UPdate

[jodaer]

A few months back there was a thread about Trulicity/Jardiance. I had mentioned I had started on both of them, and someone said to let them know how it goes.

Background: I have CKD and am a T-2 diabetic. I'd been on Metformin since almost the beginning, about 20 years. In Jan my neph ran the new lab test for GFR, the more accurate one, and my gfr went from around 140 to 128. Lots of panic and doctor took me off metformin and put me on Jardiance and glipizide until I could get in to see my endocrinologist.

Oct 2022 my A1C was 6.6. The highest in a long time. It usually runs about 6.1-6.4

Feb 24 had an A1C and it was 7.7. Early Mar saw my endo, she stopped the glipizide and put me on Trulicity, the lowest dose.

FF to yesterday and another A1C which was 7.8

So, it appears that I'm on 2 wonder drugs and neither is doing what they are supposed to do. The Jardiance is more for my kidneys than diabetes and I see my neph in July, with labs done in late June so wont' know how that one is working.

Oh, and instead of losing weight I gained some, which can be a side effect of Trulicity.

I'd like to hear from someone who had a different reaction or even the same.

[Blackknight1989]

That’s a normal response of SGLT2 initiation. In the first 2-3 weeks there is an initial drop in eGFR. Doctors and patients panic and stop treatment…the EMPA-Kidbet study addressed this and says it causes no harm. That is why Jardiance in now approved in the US as well as the UK for both T2D and NON-T2D CKD patients. I have the study I just can’t find it currently. Here is an article from the Lancet since you are from the UK that outlineds their recommendations to initiate Jardiance across all of the CKD spectrum. Lowers CV risk over 30% doctors need to read the studies.

Heee is the EMPA-Kid eye study that the FDA stopped early in 2023 because Jardiance is so effective and has so many benefits regardless of where you are on the CKD spectrum. Is go talk to your doc and start the treatments again but that me.

[jodaer in reply to Blackknight1989]

Thanks BK but I'm referring to my A1C. I won't know how Jardiance is affecting my ckd until end of June.

[galesr]

I have lost weight on Trulicity

[Bassetmommer NKF Ambassador]

I am not on Trulicity but Ozempic. Same class of drugs, GLP-1s. I did not have any change when I first went on it. But about four months in..... wow. My A1c was around 6-2 to 6.5 and it went to 5.8. Then it went to 5.6 and has remained there for over a year and half. I am on the smallest dose, .25 mg. because I could not tolerate it when I went up. Matter of fact, it made my sugar TOO low. I know you are supposed to lose weight on it but with the dose level I am on, nope. That's ok. I like the one shot a week for my A1c. I also noticed that when I consume something like pasta, my glucose does not go crazy at all. That has been really nice. I also take a low dose of insulin only at night. But that has tapered down now over 12 units.

[jodaer in reply to Bassetmommer]

I've been on it for 3 months and A1C has gone up. I see the doc in 2 weeks so will discuss with her. I'm on the lowest dose also. I would have thought with the 2 "miracle" drugs for t-2 it would at least go down. My morning fasting BS are usually around 180. When I was on metformin it usually ran in 130s.

[jodaer]

My bad, I thought I had proofread my post. eGFR went from 40 to 28. Sorry for the confusion.

[GoodHealthIsAJourney]

Do you know why they still want you on insulin with low A1C and hypoglycemic episodes? Sounds pretty dangerous?

[darkstar1974]

Insulin is super effective when combined with activity. If I plan on any kind of activity within 1-3 hours after injecting rapid acting (mealtime) insulin. I will opt for not doing the activity or depending on the activity reduce or not take the insulin.

11 units is a pretty decent dose of basal insulin. Especially when combined with another medication that will effect insulin sensitivity. You might want to taper that down a bit to 7 or 8 for a few nights and see what happens.

The book Think Like a Pancreas helped a lot.

amazon.com/Think-Like-Pancr...

With an A1C in the lower 5's you have some room to experiment with slightly reduced insulin intake to jive better with the added insulin sensitivity you're getting from the Wegovy.

[Blackknight1989]

Here is a recent article on Jardiance that has several links to the studies I referenced in my initial posts…hope it helps…lots of POSITIVE news for all CKD patients regardless of classification or T2D status. Link:

healio.com/news/cardiology/...?

[Bassetmommer NKF Ambassador]

Ahhhhh I think your doctor is missing something here. Having consistent lows is very dangerous. It causes more car accidents than people know. My husband has issues sometimes with drops, and of course, they coincide with days he exercises more and eats better. I think his doctor sees the highs and prescribes for those. I told my husband on the days he exercises and we only have salad, or low carb dinner to lower his night dosage on his own. He asked his doctor and she agreed with this. He has to take some control because the doctor is not there all the time. He also carries glucose tablets, but I have noticed he is using those less. I am on Ozempic and had too low numbers when I went up to only .5mg. I am back down to .25 and also have lowered my nighttime insulin but on the days we eat a higher carb meal, I adjust it accordingly.

[jodaer in reply to Bassetmommer]

I totally agree on the low glucose #s I talked to my doctor yesterday re my higher than usual ones and she's of the mind that higher is safer than low. We will discuss further when I see her in 2 weeks because mine are too high and I'm not comfortable with them that way.

[Bassetmommer NKF Ambassador]

Just curious, the weight they gave you seems unfair. I would think that was fine. I was told a higher weight for me to get transplant than 205. which I am not at either. But if I go to another hospital in a city about 2 hours away, they will take me and my fat butt with no problem. I think it is total discrimination.

[Bassetmommer NKF Ambassador]

EXACTLY this is something I am trying to fight within the kidney world. Just because someone is large, does NOT mean they are unhealthy because of their size. I too eat like a fanatic. I lost weight when I initially went on a renal diet. Actually lost 50 pounds over a year or more. It has fluctuated a bit, like less than 10 pounds on then off. I have done everything I could to lose weight and it does not go past a certain point. I actually tried eating less than 900 calories a day and felt sick, so I stopped that. My cardiologist says there is a point where you will not lose weight when you spend you life dieting. Only surgery can change it..... and I was turned down for that. It is like .."no transplant for you, fat girl". I so empathize with you.

[kellyscats1 in reply to Bassetmommer]

It is tough and sadly if person is morbidly obese it will catch up to you..during surgery fat does not have a blood supply to heal.. all of your body is stresses..you can be fat an d heathy at 30... but not at 60..and dieting is not always a good answer,, the ony people i know who have had successul surgical weight loss are those you went to the gastric bypass..I know many people who have great success with it.. and like when my daughter had it 20 years ago she had to save and pay for it herself...she had to loose 20 lbs on her own before they even cosidered it.. but it worked..

[Blackknight1989]

Amen sister. My eGFR is 17-21 and I hate coming to see the “I’m 98 and my eGFR dropped from 100 to 97, SHOULD I WORRY??”

Sorry I know that is a horrible attitude but I just can’t stand to see those.

Please forgive my meanness and unabashed jealousy of a “near normal” (at least compared to mine) eGFR. I’m not proud of the way I react but there it is…lol!

[Adlon57]

I have diabetes 2 since Mar 2020, but recently GP's getting their tails up about my blood sugar [88] normally they go on about exercise, but that's out the window, I have been declared terminal due to double seizure, [epilepsy] in Jan 2018, irreparable brain damage, got to take things s l o w l y! I was seventeen and a half stone in 2020, now 15 half now, so it not from lack of trying with 'diets' GP agrees not real to lose about three stone, been on metformin/sitagliptin currently [stopgap?] now been put on Jardiance, to attempt lose weight, but have bad urinary flow due to schwannomas on prostate to complicate matters [Prostate Cancer from June 2022🙄] will need to enlarge incontinence pads supply😵🙄 I don't worry about life expectancy anymore, it's quality of what I have left, ok I am aged 67, on a ok pension, but I can't really look back on a good life, side effects of medication have seen to that, short term memory ALL my life!