More med questions

[jodaer]

I've been on Jardiance for about 2 weeks now. My fasting blood sugars have gone up about 30 points since. I am also taking 5mg of glipizide. I've always had good control of my diabetes, A1C has always been around 6, give or take a couple either way. I had been on Metformin prior to this.

I had labs and a cystatin Egfr and it dropped by 10 pts to 29. Both doctors went nuts to get me off metformin but in looking at info on Jardiance it says not to use under egfr29. And nowhere in the literature does it say it helps the kidneys.

I was on 2000mg of metformin, now I'm on 5 of glipizide and 10 of Jardiance. It seems like that's a big drop in medicine.

I'm 80 yo and my endocrinologist said an A1C of 7 is OK for a person my age.

I'm not really sure what my question is. I'm just a bit confused by it all. My neph is good at answering questions but I didn't have any when I last saw her. Endo is not so good. I would just like your opinions on what is going on. I know you have them, and all are welcome.

[orangecity41 NKF Ambassador]

Thanks for sharing info on A1C. I am pre-diabetic and did not know that age was considered on the A1C range. I am 81.

[jodaer in reply to orangecity41]

I've been a diabetic for over 20 years and no one has ever mentioned age to me until now. Not sure exactly what she meant. She just added that to a msg in My Chart. I will talk to her more about this in a few weeks when I see her in person.

[Bassetmommer NKF Ambassador]

Hi Jodaer.

There is a couple of things going on here. First, it takes a while for any drug to work in the body. Two weeks may not be enough time to be effective. Secondly. SLGT2 inhibitors, like Jardiance are very much so kidney protective. However, you are correct. Jardiance is not recommended for low GFR. I saw different levels mentioned in what I read. I am not sure if you are truly at risk. BUT.... there are other options out there to try.

It is a matter of finding the right one. Make sure you are still eating the same diabetic mindful way. If after a month, and the A1c is not going down, maybe something else might be better for you. I was put once on a brand-new diabetic drug years ago called Tradjenta. My A1c went bonkers. I never had as high levels as I did on that drug. Doctor kept saying stay on it. About 3 months in I took myself off and went back on the drug I was on before, which was Januvia. I am no longer on that med either as I take a GLP-1 for my diabetes. I take Ozempic and it brought my A1c down to 5.6 and it has been there for over a year. There are all sorts of new kidney protective and diabetic drugs out there now.

Hope this helps.

[jodaer in reply to Bassetmommer]

The info I had was it shouldn't be used if eGFr is under 29. Mine was 29 so borderline. I will talk to the doctor when I see her in 6 weeks and see what the labs say in 2 weeks. I guess I'm just anxious. things were going pretty good and then this new test threw it all into flux. Thanks for the info..

[neidrum in reply to Bassetmommer]

I just went to ER the diagnosis was degenerative joint diseased (acute lumber back pain). The med prescriptions are Naprosyn 375mg & tramadol 50mg both of these are bad for my kidneys. I just got my kidneys together I was wondering if there something else that could take away the pain. I'm using cold & hot pack 20 minutes during the day & 8 hr. tylenol 625 in the morning & when I go to bed it's not relieving the pain. ( It did stop the sharp pain in my left buttock and left thigh but in the lower middle of my back it's still there)

I'm not able to get in the tub to soak because I have arthritis in my knees (can't get out the tub). I see my new primary care dr. the 15th but when I told the dr. in ER that med is bad for my kidneys he said it's okay and I'll probably get the same answer from my new dr. any suggestions thanks.

[jodaer in reply to neidrum]

I think the tramadol might be OK but not sure about the naproxen, This is a conversation for doctor. Research meds before you see him. What I would suggest is seek out an opinion to get some kind of epidural to help with the pain. I have random pain and have trouble with finding something to take care of it. You might also try massage therapist, yoga and a chiropractor for relief.

[neidrum in reply to jodaer]

medicare advantage cover treatment for chronic pain. I'll ask my dr to get an prescription for massage therapy thank you jodaer and google.

[Sammi_n_Munk in reply to neidrum]

Yes, as jodaer says, I’ve also heard that Naproxen (Aleve), is pretty much a direct enemy of our kidneys, much as other anti-inflammatory drugs are as well. I actually had a pretty sad conversation with a nurse once while I was hospitalized, who had relied on Aleve during her years in college for back pain. She was advised by her doctor to put a stop to that quick, because it began to very negatively affect her kidneys. She was still quite young at the time. This, of course, was years ago, but I think of her from time to time, and wonder how she came along. She told me her story while warning me about all of the Advil I was taking at the time. This is just my two cents of course, I’m no expert, but please do be careful with Naproxen. All my best to you! 🙏

[S_dillow]

jardience is not supposed to be used in people with ckd or diabetes past a certain age in a study i saw somewhere on the net...i wish i could remember where.what the heck are these doctors smoking?

[jodaer in reply to S_dillow]

I don't know what they are thinking.

[S_dillow]

i dont know either but somethings screwy in st louie about the whole thing.maybe new endo and nephro?

[Bassetmommer NKF Ambassador in reply to S_dillow]

screwy in St Louie....lololol

[jodaer in reply to S_dillow]

They are new. Not too worried at the moment as there is a chance I might be relocating in the next several months so will wait and see. The neph i really like, endo not so much.

[S_dillow]

sorry but well....i was being nice. .

[S_dillow]

ok.doctors that do that kind of stuff tend to tee me off something fierce ..,

[Darlenia]

Hi Jodaer. I won't be of much help to you since my hubby takes insulin. Re your endocrinologist, she's actually right about an A1c of 7 being fine - apparently as one ages, the A1cs go up in the normal process of aging. (Interestingly, my hubby and I both have A1cs in that range.) A larger problem as we age is daily glucose management, it's very important to not let the sugars go too high to save the kidneys, but it's also really important they don't go too low at all times. So it's a very delicate balancing act. I was reeling a few years ago when high sugars took out my hubby's kidneys, and right now I'm reeling after I found my hubby in a hospital emergency room a few days ago - passed out from low blood sugars while he was behind the wheel and on the road no less. The older one becomes, the easier it is to pass out with this, particularly for those with renal issues, etc. Fluctuations, especially the low swings, seem to occur more easily and these don't show in A1c data. So...simply be careful, talk to your endocrinologist, keep a good eye on your daily sugar levels, and so on. We very much want everyone, including you, to stick around for a very long time!

[Bassetmommer NKF Ambassador in reply to Darlenia]

This is a well-informed reply and I hope others read this. You are correct that at a certain age, A1c of 7 is not considered bad. What is interesting, about 20 years or so ago....6 was normal. They saw $$$ and lowered it to 5 for normal... but for the older folks, that can be too low and can cause hypoglycemia, where the sugar is too low. Which, in my opinion, is more dangerous that a high spike. My husband and I have both had high spikes and he use to break out in a sweat. This was before he was on drugs for his diabetes. But when it goes too low, it is more dangerous, and people pass out. And then what, unless you have one of those expensive shots to take. He is now on the right combinations of drugs and maintains his sugar with a Dexicon reader. He can check anytime and there is an alarm if her gets below 62. Pain the butt in the middle of the night when it goes off. But better off awake then dead.

[jodaer in reply to Bassetmommer]

I've had diabetes for about 20 years and at that time anything under 7 was good. Then about 10 years later it was oh no it should be 6 or under. $$$ for sure as they changed all the numbers, bp. cholesterol, etc. I can see that as you age the A1C might go up, but it would be a gradual raise. It's going to take some time to do that about face. I've never had a problem with low blood sugars but agree that low is worse than too high.

[Darlenia in reply to Bassetmommer]

You're so right about the seriousness of hypoglycemia....this was my hubby's first time passing out. It happened so fast he had no symptoms. It's so deadly. I do think now that Mother Nature allows older folks to have higher sugar levels to prevent that from happening. It's great your hubby has a Dexcom reader, my hubby will be getting that too or something similar on Wednesday. For sure, I definitely don't want to discover a cold body in bed. This has really, truly rocked my world. So many highs and so many lows. I'm going to be writing a heartfelt thank you to the passerby that called 911, the EMS crew that brought him around, and the policeman that took and secured his car. Angels do exist out there and on this forum. I deeply appreciate each and everyone so very much. Blessings to all.