Type 1 (LADA) Trying Ozempic?

Today was okay until about 4pm. I just had coffee and water until 2ish, when I made myself eat maybe 1/4 cup chicken with peppers & zucchini in the air fryer. Sprinkle of goat cheese. I’ve felt not well since especially the last 2 hours laying down nauseous. I don’t think it’s just in my head (which has been aching).

I hope this all resolves itself soon. The appetite suppression is like nothing I’ve experienced, which is great but I’m not eating near enough. 2 days in no worries, but I just want normal appetite long term, not too sick to eat anything. I’m not sure I’ll be able to eat dinner tonight. I’ve probably had 300 calories total today.

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I’m on the hydration, but I can’t imagine exercising. I’ll try to do some walk’s tomorrow morning if I feel better.

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The nausea and bloating after eating will pass after a couple of weeks. Eat ing slower may help. You will find that you can eat about 1/2 of what you use to, and you won’t feel the need to snack. Make sure to test your basel setting, I had to reduce mine by half. Meal doses are tricky; I cut them by a 1/3, and do split dose. I suggest until you know what your new meal dose will be that you do not dose until eating or at the end of the meal.

I am T1D for 58 years, now 70 yr old, pumping for more than 25 years. I started Ozempic in October, and lost 18 lbs. My time in range is 87%; A1c was 5.9, and now is 5.8.

I think it is a big deal for T1Ds. The side effects are tolerable, and will improve lives.
Mike

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Thank you. I was ready to quit when I woke up this morning (not that I can “quit” until the week is up), but today has been better. I have been chewing ginger gravol and was able to eat a small keto bar mid morning and a few pieces of veggies with goat cheese for lunch. Lots of water and fizzy diet drinks. Could only finish half my morning coffee. Got some short walks in too. Hoping the worst is behind me!

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@jo_jo and others, you’re experiencing the same as listed in another thread - slow titration is key, my Endo used the click method every 2 weeks (0.25, 0.25 plus 5 clicks, 0.25 plus 10 clicks, etc).

For those who want justification to you Endo to get a GLP-1 prescribed, I suggest sharing this article on the SIX islet hormones affected in T1D:

Good luck, hang in there!

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My Endo told me to stay on 0.25 for 4 weeks. Tomorrow, I take my 2nd dose of 0.25. However, I’m planning to take it in my thigh vs my abdomen, as I’ve heard this limits side effects. This sort of makes sense to me, as I’m able to absorb in my stomach far more effectively than in my thigh when it comes to insulin. Here’s hoping…

I can see the logic of the slow titration, but I’ll run it by my Endo before I try it. He said I may not need to even go up from 0.25, and that if at week 5 I decide to, and the side effects are worse, to go back to 0.25 for another 2 weeks.

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It’s day 7, so I take my 2nd dose of Ozempic tomorrow. I think it’s pretty much out of my system now, because I don’t feel sick, I need more insulin than I did beginning of the week for the same foods, and I’m starting to have my old cravings for junk food again (albeit, I’ve had the willpower not to give into those so far, so maybe the Ozempic is still there somewhere). I have a hard time getting I:C dosages right on the best of days, so an extra variable in that regards is not ideal (it would be one thing if it gave me a new, less aggressive I:C ratio, but it seems that was only so in the beginning of the week).

We’ll see how week 2 goes!

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@jo_jo FWIW (not much), I started, stayed and am well-controlled on .75mg of Trulicity, which is considered a very low dose (according to the pharmacist). Since you seem to be sensitive to the Ozempic, you may not need to go up much and, if you do, I agree with @MsCris - go slow.

Continued good luck!!

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Started week 2 on Tuesday, and it’s Saturday. Had some nausea on and off, but far better than the first week. I was down 12 pounds yesterday. I am not doing any exercise other than my curling league, which is only 2 hours a week. I would like to incorporate exercise, but I’ve felt too gross to do so thus far. I think I could add in the light weights, squats, stretching, but the elliptical seems too intense for how I feel. I may just push myself to do it anyways. I don’t know if I’ll go up to the .50 dose at the end of 4 weeks. I can’t imagine feeling worse, and I’m still getting the benefits on .25 (with the MAIN benefit being my obsession with food and overeating junk and cravings being GONE). BUT, my intention here was to aid myself in creating healthy habits and a regime without the intense cravings, and yet I haven’t been able to exercise or eat healthy, I just don’t want to eat at all. I basically have half to a full coffee, water, then MAYBE some baby rice cracker things with a small amount of cheese or nothing until lunch. Lunch is maybe a yogurt or egg with some veggies, maybe a power bar mid afternoon and soup with a rice cake for dinner and honestly I have to try to make myself eat that. It’s not healthy or sustainable. I’m going to try this approach: first few days eat what I can (they are the worst in terms of nausea), then make myself eat proper foods, even if the portion is tiny (ie broccoli and salmon with some berries, or something like that). Another craving that’s almost gone is my diet pop. So glad I’m drinking more water I didn’t think I’d ever get over that one.

This is my update, so I can look back and see my journey and recognize patterns or progressions.

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@jo_jo Congrats on the weight loss and more control of consumption, that part is impressive! I’m surprised that the elliptical is more daunting than weights or squats, but may be you really get in to it! The one concern I’d have is whether you’re getting the nutrition and bulk you need for the long term; coffee, water, and rice crackers (really? I’ve stayed nearly completely away from rice.), yogurt, eggs, and a few veggies (the latter seems good as long as its varied and a decent quantity) overall seems marginal from a nutrition and bulk perspective to keep your body going and digestive track (tract?) operational. I’m sure you or others here know more than I about this, so I’ll state the concern and let you/them interject. Still, the weight loss and control seems what you were aiming for.

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I agree fully. The rice crackers were all I could stand for a few days due to the nausea. I just bought some tenderloin and broth and vegetables. I’m going to make a vegetable beef soup and eat that for a bit. I know I need to eat more, but feel too sick when I do. I’m hoping it’ll pass and I’m going to try hard to eat protein.

Exercise: yes I despise the elliptical so it’s daunting for me. By weights, I mean 5lb dumbbells. By squats I mean max 3 sets of 10. I prefer to get my cardio from long walks, but since Ozempic I’ve done 2 and felt like my heart was racing too fast and I was nauseated—plus it’s been raining/snowing. So my elliptical stares me down daily and I’m finally feeling like I should just get on it.

So I just checked my blood ketones because I was feeling especially sick today and they are 2.3 which is pretty high. My blood sugars are normal though. Can I turn this around at home? Or do I need an IV?

I’m not an expert on ketones, so don’t trust my advice too much. That said, I’d drink lots of water to help flush out the ketones, and I’d eat some easy carbs so that I could take an insulin bolus to get energy from the carbs rather than letting the body go into metabolizing fat (thereby making ketones.)

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The blood ketones are down to 1.5 so I think I may be good if I can keep hydrating. I don’t feel good, and could not eat right now. I’ll try the carbs + bolus in a bit if I can manage it. Going to call the nurse hotline in the meantime.

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Sorry if I missed it but definitely get electrolytes in your system. Pedialyte or something like that. That’s one of the first things we do when Liam has ketones and it turns them around quickly (of course insulin and additional hydration from water as well.)

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Blood ketones are now .7 but I still feel like crap. Had to leave curling early. I’ve been hydrating and ate a granola bar (only thing I’ve eaten all day and it’s after 2) and took a bolus. I wonder if I need to eat more carbs on Ozempic because I’m pretty much coasting on basal with maybe 1 bolus a day for the lunch. I think ketones can happen with too little food too? The combo of not eating hardly anything + Ozempic has decreased my basal by 40% ish

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Ketones are a byproduct of metabolizing fat. If you don’t eat carbs, then your body will be forced to use your bodyfat, making ketones. I have no idea at what point the ketones become harmful in this case.

When we don’t eat our body goes into starvation mode, slows everything down, and tries to hold on to it’s glucose. So the basal requirement drops. The rule of thumb when fasting 24 hours for some medical procedure is to cut the basal by 50%.

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That all sounds logical!

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Jo-Jo,
Let me get this straight, you lost 12 lbs in one week? That seems like a lot. If you have ketones the advice is to take insulin and eat carbs. This is what I do and I have a rapid recovery. You can be euglycemic and still have ketones from fat metabolism,

I find that all my basels are now split or square wave (30-45 min). And it takes a little more. My basels decreased. And I have more of a craving for carbs. Try nuts to snack on - you can spread it out over time and not feel full. Anymore, I can hardly eat my yogurt in the AM, so what I can finish I’ll have an hour later.

Mike

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Friday: I’m on the last week of the first pen of Ozempic, month 2/pen 2 starts on Tues, next week. The side effects are gone, so long as I keep hydrated (electrolytes and water). I’m down 14lbs. I am going to continue on 0.25 for another 2-4 weeks, as it’s working well for me for the main purpose I’m taking it for (improve relationship with food–cut cravings so I can focus on healthier options). Scared to titrate up, but will talk with my Doctor about that when the time comes, and may book a week of vaca or something during that phase because I don’t want it to interfere with work.

One thing I’ve noticed, which may or may not be related, is my anxiety and depression have been noticeably extreme. Lots of crying, feeling hopeless, racing heart, anxious feelings. I have a pretty stressful situation in life the last few years and especially the last few months, so it could have nothing to do with Ozempic, but I’m going to note it here.

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