereditary heart issues), complained about the water weight constantly but to no avail. 

The docs gaslighted me into believing my weight was a product of what I was eating, even though I could not identify what it was I was eating. My weight continued to go up and down sharply and quickly.

I went to Hospital C, a small hospital in a mountain state, when my legs swelled so much they busted open and started leaking pools of water, which caused hurtful infections on my legs. This was March 15, 2022, and I weighed over 280lbs. In five stays, 25 weeks over eight months, they would treat the wounds, pump some water out and tell me I should get lap band surgery. I would have several discussions with food services about making sure I got healthy food and often sent things back to the kitchen when it was something I could not eat. One of the docs said if I at like that at home this problem would go away. I pointed out I did eat like that at home and since I had been in the hospital, I put on ten pounds. At least they finally believed Lasix did not work for me, so we at least switched diuretics. 

I went back in Hospital B for about a month, but the care was awful. The Fellow who had been a great doc the first time had finished the program and moved back to his country. They way over-medicated me. I left there weighing three pounds more than when I got there, almost 230lbs. 

Thirty-six hours after discharge, I fell on the floor (overmedication) and was taken to Hospital D, a large hospital where rich Atlanta goes. The docs there said I had way too much water and pumped out about 25 lbs. I will admit, I thought they pumped out just about all the water.

But a few weeks after discharge, I was back in an ambulance (first of two minor heart attacks) and was taken to Hospital E, known as one of the better hospitals in the area, but many people think A and D are better. The docs kept saying how much water I had in me while I kept thinking my legs and midsection barely looked swollen. Bottom line, the combination of my bad kidneys and an 85% hidden heart blockage were causing me to retain water, often rapidly. I entered the hospital weighing 238lbs and left three weeks later at 187 lbs. Over the past few weeks, it has gone to 175lbs. The other day, my doc said he thinks we have about fifteen-twenty more to go. 

To put the weight into perspective, we have pumped out the equivalent of over 27 2-liter bottles of soda. It is like I was carrying 27 2-liter bottles full of liquid around with me all the time. 

Turns out I was not fat, nor was I eating incorrectly, but I was retaining water due to underlying health issues. I am feeling healthy for the first time in six years. Although the kidney and heart damage are permanent, both are working so much better. 

The point of this long, rambling post is do not just accept the first answer your doc gives you. Saying you need to be on diabetes drugs is the easy way out for your doc. If the diagnosis does not make sense, push for every test known to man. My reluctance to push the docs and make them dig more cost me six years, my house. my car, my savings, friendships and family (they were tired of me being sick so stopped calling, emailing, texting, etc. None of them have spoken to me in a year, since my sister told me she was tired of hearing I was in the hospital again and should just take a handful of pills.) 

[Guest]

13 hours ago, CJK said:

.... my sister told me she was tired of hearing I was in the hospital again and should just take a handful of pills.

What a horrifying story! 😢 Please accept my sympathies for what you've had to endure. It's super difficult to walk the tightrope between kidney and heart failure because what helps the heart (decreasing fluid load) hurts the kidneys and vice-a-versa. Although it's very rare, I hope you've been checked for a glucagonoma, especially if you've had a rash that looks like this:

[Bargara Leatherboy]

20 hours ago, Unicorn said:

I recommend very strongly that you do not take glipizide with a Hgb A1c of under 6.5%, and especially with a Hgb A1c of 5.5%. This is associated with an increased mortality rate. Ozempic is at least safe to take, but only if you need it for weight loss. No guidelines recommend treating to a Hgb A1c of less than 6.5%, let alone 5.5%. And using glipizide in this situation is dangerous (scientific reference is higher up in the string). 

Thank you so much for bringing this to my attention - I have located the reference - and will reread it minutely.

We learn so much more from each other than we do from our medical teams. 

 

 

[CJK]

21 hours ago, Unicorn said:

What a horrifying story! 😢 Please accept my sympathies for what you've had to endure. It's super difficult to walk the tightrope between kidney and heart failure because what helps the heart (decreasing fluid load) hurts the kidneys and vice-a-versa. Although it's very rare, I hope you've been checked for a glucagonoma, especially if you've had a rash that looks like this:

My legs have healed significantly, but at one point they did look like the pic on the left. Believe it or not for some time they actually looked worse. 

[Guest]

1 hour ago, CJK said:

My legs have healed significantly, but at one point they did look like the pic on the left. Believe it or not for some time they actually looked worse. 

If it hasn't been done, just have a blood level of glucagon checked, and an ultrasound of your pancreas....

[CJK]

1 hour ago, Unicorn said:

If it hasn't been done, just have a blood level of glucagon checked, and an ultrasound of your pancreas....

Thanks. We finally have everything in balance. My legs are pretty much healed, it's just the skin has to go back to normal. I did lose all the hair on my legs, though. 

[Cooper]

On 1/25/2023 at 7:48 AM, Cooper said:

Over the past couple of years my A1C and Poct Glucose  test results have gone  from borderline to high and back again. My doctor is aggressively treating my diabetes. 

For those of you who are on medication(s) which ones are you on, how long have you been on them, and are they helping? I started out  on Metformin with no results. The doctor then added Glipizide and, most recently, Farxiga. 

I’ve also met with a dietitian and have made some changes in my diet. I’m an   active person and exercise regularly. I’m not overweight and have no family history of diabetes. Yes, I have lost weight on the Metformin. 

I’d appreciate hearing from members who are also diagnosed with diabetes and taking medication. 

 

 

When I started this thread my A1c was well above the diabetic range. My doctor prescribed additional medications and I met with a dietitian to review my eating habits. I was a good patient and followed their advice. 

Recently, I had a blood workup done and received the results this AM. My A1c, after 4 months on meds,  is back in the normal range. I don’t speak for others but my meds & diet definitely worked. 

Thanks for the information others have provided. Good luck to all dealing with diabetes. 🙏

[Stormy]

I’m borderline.  I started a weekly shot of Trulicity last month.  Hope it works.  

[DWnyc]

Check out intermittent fasting. Not for everyone and requires a huge amount of personal discipline (especially in social settings) and unlearning generations of food lessons some of which are referenced above (eg large breakfast vs no breakfast etc).

Depending on one’s personal situation and comorbidities it can help for weight loss and A1C / insulin regulation.

Used to be considered a fad but now has a growing body of medical research behind it.   

[+ Lucky]

My first test result after starting Ozempic was quite good.

[craigville beach]

18 hours ago, Stormy said:

I’m borderline.  I started a weekly shot of Trulicity last month.  Hope it works.  

it has worked well for me for over a year now.  i take 1.5 mg every week    it is expensive 

Edited April 15, 2023 by craigville beach
incorrect amount

[marylander1940]

Will California’s Plan to Make Its Own Insulin Work? - The New York Times

WWW.NYTIMES.COM

---

Recent moves by major insulin suppliers might undercut the state’s initiative before any new product emerges.

related to this important subject... hopefully it will work and other states will follow. 

[JourneysEnd]

I've been Type 2 for 2 years, thanks to post-COVID. Managed well with Metformin and intermittent fasting. It's the last remaining post-COVID effect (the joint pain/swelling was the worst, lasted about a year after I'd been in hospital with COVID) and after 2 years, I'm resigned to it being permanent. 

Our diabetes teams (in the UK) use a lot of gliclazide, which I'm not really a fan of. I've seen some terrible hypoglycemic crashes with it. We also use a lot of empagloflazin, which also treats heart failure. A very useful combination for elderly patients with both conditions.

[Cooper]

22 hours ago, Lucky said:

My first test result after starting Ozempic was quite good.

@Lucky, That’s great news. Congrats! Other than Ozempic are you taking any other meds for diabetes? 

[+ Lucky]

4 hours ago, Cooper said:

@Lucky, That’s great news. Congrats! Other than Ozempic are you taking any other meds for diabetes? 

Thanks, @Cooper. Yes, I take two other drugs. Perhaps the dosage will be cut once I see the doctor this week.

Edited April 16, 2023 by Lucky

[samhexum]

On 4/15/2023 at 11:10 AM, Lucky said:

My first test result after starting Ozempic was quite good.

 

On 2/25/2023 at 10:19 PM, Danny-Darko said:

Congrats and keep up the good work!

I've been on Jardiance and Ozempic after years of being on Metformin.

My doctor recently switched me from Metformin to Ozempic.  

I gave myself my second shot last night.

Does my typing looking thinner?

 

[BonVivant]

For me, synjaedy has done wonders to control my sugar level. See: 

Type 2 Diabetes Medication | Synjardy® (empagliflozin/metformin HCI) tablets

WWW.SYNJARDY.COM

---

SYNJARDY is a type 2 diabetes medication to help lower blood sugar and reduce A1C in adults, along...

 

 

it’s a combo of metformin + JARDIANCE. 

[+ Lucky]

Metformin has anti-aging benefits!

"A recent study published in Aging found that when taken, Metformin may alter age-associated deficits and ultimately improve muscle function.  This study called The Metformin to Augment Strength Training Effective Response in Seniors (MASTERS) Trial was a randomized, double-blind, and controlled trial. It compared the effects of Metformin to a placebo for a 14-week period of progressive resistance exercise training (PRT)."

https://www.sciencetimes.com/articles/29829/20210223/a-study-showed-metformin-anti-aging-benefits.htm 

[Guest]

5 hours ago, Lucky said:

Metformin has anti-aging benefits!

"A recent study published in Aging found that when taken, Metformin may alter age-associated deficits and ultimately improve muscle function.  This study called The Metformin to Augment Strength Training Effective Response in Seniors (MASTERS) Trial was a randomized, double-blind, and controlled trial. It compared the effects of Metformin to a placebo for a 14-week period of progressive resistance exercise training (PRT)."

https://www.sciencetimes.com/articles/29829/20210223/a-study-showed-metformin-anti-aging-benefits.htm 

Yow! A good example of why one should go to original studies rather than the lay press if one really wants to know the facts. Metformin is certainly extremely safe and effective, and has many helpful effects for diabetics. But the MASTERS study actually showed the opposite of what the Science Times article claims, if one cares to read the actual study:

Metformin blunts muscle hypertrophy in response to progressive resistance exercise training in older adults: A randomized, double-blind, placebo-controlled, multicenter trial: The MASTERS trial - PubMed

PUBMED.NCBI.NLM.NIH.GOV

---

Progressive resistance exercise training (PRT) is the most effective known intervention for combating aging skeletal muscle atrophy. However, the hypertrophic response to...

 

PRT stands for progressive resistance training:

"...These results underscore the benefits of PRT in older adults, but metformin negatively impacts the hypertrophic response to resistance training in healthy older individuals...". 

And what's that nutty talk about "Metformin, a drug that's been used to treat diabetes since the Middle Ages..."? It was first described by Emil Werner in 1922:

Analogue-based Drug Discovery II

BOOKS.GOOGLE.COM

---

Born out of a project of the IUPAC's committee on Medicinal Chemistry and Drug Development, this reference addresses past and current strategies for...

 

(Page 48)

and approved for use in the US for diabetes in 1995 (1957 in France):

Metformin - Wikipedia

EN.WIKIPEDIA.ORG

 

"...French physician Jean Sterne began the study in humans in the 1950s.[24] It was introduced as a medication in France in 1957 and the United States in 1995...".

[+ FreshFluff]

My endocrinologist told me there's no downside to trying Metformin for appetite control, so I'm going to give it a try. I had been thin all my life and am still in the normal BMI range, but I'm going in the wrong direction. Latest A1C is 4.9 (keeps decreasing?), fasting insulin is 6.4 but WTH.  If the side effects kill me, we'll try something else.  
 

The endo said she would prescribe Ozempic if needed, but the risk seems greater than the benefit for non-diabetic people with a normal BMI. My peers, including some thinner than I am, are all on it though,