Queasiness from Ozempic

[Merryfield]

As a result of taking steroids for PMR, my prediabetes became diabetes. After that and vacations where I overdid it, my A1c. soared to 8. Doc put me on Ozempic. If this chain of events has occurred to anyone else, how do you deal with the nausea? I get sick to my stomach every time I eat. I have reduced back from .5 to .25 mgs of Ozemoic. It’s dinner time but the thought of food is sickening. This is a horrible way to lose weight.

[Nothingnoted]

I hope your diabetes gets better pretty soon I for about a year I've been dealing with some and ulcer from diabetes and finally it's closed up but it was pretty hard I had to give up sugar and rice all together I just hope your sugar levels get better and you feel better soon

[Merryfield in reply to Nothingnoted]

Thank you for your good wishes. Hope your sugar levels are now lower.

[Nothingnoted in reply to Merryfield]

Thank you they've gone lower but it's not where the doctor really wants it it's only gone down to 7.8 he wants it down lower but my whatever I have my sugar taken because I don't have a machine it's always like 70 or 80. The reason why I have an ulcer is because I let a callus get worse and the callus turned into an ulcer that's one thing you have to watch with diabetes is bunions I hope your sugar level will go down pretty soon too and you will feel better

[SnazzyD in reply to Nothingnoted]

Yes, cutting all refined carbs drastically is necessary on Pred. Some have to cut out more than others to keep their sugars stable on Pred. I had to cut out all refined carbs while on high doses of Pred until I was well under 10mg and even then I had to be very frugal. I still ate a lot, just not carbs which was difficult but boy, am I glad now.

[Merryfield]

I am sorry for all you are going through. I eat a little breakfast before taking my meds. Sometimes am not hungry til dinner. But the nausea can be mild or moderate most of the day. Have you found a way to quell it?

[SnazzyD]

Unfortunately, Pred does force your blood sugars up because of its affect on the liver even before you eat a morsel. Having raised blood sugars on Pred doesn’t necessarily mean you are properly diabetic but it can cause you to become diabetic if those sugars remain high over a long period. Am I right in thinking you are just on Ozempic for it? If so it seems they are trying to treat weight gain and the insulin resistance that can come from it. The ‘easy’ way to deal with Pred/sugars issue is cutting down carbs drastically. Just losing weight alone is a long way round and not guaranteed to work and merely increasing exercise doesn’t work either. With PMR it often isn’t possible to do enough exercise. Even some put on diabetes meds here have managed to control their glucose by cutting out all white/beige carbs and reversed the situation. I have no idea why doctors don’t know about it. Mine even thought I wasn’t absorbing my 40mg Pred because I had no weight gain or raised sugars. I told him and it was a revelation, though doctors don’t really cover diet in training. Anyway, did you try this approach or have got your situation all wrong?

[Merryfield in reply to SnazzyD]

I am on Metformin and Jardiance as well as Ozempic. Have virtually cut out alcohol, sweets and carbs except for seed bread. The Jardiance kicked off some weight loss. Down 20 lbs since December-7 or 8 due to Oz.

[PMRpro Ambassador]

Had you tried cutting carbs drastically beforehand? It may be hard work for some but at least it doesn't make you feel nauseous! There are a couple of people on the forum who were able to reverse their diabetes just by cutting carbs, I think Koalajane is one.

[Merryfield in reply to PMRpro]

I eat very few carbs except for seed bread but will be even more careful.

[PMRpro Ambassador in reply to Merryfield]

Are you sure? Fruit? Root veg? People often say they eat no carbs but aren't losing weight, But when they keep a diary they discover they are eating a lot more than they think.

[SnazzyD in reply to Merryfield]

I’m also a great fan of the food diary. It really does shine a light on actual carb intake including drinks, especially if you are one of us who really cant get away with much. Bread was an absolute no no for me, even ‘healthy’ read.

[Koalajane]

steroids gave me diabetes but by cutting carbs drastically I quickly got into remission, I was put on gliclazide until my first review when I was taken off it.

You might find more out on the Diabetes forum

[Merryfield in reply to Koalajane]

Thank you. I will get a blood draw in about three weeks. Hope the sugars are lower.

[PMRpro Ambassador in reply to Merryfield]

The trouble is, just measuring blood glucose can be very misleading. Pred makes the liver release random spikes of glucose from the body stores. If that happened shortly before they took the blood sample, then it could look really concerningly high when in fact, overall it isn't too bad. They need to measure the Hba1c as well which reflects the average blood sugar level over a period of 3 months. And often that isn't as bad.

Pred-induced diabetes is different from Type 2. It isn't lack of insulin or insulin resistance though it can develop to that if it isn't kept an eye on. All you can do is moderate the carbs/sugar you can control in your diet.

[Merryfield in reply to PMRpro]

Hi, Pro. My glucose test was one of those that averages the three months. It has been high in the prediabetic range for several years before pmr but the steroids caused me to tip into full-blown diabetes 2. This was shortly after my only child suddenly died. Then wild eating during two long trips caused glucose to soar. I am going to focus on chick, fish and veg. Will have to dump the seed bread, pineapple in water, sneaky small sweets and very rare alcohol. Well, maybe not the pineapple. Always appreciate your knowledgeable assistance.

[Merryfield]

Love your sense of humor! I am probably not eating enough green, red and yellow veg. I am doing good at virtually no red meat, desserts, pasta or alcohol. Pizza once in a while tho. I take both a laxative and softener every night. Will look into Colace. Never heard of it.

[Merryfield]

Ok, I realize I am covered on the also colorful stool softener! The nausea is better since I backed off the.5 dose and went back to .25 mgs. Thank goodness.

[Merryfield]

Hmm. I will ask my doc about getting off Metformin.

[Merryfield]

no. you are much better monitored than I am, for sure. i am going to see how .25 works. .5 was unbearable.

[Gimme]

I reversed my pre diabetes last year by following a low GI diet and lost 2 stone, so it is difficult to say if it was the diet or the weight loss or both. However, this was before I started taking pred, so I have no idea what my Hba1c looks like now. As soon as I started pred, I went back to the low GI diet and my weight has stayed stable. I would probably lose weight if I felt more well and could exercise more. I've always found swimming good for weight loss, and assumed it was because you need so much energy to keep warm in the water. Luckily, my PMR des not stop me from swimming. To control the diabetes, you really do need a combination of dietary control and exercise to stop your blood sugar spiking. Plenty of studies on the effects of weight training in women with Type 2 to help them control blood sugar. I'm not sure that heroic exercise is on the cards for us and probably not wise either, but the good news is that continuous low level movement is best for fat burning and weight loss. I find walking far too painful and it takes too long for me to recover, so I do a combination of swimming and low level weights, taking care not to overdo it. Anyway, that doesn't really answer your question, but that is the approach that has worked for me, so far. I have been desperate to avoid more drugs, though I guess that could change.

[N-London]

I am really interested by this conversation. I am trying to lower my pred. Currently at 5mg about to go to 4. Also using Ozempic fully for weight loss. Seems to be working well. They give me a call every month before they will prescribe the next dose but on top I have a monthly call with a diet coach. She is great. You don’t have to cut out lots but what I did learn is to watch the order you eat things. So eat your carbs last in a meal, even if you only have salad first it lines the stomach and stops a sugar spike. So if you like tortilla chips, eat them with something like hummus to counter the sugar in the system.

The other I learned is if you fancy a piece of say chocolate cake, have half and put cream on it. Crazy as it sounds the protein in the cream balanced out the sugar.

I am overweight ( what do you expect after 6 years on pred) but bordering obese. This combo seems to work.

I cut out a lot of alcohol, not all, and don’t eat anything between smaller meals. Thankfully nausea has not been too much of an issue, just the occasional bout.

I am convinced the way to win is just a lifestyle change, that takes time and is a mind game.

[Merryfield in reply to N-London]

Good tips. I agree, adhering to diabetes diet is indeed a mind game. Mind over desire.

[Raewynne]

Yes queezieness is awful.I find peppermints help.I became diabetic too.Ended up on insulin.It has settled down but I try to watch what I eat .Unfortunately I am recovering from another serious side effect of prednisolone right now and it's affecting my diet shockingly but I am still alive .Good luck.

[Merryfield in reply to Raewynne]

So sorry about the other serious side effect. May I ask what it is? I will look for sugar/free peppermints. Thank you.

[Merryfield in reply to Merryfield]

Got sugar free mints. Kinda gave me heartburn. Maybe I will try mint tea.

[SMH4CRNA]

Anyone on GLP-1 Agonist and scheduled for any type of surgery or procedure requiring anesthesia, please consult with your provider when to stop these before the day of surgery. These medications slow down metabolization (hence, why you do not feel hungry). The time required to not eat before surgery may need to be prolonged. We are finding patients still full of food and putting themselves at risk for pulmonary aspiration. We had one a couple weeks ago at the hospital I work. Sorry, to get off topic, but these medications are a hot topic in the anesthesia community.

[Merryfield in reply to SMH4CRNA]

Good to know

[Merryfield]

This sounds grim. Sounds like Wegovy, like Ozempic, has to be taken forever, or the weight comes back.

[Merryfield]

It's such a journey. I like the fact that friends comment on how much weight I have lost and I can wear clothes I couldn't get into before...but I hate the queasiness and that I will probably have to stay on Ozempic. Good luck with what you decide to do.

[Wizards]

I was on prednisone for 8 yrs and gained 60lbs on a diet that was between keto and diabetic. I cut out my fruits, bread, pasta etc and still managed to gain. Mind you prior I could gain 3lbs just having 2 drinks so I knew I was in for a rough road.

I've kept as active as my body would allow doing swimming and diving and prior to covid took up weight lifting because I could feel my muscle loss which I improved. It also helped with my bone density.

For the last 5 years I was pre-diabetic so was very strict and still managed to gain.

During covid I was down to 5mg and less and started walking with great pain but I pushed through and lost 30lbs and since off I'm fighting for the rest.

I too have just recently started ozempic. I've gone from 8 yrs of diarrhea to borderline constipation, however I ate my husband's chili tonight and it worked better than an laxative, lol.

It does curb cravings and appetite but haven't lost much yet but only 3 weeks.

I'm envious of people like my cousin with GCA/PMR who continue to stay slim and others.

My sugers reduced immediately after I was off prednisone but now I'm contending with trigger fingers in almost every finger along with astioarthritus.

Getting old is not for the weak.

[Merryfield in reply to Wizards]

Bless you, Wiz! Lord! It took me 35 years years to gain 60 lbs. I have lost 20 since Dec, but despite trying mints, I have been queasy since lunch. Started immediately after I ate. I am 74, so eating very little, even on Jardiance and Ozem, the weight is slow to come off. Can you ship me some of your hubby’s chili???

[Wizards]

If I could I would LOL. I should have 1/2 bowl daily for bowels but afraid I'd gain weight lol.As I said old age is not for sissies.

[Merryfield in reply to Wizards]

The only thing you can do about old age is laugh at it and keep moving!

[Wizards]

Absolutely