A bit more on my dapagliflozin experience

[Docb]

Started this in Jan and my previous reports have suggested that it was having a small but distinct effect on my blood glucose levels. Just had a HbA1c done. My model predicted an HbA1c of around 50 and the result was 49. This compares with the 54 from immediately before I started taking it. To all intents and purposes nothing has changed in terms of bodyweight or diet. I have been experimenting with neuropathic pain treatment but I have nothing to suggest they hav had any effect on blood glucose.

The upshot is that for this one individual, dapagliflozin (5mg daily) has led to a both an overall reduction in finger prick levels and resultant HbA1c. This is without any side effects.

For the nerds... the result correlates very well with all the other 90 day waking average and overall 90 day average prior to the test results calculated from my data set. You can make sense of finger prick tests in terms of HbA1c prediction providing you have got enough data and patient enough to record it and analyse it.

 

[JITR]

Just had a HbA1c done. My model predicted an HbA1c of around 50 and the result was 49. This compares with the 54 from immediately before I started taking it. To all intents and purposes nothing has changed in terms of bodyweight or diet. I have been experimenting with neuropathic pain treatment but I have nothing to suggest they hav had any effect on blood glucose.

The upshot is that for this one individual, dapagliflozin (5mg daily) has led to a both an overall reduction in finger prick levels and resultant HbA1c. This is without any side effects.

Out of interest, using this, your improvement from 54 to 49 mmol/mol (7.1% to 6.6%) is equivalent 8.71 to 7.98% mmol/l. That's a 0.5% reduction in HbA1c compared with metformin which, as I have read, can achieve up to 1.5%. Potentially dietary changes can do more that that. Have you already tried a lower a lower carb diet without dapagliflozin to see what that could do?

Reduction in finger pricks due to greater stability?

 

[Docb]

In answer to your question, no. I got to around 100-120 g carbs/day by making a few simple changes to my diet soon after finding the forum and have not tried to go lower. Being a middle of the road person I was quite content to pull gently on all four levers (lower carb, bit of weight loss, keep up the exercise, take some pills) as a means of getting my diabetes under control. As levels have risen over the last year or so I went for the extra pills rather than trying to reduce carbs, lose weight(I'm not overweight) or more exercise all of which would mean too much faffing around at my age.

My main point is that the medications do work at least for me and my numbers show by how much and that is something that others can look at when planning their own way forward. As you might guess, I am not one for Pistol Petes or any other internet grifters magic "sugar" reduction diet and I am not averse to taking medication if it works.

The conversion site you pointed to gives a conversion from average finger prick to HbA1c which is very similar to the algorithm I use which is based on the correlation between HbA1c and average blood glucose from the 90 days previous to the test. I also look at the correlation between waking average and HbA1c. With something that varies as much as blood glucose it is very difficult to determine an "average". You need a lot of tests taken at various times of the day to get something even vaguely representative of an average so I'll keep up the testing to refine my model. You are right much of my testing is not needed to check on my blood glucose control.

 

[JITR]

Out of interest, using this, your improvement from 54 to 49 mmol/mol (7.1% to 6.6%) is equivalent 8.71 to 7.98% mmol/l. That's a 0.5% reduction in HbA1c compared with metformin which, as I have read, can achieve up to 1.5%. Potentially dietary changes can do more that that. Have you already tried a lower a lower carb diet without dapagliflozin to see what that could do?

Thanks to a distraction, I missed out what I intended to say so I have updated my post, as quoted here. The variables in your control model are medium carb diet, exercise, weight control and pills. You seem to regard weight and exercise are constants, so I wondered if you think there may be scope to vary your diet a bit to get HbA1c down by 0.5% or more. Just a thought, not a recommendation.

 

[Martin.A]

I got to around 100-120 g carbs/day by making a few simple changes to my diet soon after finding the forum and have not tried to go lower.

Same here. I've deliberately stuck to 130g per day (on average) for over 5 years but I expect I'll reach a point, sometime in the future, where that won't do anymore and I'll either have to go lower or discuss meds with my DN. Like you I don't need to lose weight (BMI 22.2) but I wouldn't be averse to increasing my exercise, eg swimming 3 times a week instead of the current 2.

 

[Docb]

Thanks to a distraction, I missed out what I intended to say so I have updated my post, as quoted here. The variables in your control model are medium carb diet, exercise, weight control and pills. You seem to regard weight and exercise are constants, so I wondered if you think there may be scope to vary your diet a bit to get HbA1c down by 0.5% or more. Just a thought, not a recommendation.

I am sure that there is scope to reduce carb intake to get my HbA1c down as an alternative to medication. The way I look at it (and there are other ways) is that further reductions in carb intake will need much bigger changes than the simple stuff I did to get to where I am. My preference, because it suits me and my circumstances, is to take the pills because it avoids all the hassle that would be needed to make those bigger changes. Diminishing returns comes into my thinking about many things.

 

[everydayupsanddowns]

I think us T1s get off lightly with the (internal/external) yearning to do without medication. For me it simply is not an option so I willingly accept medication as a component of my diabetes management toolkit. Thereafter it’s all about balancing meds and menu - as it is for everyone taking diabetes medication 🙂

 

[harbottle]

I opted to stay on 500mg of Metformin after being told there was an argument for stopping it in 2022.
Earlier this year they stopped it prior to a medication review and told me to stop taking it for 3 months to see what happens.

I don't count carbs much these days, just avoid the 'usual suspects' (Bread, pasta, rice, etc.) but do eat potato.
Using a Libre shows some weird effects when I do eat carbs (Usually two 'peaks'?!?)

 

[harbottle]

Started this in Jan and my previous reports have suggested that it was having a small but distinct effect on my blood glucose levels. Just had a HbA1c done. My model predicted an HbA1c of around 50 and the result was 49. This compares with the 54 from immediately before I started taking it. To all intents and purposes nothing has changed in terms of bodyweight or diet. I have been experimenting with neuropathic pain treatment but I have nothing to suggest they hav had any effect on blood glucose.

The upshot is that for this one individual, dapagliflozin (5mg daily) has led to a both an overall reduction in finger prick levels and resultant HbA1c. This is without any side effects.

For the nerds... the result correlates very well with all the other 90 day waking average and overall 90 day average prior to the test results calculated from my data set. You can make sense of finger prick tests in terms of HbA1c prediction providing you have got enough data and patient enough to record it and analyse it.

I recently stopped my 500mg of Metformin. Fingerpricking seemed to give the same results after a week or so, but it's hard to say, as it seems very variable at times. The same meal doesn't always give the same results and morning results can be variable, anywhere between 4.7 and 6.2 and post breakfast is just random.

Average seems to be remaining around 6.0-6.4 though.

 

[grovesy]

I started taking 10 mgs 5 weeks ago after years of reluctance to try, it seems to have lowered my levels. As yet I have not had any noticeable side effects.