I am about to start using wegovy…a bit apprehensive. Any tips?
Hi @mstan,
There is a good thread with comments here:
Glucagon-like peptide 1 (GLP-1) agonists are medications approved for treatment of diabetes that recently have also been used off label for weight loss.1 Studies have found increased risks of gastrointestinal adverse events (biliary disease,2 pancreatitis,3 bowel obstruction,4 and gastroparesis5) in patients with diabetes.2-5Because such patients have higher baseline risk for gastrointestinal adverse events, risk in patients taking these drugs for other indications may differ. Randomized trials examining efficacy of GLP-1 agonists for weight loss were not designed to capture these events2 due to small sample sizes and short follow-up. We examined gastrointestinal adverse events associated with GLP-1 agonists used for weight loss in a clinical setting.
https://jamanetwork.com/journals/jama/fullarticle/2810542
Bowel obstruction can lead to the loss of blood supply and colon death.
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As a type 1 who has been on GLP-1s for over a decade, just be very cautious with your blood sugar levels. Do you have a CGM? I’ve found that my insulin needs decreased DRASTICALLY. My dose just went up so that threw a wrench into things and now I’m having to figure out what my ratios are for the first couple of days after I take it vs. when it’s starting to wear off after a week.
It’s been so worth it though - my A1cs are better and I’ve lost a lot of weight.
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That can happen other ways; it’s something we all need to think about regardless of whether we use GLP-1s. I’ve found quite consistently that my insulin sensitivity spiked after a day doing hard labour. The next day I go low continuously simply because my basal is too high after the spike.
On a slightly lesser scale my sensitivity goes up in spring, when I start jumping around, and down around now, when I stop. I used to shift my basal by around 20% to cope with those changes, but these days I just keep it at “summer” and like my AIDS handle the BG overage.
I regard GLP-1s as incredibly important for us. I suspect in the confrontational environment we live in simple use for weight loss will get dissed out of existence but for us I’m pretty damn sure the scientific reports of the results will be spectacular in a few years time.
I’m certainly with you on the CGM but then I think everyone should have a CGM. Would certainly help a few non-Ds I’ve encountered 
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Well, I’ve been diabetic for 30 years so I know what’s related to the medications I’m on and what’s not. There are so many factors that affect blood sugar, so I’m pretty tuned in to what causes mine to change. When I increased my ozempic, it was a significant change that I could tell was directly related to the medicine.
It’s been a great help to me and obviously lots of other diabetics (and non-diabetics). And yes, everyone should have a CGM. Life with diabetes is much more predictable that way.
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