Flozins: What one is best?

[Yeoc]

All things being equal, is there any advantage that one of them has over the others in terms of efficacy it effectiveness etc? Anything that sticks out? I accept that it may not be cu and dry and we may be dealing in certain generalities in terms of statistics, but even so. What do people feel?

 

[trophywench]

Well according to today's headline, Canagliflozin is the one to opt for if you want it to do whatever they reckon it does.

 

[Yeoc]

Grandfather on my mums side was type 1 - Mum pre diabetic, only other siblings - both uncles are both type 2. My only brother is pre diabetic and my only sister is type 2.

So nobody on my mothers side has escaped diabetes.

I am type 2 as well.

I tried Metformin, short and long acting but was extremely sick non stop for 5/6 weeks, I have had liver cancer in my history so gp not happy with how bad that was effecting me. Got that at 17 years old having never drank alcohol - lucky me lol.

I just want the most effective treatment possible in helping to lower hba1c with the least potential for side effects. I say just lol. A big ask. I know very little about these new medications, any pros or cons or if any of them stands out as clearly superior in statistical profile,

I would do the research, re/invent the wheel as it were, but I have a ton of other health issues and have spent decades doing just that and so I have ran out of steam so to speak.

Hoping to lean on the understanding, knowledge and wisdom of others.

Thx for yours in this regard Trophy? appreciated.

 

[mikeyB]

Hi Yeoc, welcome to the forum.🙂

You’re only past first level of treatment. Flozins at the moment are more third line, but there’s not a lot to choose between them, and theres a fair few treatments you can try before going for peeing all the glucose out night and day.

How did you come to be diagnosed, and what advice have you been given about diet?

 

[Yeoc]

Hi Yeoc, welcome to the forum.🙂

You’re only past first level of treatment. Flozins at the moment are more third line, but there’s not a lot to choose between them, and theres a fair few treatments you can try before going for peeing all the glucose out night and day.

How did you come to be diagnosed, and what advice have you been given about diet?

Hi MikeyB,

I was diagnosed many years ago and given dietary advice along the lines of eat a balanced diet that included lots of complex carbohydrates. I ignored that as it seemed to be a disease that related to glucose and advice that included eating plenty of carbs seemed bad. I did a lot of research and decided, rightly or wrongly to go low carbohydrate. I got dietitians tellinrbg me I did not have enough carbs in my diet and questions of where am I getting my carbs from. To me that seemed like asking an AA meeting asking members where they were getting their alcohol from and suggesting options lol. Anyway I went from 75 hba1c to 43 via diet alone and was strict within reason for years. Now I need more help as my numbers have gone up over 50 hba1c despite doubling down on the diet. Metformin has been tried and is out, so it is now a question of what is best to help. My sister is on one of the Flozins and reports no I'll effects and lowered hba1c - hence me asking questions here.

 

[mikeyB]

Hi Yeoc. You’ve done right to ignore that dietary advice, it’s years out of date. Low carb is the way to go. You’ve done superbly on diet alone, but it looks like your genes are catching up on you. Well done, and bad luck. Not your fault.

If your sis is on a Flozin and has no ill effects, and the doc is OK with it, then give it a go. The Canaglifozin mentioned by Jenny has just recently been found to protect against kidney problems.

And keep asking questions, nobody minds any question. There’s no such thing as a daft question, only daft answers.

 

[Bronco Billy]

The reason you were advised to eat complex carbs is because they help moderate a BG spike after eating. Were you advised to eat plenty of carbs or simply to make sure that the carbs that were in your diet (which we all need) were of the complex type?

 

[Yeoc]

Thx MikeyB time and thoughts appreciated

Hi Bronco,

Thx for the question/thinking.

The main push was along the lines of: I am lacking carbohydrates in my diet, where are my carbs, I need them.

So it was much more about eating more carbs as part of a balanced diet, no real focus on complex beyond it not bein junk food.

I disagreed with them and asked how many patients they had that reversed their diabetes. They told me that does not happen and that diabetes always gets worse. I never went back to see them as I felt their patients only ever got worse precisely because of their dietary advice. I did reverse my numbers and got to pre diabetic levels for many years. The last year diet alone is not doing the trick. I will still stick to the diet even with medication, I include a limited amount of complex carbs. But yea, the dietary advice I had in the past didn't seem trustworthy.

 

[Yeoc]

Out of interest would complex carbs moderate a BG spike over and above a protein/fat meal? Hard to see how carbs can lower BG in any form. I mean complex carbs as I have used them, have been in exchange or instead of simple carbs, as a small part of a low carb but not Atkins or no carb diet. But surely complex carbs only lowers a BG spike in the sense of being a better alternative than simple carbs? I don't see how they are actually good in of themselves or how they would lower BG by adding them to a protein/fat meal.

I might be missing something as my understanding of the biochemistry is strictly layman.

 

[mikeyB]

Don’t worry about the biochemistry, Yeoc. Complex or otherwise, the trick is to avoid spikes in BG. The same applies to any food, really. Even in normal humans, there is a spike after eating, but it doesn’t go into double figures (though it might after a couple of cans of Mountain Dew). Just a couple of points on the BG scale, but it’s there. That’s what to aim for, nobody on Earth can keep a rock steady blood sugar.

 

[Yeoc]

Sounds sensible MikeyB, thx.