HELP !!!

[susieq67]

i was diagnosed Type 2 in 2014 and up until the end of 2022 was managing the condition very well - sugars mainly within range BUT at the end of 2022 I had a nasty fall and fractured a number of vertebrae. Since then my exercise has been very limited and my HbA1C readings have gradually risen until I'm now showing 80 rather then 50's that I was previously getting 😱

I've been on Metformin from the beginning and over the years various other meds have been added or changed so that now I'm on Metformin (1000 x2 daily)plus Dapaglifozin 10mg x 1daily. My DN added in Rybelsus 2 months ago - initially 3mg x 1 day, then upped to 7mg x 1 daily. After my conversation with her this morning that is now to be upped to 14mg per day. I've lost a couple of lbs in weight, but then I wasn't overweight anyway. What puzzles me is the increase in my sugars since being on Rybelsus - they were at 70 when I started on it 2 months ago and are now 80 ? So instead of them starting to go down they appear to be going up !

I'm very mindful of what and how much I eat - the only carbs I regularly eat are 2 slices of wholemeal bread from a small 400mg loaf , a few sugar free biscuits and either 1 Weetabix of 1 Shredded Wheat with strawberries and plain sugar free soya yoghurt for breakfast. Lunch is a sandwich made with the 2 slices of bread and filled with cheese, ham or chicken and lettuce or avocado. Evening meal is salmon, chicken or something with eggs - plus 3 - 5 different vegetables (no potatoes). I try to limit the amount of fruit I eat to berries, the occasional small plum or small (lunch box size) apple. I do also have the occasional "no added sugar" fruit yoghurt to maintain my dairy intake as I also have osteoporosis.

So question 1 - has anyone else had an increase in their BG levels whilst taking Rybelsus (Semaglutide) ? and did it settle down eventually ?
and
Question 2 - I really don't know what else I can cut out of my diet to help bring my levels down

In all probability I think my lack of exercise is one of the reasons but as I said at the beginning of this "essay" I'm very limited in the amount of exercise I can take. When I had the aforementioned fall I was lucky not to break any major bones (hip etc) but it has left me in chronic pain ever since.

My lovely DN is equally puzzled and is suggesting insulin if there is no improvement in the next couple of months - which I'm trying to avoid if at all possible.

Thanks if you've got this far - any comments/advice will be welcomed 🙂

 

[Alan44]

Sorry, I'm of absolutely no help, but hopefully someone will pop along with some words of wisdom and advice

Alan 😉

 

[Vonny]

How disheartening for you @susieq67 - it's hard when you are trying your best. I don't know if you have to watch your carb intake with Rybelsus, but Weetabix is very carb heavy so maybe you could swap your breakfast to something like bacon and egg. I have a 2 egg omelette most days for breakfast, and some low-carb crackers with brie for lunch. If you need to increase your dairy intake, you can have a lot of cheese, also full fat yoghurts and cream as you will need to increase your fat intake if going v low carb.
Since you're not eating potatoes with your evening meal I'm afraid I'm at a loss as to what to suggest for that.
Hoping someone on Rybelsus will be along soon with some words of wisdom. Good luck

 

[Leadinglights]

i was diagnosed Type 2 in 2014 and up until the end of 2022 was managing the condition very well - sugars mainly within range BUT at the end of 2022 I had a nasty fall and fractured a number of vertebrae. Since then my exercise has been very limited and my HbA1C readings have gradually risen until I'm now showing 80 rather then 50's that I was previously getting 😱

I've been on Metformin from the beginning and over the years various other meds have been added or changed so that now I'm on Metformin (1000 x2 daily)plus Dapaglifozin 10mg x 1daily. My DN added in Rybelsus 2 months ago - initially 3mg x 1 day, then upped to 7mg x 1 daily. After my conversation with her this morning that is now to be upped to 14mg per day. I've lost a couple of lbs in weight, but then I wasn't overweight anyway. What puzzles me is the increase in my sugars since being on Rybelsus - they were at 70 when I started on it 2 months ago and are now 80 ? So instead of them starting to go down they appear to be going up !

I'm very mindful of what and how much I eat - the only carbs I regularly eat are 2 slices of wholemeal bread from a small 400mg loaf , a few sugar free biscuits and either 1 Weetabix of 1 Shredded Wheat with strawberries and plain sugar free soya yoghurt for breakfast. Lunch is a sandwich made with the 2 slices of bread and filled with cheese, ham or chicken and lettuce or avocado. Evening meal is salmon, chicken or something with eggs - plus 3 - 5 different vegetables (no potatoes). I try to limit the amount of fruit I eat to berries, the occasional small plum or small (lunch box size) apple. I do also have the occasional "no added sugar" fruit yoghurt to maintain my dairy intake as I also have osteoporosis.

So question 1 - has anyone else had an increase in their BG levels whilst taking Rybelsus (Semaglutide) ? and did it settle down eventually ?
and
Question 2 - I really don't know what else I can cut out of my diet to help bring my levels down

In all probability I think my lack of exercise is one of the reasons but as I said at the beginning of this "essay" I'm very limited in the amount of exercise I can take. When I had the aforementioned fall I was lucky not to break any major bones (hip etc) but it has left me in chronic pain ever since.

My lovely DN is equally puzzled and is suggesting insulin if there is no improvement in the next couple of months - which I'm trying to avoid if at all possible.

Thanks if you've got this far - any comments/advice will be welcomed 🙂

You may benefit from using a home testing blood glucose monitor to see if any of those meals are too high in carbs for you to tolerate despite the numerous medications. Testing before you eat and after 2 hours will tell you if the meal is too high carb if the increase is more than 2-3mmol/l.
I suspect you would need to self fund but you may be lucky and your GP may prescribe one and test strip but if not inexpensive ones can be bought on line, GlucoNavii, TEE2 or contour Blue are ones people find reliable.
You do seem to be having quite a bit of bread and it may be you are particularly sensitive to that.

 

[pjgtech]

As above I was going to mention the bread, maybe try to cut down on that? I hope you find a satisfactory resolution. Cheers

 

[everydayupsanddowns]

Sorry to hear about your rising levels despite all the efforts you are making, and the meds you are taking.

From what I’ve read, forum members seem to be having a broadly positive experience with rybelsus (seeing weight loss, and improved BG levels).

It’s very challenging trying to increase activity with the injury you have experienced. We have some members who find ‘aquafit’ helpful as the water carries most of the weight. Others have found seated exercises on Youtube a helpful resource.

Don’t worry that insulin is on the table - as a T1 you don’t really get that feeling of insulin being the ‘threat’ at the end. It’s your go-to from the off. We have lots of T2s who are able to use insulin very effectively to balance their glucose levels. It may be must what you need?

 

[susieq67]

Thank you all for your replies 🙂

@Vonny from research I'd already done I thought that Weetabix was relatively OK (I only have half a portion, so 1 not 2) with only Puffed Wheat being lower in carbs - and that's like eating cotton wool ! I've never been able to stomach a cooked breakfast I do eat quite a lot of cheese, but have the low fat variety and have to watch my fat intake as I also have a heart condition.
@Leadinglights I have had a monitor for some years now (my DN issued me a new one a couple of years ago) and I do test my levels regularly - usually on waking and before meals - although just lately I'm also testing after meals). I get one box of strips on my repeat medication prescription and purchase extra direct from the manufacturer (they're the cheapest !).
@everydayupsanddowns I think my resistance to using insulin is more based on how I will have to advise the DVLA and how it's likely to affect my motor insurance !

I have 3 months "grace" now till my next HbA1c blood test in February after increasing Rybelsus to 14gr and am hoping that the increased dose will have a positive effect. As I do eat a lot of vegetables and a fair amount of fruit I'm off now to check the sugar/carb values of the ones I eat most regularly to see if there are any culprits hiding there 🙄

 

[Leadinglights]

Thank you all for your replies 🙂

@Vonny from research I'd already done I thought that Weetabix was relatively OK (I only have half a portion, so 1 not 2) with only Puffed Wheat being lower in carbs - and that's like eating cotton wool ! I've never been able to stomach a cooked breakfast I do eat quite a lot of cheese, but have the low fat variety and have to watch my fat intake as I also have a heart condition.
@Leadinglights I have had a monitor for some years now (my DN issued me a new one a couple of years ago) and I do test my levels regularly - usually on waking and before meals - although just lately I'm also testing after meals). I get one box of strips on my repeat medication prescription and purchase extra direct from the manufacturer (they're the cheapest !).
@everydayupsanddowns I think my resistance to using insulin is more based on how I will have to advise the DVLA and how it's likely to affect my motor insurance !

I have 3 months "grace" now till my next HbA1c blood test in February after increasing Rybelsus to 14gr and am hoping that the increased dose will have a positive effect. As I do eat a lot of vegetables and a fair amount of fruit I'm off now to check the sugar/carb values of the ones I eat most regularly to see if there are any culprits hiding there 🙄

I'm afraid puffed wheat is probably one of the highest carb cereals, it is the example I use to illustrate that something can be low SUGAR but very high CARB. I think it is something like 68g carb per 100g with 0.8g sugar.
You would be better with a low sugar or keto granola which for something less than 45g carbs per 100g and would taste much nicer as. well but even so a small portion on full fat Greek yoghurt and berries would make a good breakfast.

 

[helli]

I think my resistance to using insulin is more based on how I will have to advise the DVLA and how it's likely to affect my motor insurance !

Using insulin does not affect motor insurance as that would be considered disability discrimination.
But you do have to tell the DVLA and renew your licence every 3 years.

 

[ew7k]

Thank you all for your replies 🙂

@Vonny from research I'd already done I thought that Weetabix was relatively OK (I only have half a portion, so 1 not 2) with only Puffed Wheat being lower in carbs - and that's like eating cotton wool ! I've never been able to stomach a cooked breakfast I do eat quite a lot of cheese, but have the low fat variety and have to watch my fat intake as I also have a heart condition.
@Leadinglights I have had a monitor for some years now (my DN issued me a new one a couple of years ago) and I do test my levels regularly - usually on waking and before meals - although just lately I'm also testing after meals). I get one box of strips on my repeat medication prescription and purchase extra direct from the manufacturer (they're the cheapest !).
@everydayupsanddowns I think my resistance to using insulin is more based on how I will have to advise the DVLA and how it's likely to affect my motor insurance !

I have 3 months "grace" now till my next HbA1c blood test in February after increasing Rybelsus to 14gr and am hoping that the increased dose will have a positive effect. As I do eat a lot of vegetables and a fair amount of fruit I'm off now to check the sugar/carb values of the ones I eat most regularly to see if there are any culprits hiding there 🙄

I recently had to inform DVLA, it is no hassle at all, and didn't affect my of insurance (which did surprise me but I don't get daytime lows). I'd also experiment with your midday sandwich, the effect of different but similar brands can be quite big. Good luck.

 

[susieq67]

Using insulin does not affect motor insurance as that would be considered disability discrimination.
But you do have to tell the DVLA and renew your licence every 3 years.

At my age (78) I already have to renew my driving licence every 3 years anyway🙄

 

[Lucyr]

Using insulin does not affect motor insurance as that would be considered disability discrimination.
But you do have to tell the DVLA and renew your licence every 3 years.

You do have to let your car insurance company know that your licence type has changed from full to 3 year medically restricted, but doesn’t affect the price

 

[trophywench]

You do have to let your car insurance company know that your licence type has changed from full to 3 year medically restricted, but doesn’t affect the price

True - but creeping old age frequently does affect the premium, @Lucyr. My own husband's car and motorhome insurance are cases in point. (Goodness only knows what they'd want if he still rode his motorbikes! We know far too well he no longer bounces well at all and his bikes never have anyway! 🙄 )

 

[Lucyr]

old age frequently does affect the premium, @Lucyr

Age affects the price whether you’re diabetic or not so not sure what this has to do with the OP not wanting insulin because of worrying it would affect car insurance?

 

[susieq67]

Age affects the price whether you’re diabetic or not so not sure what this has to do with the OP not wanting insulin because of worrying it would affect car insurance?

It went up almost double this year so don't fancy another major hike next year due to any health issues.

 

[CliffH]

It went up almost double this year so don't fancy another major hike next year due to any health issues.

I've got a feeling it's illegal for companies to increase car insurance premiums because someone's diabetic, unless there are other factors.

 

[trophywench]

Yes Cliff - one of the reasons that being classed as Disabled is suddenly beneficial!

 

[pauly4]

i was diagnosed Type 2 in 2014 and up until the end of 2022 was managing the condition very well - sugars mainly within range BUT at the end of 2022 I had a nasty fall and fractured a number of vertebrae. Since then my exercise has been very limited and my HbA1C readings have gradually risen until I'm now showing 80 rather then 50's that I was previously getting 😱

I've been on Metformin from the beginning and over the years various other meds have been added or changed so that now I'm on Metformin (1000 x2 daily)plus Dapaglifozin 10mg x 1daily. My DN added in Rybelsus 2 months ago - initially 3mg x 1 day, then upped to 7mg x 1 daily. After my conversation with her this morning that is now to be upped to 14mg per day. I've lost a couple of lbs in weight, but then I wasn't overweight anyway. What puzzles me is the increase in my sugars since being on Rybelsus - they were at 70 when I started on it 2 months ago and are now 80 ? So instead of them starting to go down they appear to be going up !

I'm very mindful of what and how much I eat - the only carbs I regularly eat are 2 slices of wholemeal bread from a small 400mg loaf , a few sugar free biscuits and either 1 Weetabix of 1 Shredded Wheat with strawberries and plain sugar free soya yoghurt for breakfast. Lunch is a sandwich made with the 2 slices of bread and filled with cheese, ham or chicken and lettuce or avocado. Evening meal is salmon, chicken or something with eggs - plus 3 - 5 different vegetables (no potatoes). I try to limit the amount of fruit I eat to berries, the occasional small plum or small (lunch box size) apple. I do also have the occasional "no added sugar" fruit yoghurt to maintain my dairy intake as I also have osteoporosis.

So question 1 - has anyone else had an increase in their BG levels whilst taking Rybelsus (Semaglutide) ? and did it settle down eventually ?
and
Question 2 - I really don't know what else I can cut out of my diet to help bring my levels down

In all probability I think my lack of exercise is one of the reasons but as I said at the beginning of this "essay" I'm very limited in the amount of exercise I can take. When I had the aforementioned fall I was lucky not to break any major bones (hip etc) but it has left me in chronic pain ever since.

My lovely DN is equally puzzled and is suggesting insulin if there is no improvement in the next couple of months - which I'm trying to avoid if at all possible.

Thanks if you've got this far - any comments/advice will be welcomed 🙂

Yes, my HBA1C was 58 and I went onto 7mg Rybelsus with 2 metformin and 1 80g gliclazide a day and HBA1C has increased to 79 !!! Currently panicking that it is having no effect !

 

[Leadinglights]

Yes, my HBA1C was 58 and I went onto 7mg Rybelsus with 2 metformin and 1 80g gliclazide a day and HBA1C has increased to 79 !!! Currently panicking that it is having no effect !

It might be a good plan to keep a food diary for a couple of weeks with an estimate of the carbs you are having at each meal and for drinks and snacks to provide some evidence for your diabetic nurse to show that despite your best efforts with diet and the combination of medications that your HbA1C is not coming down.
Do you have a monitor so you can check your blood glucose before and 2 hours after meals to see if there are any foods which are causing a problem which would be shown by a larger than 2-3mmol/l increase or more than 8-8.5mmol/l.

 

[susieq67]

Yes, my HBA1C was 58 and I went onto 7mg Rybelsus with 2 metformin and 1 80g gliclazide a day and HBA1C has increased to 79 !!! Currently panicking that it is having no effect !

As I understand it the initial dose for Rybelsus is usually 3mg per day to get your body used to the drug, increasing to 7mg and then 14mg daily. I'm now at 14mg per day and I think that my BG levels are now beginning to come down - but I won't know for sure until my next blood test due mid-February. Additionally I have lost some weight (just over7lbs) which I didn't really need to lose as I wasn't overweight to start with !

It might be a good plan to keep a food diary for a couple of weeks with an estimate of the carbs you are having at each meal and for drinks and snacks to provide some evidence for your diabetic nurse to show that despite your best efforts with diet and the combination of medications that your HbA1C is not coming down.
Do you have a monitor so you can check your blood glucose before and 2 hours after meals to see if there are any foods which are causing a problem which would be shown by a larger than 2-3mmol/l increase or more than 8-8.5mmol/l.

I'm very aware of how many carbs I consume every day and keep them as low as possible - but because of other health issues I can't omit them altogether, and I do monitor my levels up to 6 times a day (before and after meals).Most of the time the "after" meal readings are within accepted ranges but overall readings are still higher than they used to be. Fruit (other than berries) seems to be a trigger for me Unfortunately I'm still suffering the side effect of nausea which I had hoped would have eased by now.