A question for the diabetics among us. - Kidney Disease

Kidney Disease

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A question for the diabetics among us.

jodaer profile image
20 Replies

What medicines are you on?

I've been taking Metformin for most of my diabetic life. 1000mg 2x a day. I recently changed to Jardiance 5mg and glipizide 5 mg a day. I've been on that regimen for 5 weeks. My A1C went from 6.6 in Oct to 7,7 last week. I'm thinking i need more medicine. My eating has been the same as usual.

I see my endo tomorrow and am just wondering what others are on that I might suggest we switch to or add.

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jodaer
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20 Replies
Bassetmommer profile image
BassetmommerNKF Ambassador

Hi Hodaer,

Adjusting to new medications takes some time. It has to build up in your system to work. And for some, it might take longer. Do you do your own glucose testing at home or do you rely on A1c at labs only?

Jardiance is one of the new kidney protective diabetic drugs. I remember when it first came out there was all sorts of black box warnings on it. I would watch my daily glucose numbers and give it a bit more time. Although you have been on it almost six months. It might not be the best for you or you need a stronger dose. Make sure you talk to your doctor soon.

I was on Januvia for years. Then over a year and half ago I went on one of the new GLP-1 drugs called Ozempic. Yes, it is supposed to help with weight loss, but it was first a diabetic drug. For me, I did not lose weight. I was able to get up to .5 mg dose,(which is still only a half dose) but then had two pancreatitis attacks and now I am back down to .25. My A1c was over 7 and now is 5.6 and has been for over a year. Since I have not had a current A1c (the lab forgot to draw one) I think I may have been even lower and maybe too low. My daily morning glucose test is never above 85.

Many years ago, I was also put on Tradjenta and it was horrible for me. My A1c was totally out of control. Doctor told me to stay on it...but I stopped it and went back to Januvia. It just was not a good drug for me. ( nor was that doctor good for me)

jodaer profile image
jodaer in reply toBassetmommer

Thanks. I'm up for letting it work but my fasting glucose has been running at 175. I'm used to 130s which has my A1C around 6. I see my endo tomorrow so will see what she says.

nonna70 profile image
nonna70

Hello, I take Metformin 500mg/day, Farxiga 10mg/day, and Rybelsus 14mg/day (it's a pill because I am blind and didn't do well with prescribed injection).

nonna70 profile image
nonna70 in reply tononna70

Oh, I forgot to say that my A1C went down a point and everyone's happy-to 5.4.

KidneyCoach profile image
KidneyCoachNKF Ambassador

CKD Stage? Metformin is considered non-reccommded beyond certain ckd stage 3b. Dosage considered too high, causing more damage to kidneys than benefits. Been up 36 hrs so may be grammatical incorrect. Sorry 😞

kellyscats1 profile image
kellyscats1

good advice and equally as important the majority of type 2 diabetics can greatly improve their numbers with good eating habits,, weight lss and exercise,,no majic pill... just work...lol

kelly

barbara55109 profile image
barbara55109

They stopped all my oral diabetes meds once I got to stage 3 CKD. The oral meds are contraindicated. I'm on both meal insulin and long acting insulin. I'm also on Wegovy - the weight loss/maintenance dosage of Ozempic. My A1C is in the 5s. I get many lows so my insulin dosage keeps going down and I have to eat Smarties almost daily. You don't say what stage CKD you have. Please ask your Dr. about why you are still on Metformin and Glipizide since you have CKD.

Darlenia profile image
Darlenia in reply tobarbara55109

Hi Barbara55109. If you don't already have a continuous glucose monitor, you might appreciate a Dexcom or Libre that can warn you when things are wonky. When one is on insulin, one generally qualifies for them as a T2D. My hubby passed out while driving a few weeks ago after sugars went too low. So scary. So it's a good idea for all diabetics on insulin to check their reading or to use a good vehicle with navigation radar before sliding behind the wheel. We're still working hard to get everything stabilized. Sending positive karma your way that you stay on a smooth and steady course.

jodaer profile image
jodaer in reply toDarlenia

My sil is on a monitor like that. It has helped him a lot.

barbara55109 profile image
barbara55109 in reply toDarlenia

Yep. I have a cgm. That's how I know it's smartie time. I have it set for 70, but I mist drop fast sometimes because it is in the 60s and 50s by the time I pull it from my purse! I've got smarties stashed everywhere, purse, car, bedside, kitchen, work desk, tv chair! I won't drive if I'm dropping. I've sat in the YMCA lobby many times waiting for the smarties to work.

Darlenia profile image
Darlenia in reply tobarbara55109

Oh no...not you too! My hubby is exactly like that. It's the scariest thing ever. I think all diabetics who want one of those monitors should get one...I really do. Diabetes is a horrible, miserable disease.

barbara55109 profile image
barbara55109 in reply toDarlenia

Yes it is scary. I didn't get lows for 15 + years since I'm a T2 diabetic. But since I went on the Wegovy and started going to the Y regularly I get them all the time. High blood sugar is bad for you, but won't kill you outright. A bad low can kill you. They can be very frightening and disorienting.

Darlenia profile image
Darlenia in reply tobarbara55109

Oh gosh, yes. If my hubby hadn't been found when he was, he would be dead 'cause not only was he passed out but his heart was near gone too. I have a whole new respect and concern over low sugars. Like you, he's a long term diabetic and this has been a new situation for us. I feel for everyone facing this. Hugs!

TopazForests profile image
TopazForests

While it sounds like metformin controlled your diabetes, the question is at what cost? My CKD was caused by a combination of many years on Metformin and a variety of anti-inflammatory meds. It sounds like your doc is trying to get you off Metformin. Like any medication changes, it takes a while for your body to adapt.

Give your body more time to adapt. Are you testing your blood sugars daily? If not, start doing that and sharing that information with your doctor, it will help him/her to make sure you are on the right dosages of the new drugs.

jodaer profile image
jodaer in reply toTopazForests

Metformin has been good for me but as you say at what cost? Something I will never know. I also took tons of NSAIDs for many years, also Prilosec so I imagine it's a bit of all. My sister had CKD too so maybe some genetics there too.

jodaer profile image
jodaer

Thanks for all the responses. I'm CKD 4 I think, eGFR is 29. I saw the endo doc today and she is putting me on Trulicity if I can tolerate it. I have IBS too so not sure about it. My eGFR has been about 40 give or take a few. Then at my last test she used the new test and it dropped to 29. So that led them to go crazy about the metformin. We had discussed that in the past, how it isn't good for late-stage CKD but then neither is Jardiance.

GoldenBailey profile image
GoldenBailey in reply tojodaer

My primary care took me off Metformin when at Stage 3B and I was placed on insulin - Tresiuva and Novolog on a sliding scale.

jodaer profile image
jodaer

I want to thank all the people who answered me with a special shout out to the ones who told about hypoglycemic levels. I've never had that problem, yet, and really didn't think much about it but now with seitching out meds ai guess i'd best be paying better attention.

HSV21 profile image
HSV21

I have been on about every Diabetes drug available over the years and always Metformin until Stage 4. I am now only on Ozempic 2.0. It immediately brought my glucose levels down to normal, even at low levels, where Trulicity and others never did. I take the higher level so I can lose weight for my transplant. I have found it is the only thing in 30 years that has helped me lose very stubborn weight. And it continues to work. I am off most all of my previous meds now, and feel great, even though egfr is 12. Good luck finding what helps you, but don't be afraid to try Ozempic. It really helps the diabetes. And I have never been on insulin or dialysis.

jodaer profile image
jodaer in reply toHSV21

Thanks, I'm on insulin now and doing well.

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