I’m in Minneapolis and have been managing type 2 for about six years, currently on metformin with my A1c hovering around 7. My endo brought up adding a GLP-1 at my last visit, mostly for the weight and glucose combo, and I was ready to go for it. Then I came across news that the FDA has ordered a warning about a rare eye condition called NAION linked to these drugs, and now I’m second-guessing whether to start.
What I can’t sort out is how rare “rare” actually is, and whether my existing eye history should change the conversation. I don’t have diagnosed retinopathy, but I do get annual dilated exams and I’d rather not trade better glucose for a vision problem I can’t undo. My doctor was reassuring but didn’t get into specifics on the eye side.
For those of you already on a GLP-1 with type 2, did this warning come up with your care team, and did it change how you monitor your eyes? I’d like to hear how others weighed it.
Still mulling this over, and that FDA orders GLP-1 warning over rare NAION eye condition piece laid out the numbers a bit more clearly, though I’m not sure how much it applies to someone without retinopathy. Planning to ask my endo directly about eye monitoring before deciding.
I am not on a GLP-1 Agonist, but I was thinking about consulting with my endo about a low dose of semagluctide for its aledged kidney protection.
I was on an SGLT2 Inhibitor for this reason prior to having my bladder removed. The issue I had after surgery was rollercoaster blood glucose levels.
My ureters are connected to a piece of small intestine to a urostomy. SGLT2 drugs lower the kidney glucose thresholds causing excess glucose to be excreted in the urine.
The problem for me was the short piece of small intestine would transport the glucose back into the bloodstream. This caused a perfect storm with my CGM and pump to do correction bolus for the highs and then going low.
Anyway I had to stop Faxiga. Kerendia Is another drug that protects kidney function. The problem is that my blood pressure is normally on the low side, and it can lower BP. So I guess I’ll continue with the lowest dose of Liscinopril.
I’m a T1 and not taking any of the GLP-1 agonists.
The FDA report hit the press 23 hours ago so it seems unlikely that there has been wide discussion with between docs and patients so far. There are other warnings about potentially related problems already listed (pancreatitis, gall bladder issues) and, of course, there are the known side effects.
This BBC article was the first I heard about it (23 hours ago ) and it seems to have a good review of the whole thing:
You may get paywalled on that link and if you are in the US I’m pretty certain you will if you try to read it on a mobile. A PC works better for me and I have a BBC log-in but no subscription.
There are numbers at the end of the BBC article. In addition there is this comment in the middle:
There is no known treatment to reverse vision loss caused by NAION. It is the most common cause of acute optic nerve injury in people over 50 years old, according to the [American Academy of Ophthalmology].
As diabetics we know that eye problems are strongly associated with our condition; “diabetic retinopathy” even has “diabetic” in its name! However the truth is that these conditions are also associated with aging so are of concern to everyone. It’s worth talking to an eye doctor about what to watch out for; things that might happen earlier in life for us and things that aren’t affected by diabetes.
) and it seems to have a good review of the whole thing: