Dapagliflozin - a good problem to have!

[Valcot]

I’m in the happy position of my DN suggesting I stop taking Dapagliflozin as the trend in my HbA1c is consistently downwards - it’s now 39. I’d stay on metformin until at least my next review in six months time. That’s great news and obviously I’m delighted. Yet my mind keeps going back to something my GP said, that Dapagliflozin is such a useful drug as it has other benefits for my heart and kidneys long term. So my question is, should I stop, as my DN suggests, or chat more about the benefits of staying on Dapa? I’m not into second guessing medical people - but getting diagnosed with T2D in my mid-50s has led me to a keen interest in my long term health and I’m starting to think about things, such as how I do all I can to prevent kidney and heart disease.

Andrew

 

[Kernow-Debra]

Well done on your achievement so far!
I dropped to 38 and decided to stop my 5mg Dapagliflozin immediately, rather than wait for the DN review.
In the previous couple of weeks I kept feeling really dizzy, and a couple of times nearly fell over. I felt like I was on a boat.

Saw DN for a review of my bloods 3 weeks later. Told her I’d stopped the Dapagliflozin and she totally agreed. Said my hba1c was far to low to continue with it.

Since I stopped taking it my balance is fine and
I’m no longer dizzy.
I’m in my late 50’s and my approach to long term health is the fewer medications the better.
I’m off Metformin too and have refused statins.
I’m happy with this as it keeps me on the right track and stops any complacency re hba1c.

I’m feeling better and moving more than I have for years. IMO lifestyle benefits your health far more than medication, if your in the lucky position to do so, obviously.

 

[Eddy Edson]

Nobody here is qualified to advise you about this, but presumably it would depend a lot on what yr cardiorenal risk profile looks like. I'd say best to talk with yr doc if you can.

 

[Valcot]

Well done on your achievement so far!
I dropped to 38 and decided to stop my 5mg Dapagliflozin immediately, rather than wait for the DN review.
In the previous couple of weeks I kept feeling really dizzy, and a couple of times nearly fell over. I felt like I was on a boat.

Saw DN for a review of my bloods 3 weeks later. Told her I’d stopped the Dapagliflozin and she totally agreed. Said my hba1c was far to low to continue with it.

Since I stopped taking it my balance is fine and
I’m no longer dizzy.
I’m in my late 50’s and my approach to long term health is the fewer medications the better.
I’m off Metformin too and have refused statins.
I’m happy with this as it keeps me on the right track and stops any complacency re hba1c.

I’m feeling better and moving more than I have for years. IMO lifestyle benefits your health far more than medication, if your in the lucky position to do so, obviously.

Well done on your achievement so far!
I dropped to 38 and decided to stop my 5mg Dapagliflozin immediately, rather than wait for the DN review.
In the previous couple of weeks I kept feeling really dizzy, and a couple of times nearly fell over. I felt like I was on a boat.

Saw DN for a review of my bloods 3 weeks later. Told her I’d stopped the Dapagliflozin and she totally agreed. Said my hba1c was far to low to continue with it.

Since I stopped taking it my balance is fine and
I’m no longer dizzy.
I’m in my late 50’s and my approach to long term health is the fewer medications the better.
I’m off Metformin too and have refused statins.
I’m happy with this as it keeps me on the right track and stops any complacency re hba1c.

I’m feeling better and moving more than I have for years. IMO lifestyle benefits your health far more than medication, if you’re in the lucky position to do so, obviously.

Thanks Debra, very useful reply and has helped my thoughts.

 

[AndBreathe]

I’m in the happy position of my DN suggesting I stop taking Dapagliflozin as the trend in my HbA1c is consistently downwards - it’s now 39. I’d stay on metformin until at least my next review in six months time. That’s great news and obviously I’m delighted. Yet my mind keeps going back to something my GP said, that Dapagliflozin is such a useful drug as it has other benefits for my heart and kidneys long term. So my question is, should I stop, as my DN suggests, or chat more about the benefits of staying on Dapa? I’m not into second guessing medical people - but getting diagnosed with T2D in my mid-50s has led me to a keen interest in my long term health and I’m starting to think about things, such as how I do all I can to prevent kidney and heart disease.

Andrew

The work on heart health and this sort of medication is quite new, and will develop over time.

I do know of a couple of potential studies applying for funding shortly to look at it, purely from a cardio perspective over the relatively longer term, potentially including some participants who fit the internationally accepted "remission" conditions.

The Flozin class of drugs, like all others, also have their downsides. For some folks they sail along trouble free but the side effects impacting some (not all) can range from a bit of thrush to a life threatening normo-glycaemic ketoacidosis.

Now, I am absolutely NOT scaremongering here, or trying to put you off taking this medication if that is what you want to do, but to suggest you read the Patient Information Leaflet (should be included in every package). This is the relevant entry on the National Formulary:

Dapagliflozin | Drugs | BNF content published by NICE

View dapagliflozin information, including dose, uses, side-effects, renal impairment, pregnancy, breast feeding, contra-indications and important safety information.

bnf.nice.org.uk

All I will say is that in my observation, it is somewhat less usual for this medication to be prescribed for those with HbA1cs in your range.

Was there a specific reason your nurse/GP prescribed it?

 

[Anji53]

Hi
I was prescribed the same drugs, Dapagliflozin, metformin, last August I also take atorvastatin and thyroxine At that time newly diagnosed my hba1c was 117. By November it had dropped and in February it had dropped again and my DN suggested I stop the Dapagliflozin at that time I was reluctant as I’d been following a very strict diet and was worried this was not sustainable. Next testing my hba1c had dropped to 35 and I expected her to say cut the Dapagliflozin but instead she said reduce the metformin to 1000 a day ( previously 2000) but that the Dapagliflozin did so much other good even if my Hba1c remained low I’d continue with it.
so I understand your confusion
tested Tuesday and my Hba1c is 37 so waiting to see what is said. At my review

I’m in the happy position of my DN suggesting I stop taking Dapagliflozin as the trend in my HbA1c is consistently downwards - it’s now 39. I’d stay on metformin until at least my next review in six months time. That’s great news and obviously I’m delighted. Yet my mind keeps going back to something my GP said, that Dapagliflozin is such a useful drug as it has other benefits for my heart and kidneys long term. So my question is, should I stop, as my DN suggests, or chat more about the benefits of staying on Dapa? I’m not into second guessing medical people - but getting diagnosed with T2D in my mid-50s has led me to a keen interest in my long term health and I’m starting to think about things, such as how I do all I can to prevent kidney and heart disease.

Andrew

 

[Anji53]

I’m in the happy position of my DN suggesting I stop taking Dapagliflozin as the trend in my HbA1c is consistently downwards - it’s now 39. I’d stay on metformin until at least my next review in six months time. That’s great news and obviously I’m delighted. Yet my mind keeps going back to something my GP said, that Dapagliflozin is such a useful drug as it has other benefits for my heart and kidneys long term. So my question is, should I stop, as my DN suggests, or chat more about the benefits of staying on Dapa? I’m not into second guessing medical people - but getting diagnosed with T2D in my mid-50s has led me to a keen interest in my long term health and I’m starting to think about things, such as how I do all I can to prevent kidney and heart disease.

Andrew

Interestingly at the next review they stopped my metformin completely but kept the Dapagliflozin for the ‘ good’ it does to heart and kidneys