weight loss drugs for diabetics

[kaysixteen]

Anyone, and esp anyone who is also a type-ii diabetic, ever have any experience with taking Mounjaro or any similar modern med, and wish to comment on any side effects of such therapies, esp with potential regard to significantly reduced blood sugar numbers and the effects thereof?

[AmLitHist]

Apologies for the long answer, but I hope it might help you and others. I started on the max dose of Ozempic about 5 years ago and stayed on it until last year, when I was switched to Mounjaro (also max dose).

I had a short (month/6 weeks) adjustment to Ozempic - stomach upset, diarrhea (though not as long or as bad as with Metformin, which I've been on for 6 years). No adjustment to Mounjaro, probably since I'd changed directly from Ozempic. Both, but especially Ozempic, are unforgiving with me if I overdo the fat I eat during a day (and to a lesser degree, carbs), with similar tummy symptoms.

I'm reading of potential long-term problems with both drugs, the latest I've seen being NAION (which can lead to permanent vision loss). There are also connections to diabetic retinopathy, thought to be related to blood glucose fluctuations. Those studies worry me.

I've been having eye problems (diabetic cataracts removed 5 years ago, aged 59; detached vitreous chamber - can't remember the correct term, sorry - leading to lots of floaters) over the past years since T2D diagnosis. Happily, my retinas are healthy, as are my pressures. I've learned to live with the floaters, but could have them treated with laser if they get sufficiently annoying.

I'd love nothing more than to be able to get off the injectables, but my doctor wants me to stay on them (hopefully being able to lower the Mounjaro dosage) for the kidney protection. I'm lucky in that my kidney numbers have remained good, as has my heart/artery health (via Jardiance). I go for a checkup next week, so we'll see. My A1C was 14 when I was diagnosed, and it's come way down after 6 years on insulin and all the rest, but I know that all the drugs aren't good for me, either. I tend to be very stress-sensitive in my sugars and A1C; after being at 7 for a couple of years, I've crept back up to 8.4 last summer and am still struggling to get back down to 7 and keep it there - fingers crossed I'm back to 7 next week (was 7.4 in February).

Neither has taken the weight off me (though maybe I'd have put more on without them?), nor has "behaving" with what I eat. Alas.

[kaysixteen]

Thank you kindly.  I have just completed two months plus one week, the first month on the starter half dose.   I had had good A1C control for many years, mid-5s, till the collapse of my overall health that led me to accept multiple professional advice and apply for SSDI last summer, which I did as I said get two months ago, spiked up the AIC to over 13 by Jan and finally induced my PCP to get me an endocrinologist, which took several months to set up.   She is taking a vigorous approach to this treatment, including extra insulin and the Mounjaro, which took her two appeals to successfully wheedle the ins co to give me.  AiC had dropped to 9.3 by two weeks back, and the doc has already dialed back some of the insulin doses:

however, after also having filed two appeals for this, endo got ins co to authorize FreeStyle Libre diabetes monitor to use with my phone.  And it works.   And this quick improvement in my numbers has, well... demonstrate that what also works is the auto alarm for low sugar warnings.  I called last Tues and told doc this, who as said reduced the dosages of both my insulins.   Still works... last nite I got woken up with low sugar alarms five times, which did not exactly equate to restful sleep experience, esp as when I get up, I have to eat/ drink something to try to push sugar up.  I am eagerly awaiting my next trip to endo, and a long discussion as to what might be done to ameliorate this problem without throwing out baby with bathwater, esp since...

damn the drug works as directed.   My appetite, already in recent years a fairly pale shadow of my grad school heyday, has now all but collapsed, usually necesssitating really just one meal a day.  I do not want to give this up, because, well, now, in addition to the loss of lymphedema fluid weight from the PT, I am just now seeing some real beginning of gut girth, and am now at a weight I have not seen since c. 2006.  Twenty pounds more and it will be 2001.

And yet, whilst the low sugar has not produced a full-fledged low sugar incident like often happens to type i diabetics, and often needs a call to 911 and perhaps a trip to the ER, well, let's just say my emotional and behavioral control is embarrassingly often melting down.  No shakes and sweats, and when this happens the sugar is not low enough to need immediate carb consumption (those readings are largely just happening at night, and even then, still thankfully no shakes or sweats--- I would sleep through em without the monitor ringing off), but what I did say is happening to me is indeed happening.   I will be discussing this with the endo as well.

[AmLitHist]

Glad to hear it's working for you, K!  I know a lot of people do have good results.

My husband had a complete blood panel run earlier this week and was complaining that his blood glucose was "high" at 91. The standing joke in our house (gallows humor) is that I'll have to be dead for a week before I have to worry about low blood sugar.

I used the constant monitor for a few months last summer but in my case it seems a useless expense:  I'm on long-lasting insulin (Tresiba 88 units once a day), so since there's nothing I can do in the moment if I have a spike, it seems silly to have my insurance pay for it on top of everything else.

Good luck with your treatments. If my A1C is still up next week, I imagine an endocrinologist will be my next stop. (I was already referred last fall/winter but with all the drama at home and related stress, it got put on hold until the stress gets under control).