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Hello

Z

Zeegoman

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Type 2
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60+ year old, Type 2 since 2000. Various oral medications and 'life style' management.

Have managed to control reasonably well over the years until last 8 months. Since when have deteriorated and am now polypharmcy dependant. Metformin, Gliclazide and Semaglutide.

Often it has been side effects of drugs I have been prescribed that have been my biggest bugbear. Currently it's the possible side effects of Semaglutide that are trying my patience. Otherwise I'm reasonably healthy.
 
Hello @Zeegoman and welcome to the forum!
Thanks for sharing your experience - it sounds like you've done a great job managing things over the years, even if the last stretch has been a challenge. Side effects can really wear you down, especially when you're juggling multiple meds. You're definitely not alone in finding that part tough - hope things start to settle for you soon, and glad you're here to share the journey with others who get it. Feel free to also share any questions you might have or any experiences you feel comfortable with sharing - everyone's always eager to learn from each other!
 
Hi and welcome.

Sorry to hear you have recently needed an increase in medication. What side effects are you suffering with the Semaglutide and which one are you using? Is it the oral one or an injectable?
Do you have much/any weight to lose?

25 years since diagnosis is a long time and dietary approaches have changed considerably since then so I wonder if some dietary adjustment might mean you don't need the Semaglutide. It doesn't have to be all sack cloth and ashes, but substituting lower carb options for bread, rice, pasta and potatoes and breakfast cereals including the often recommended healthy porridge can have a big impact on lowering levels. If you want more details of a lower carb approach please ask. For example, I still have steak and chips but it is celeriac chips instead of potato and I bulk out my plate with salad and coleslaw and some fried mushrooms. For breakfast many of us have Creamy Greek style natural yoghurt with a few berries and mixed seeds or nuts. Lunch I often have half an apple with a chunk of nice cheese and maybe a few nuts for a snack. Anyway, just thought I would mention it as 25 years ago I believe the advice was to cut down on sugar and fat and indeed 6 years ago when I was diagnosed, but all carbohydrates break down in our digestive system to release glucose into our blood stream and raise our levels and most of us will eat quite a lot of carbs in a day which are not sugar, so it makes sense to reduce those too and is very effective for many people here on the forum.
 
rebrascora said:
Hi and welcome.

Sorry to hear you have recently needed an increase in medication. What side effects are you suffering with the Semaglutide and which one are you using? Is it the oral one or an injectable?
Do you have much/any weight to lose?

25 years since diagnosis is a long time and dietary approaches have changed considerably since then so I wonder if some dietary adjustment might mean you don't need the Semaglutide. It doesn't have to be all sack cloth and ashes, but substituting lower carb options for bread, rice, pasta and potatoes and breakfast cereals including the often recommended healthy porridge can have a big impact on lowering levels. If you want more details of a lower carb approach please ask. For example, I still have steak and chips but it is celeriac chips instead of potato and I bulk out my plate with salad and coleslaw and some fried mushrooms. For breakfast many of us have Creamy Greek style natural yoghurt with a few berries and mixed seeds or nuts. Lunch I often have half an apple with a chunk of nice cheese and maybe a few nuts for a snack. Anyway, just thought I would mention it as 25 years ago I believe the advice was to cut down on sugar and fat and indeed 6 years ago when I was diagnosed, but all carbohydrates break down in our digestive system to release glucose into our blood stream and raise our levels and most of us will eat quite a lot of carbs in a day which are not sugar, so it makes sense to reduce those too and is very effective for many people here on the forum.
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Unfortunately I need the Semaglutide. I'm not overweight and it is the oral form Rybelsus that I take.

The main thing for me is an extended period of anxiety following taking the drug. They don't list it as a side effect however, I am convinced it is.

I got/get other listed side effects, some of which have dissapated with use. I am hopeful that the anxiety will follow suit. However, it could become a deal breaker if it persists. The likelihood is that this would lead to insulin.
 
Hi @Zeegoman and welcome to the Forum 🙂. I hope it all gets better for you but in the meantime there are lots of Type 2s on here who can offer help and support.
 
Welcome to the forum @Zeegoman

Hope the anxiety you have been experiencing reduces over the coming weeks and months.

How long does the period of anxiety last? Have you tried any recognised techniques like breathing/grounding exercises which may help you focus your thoughts?
 
Just a question.

Are you 100% certain that your body and bodily reactions to this that or the other have not changed due to the cumulative effects of your age? Has taken mine quite an extended time to demonstrate that effect to me - and I have and am still struggling with some of that effect, both physically and mentally.
 
That is my hope as well. I have been a mindfulness practitioner for years.

The current problem is that the anxiety that I think is fuelled by semaglutide last much longer than my run of the mill type. It is what I would call free floating and is not driven by any particular issue.

I initially thought that esophageal irritation caused by semaglutide was the driver but that has settled.
trophywench said:
Just a question.

Are you 100% certain that your body and bodily reactions to this that or the other have not changed due to the cumulative effects of your age? Has taken mine quite an extended time to demonstrate that effect to me - and I have and am still struggling with some of that effect, both physically and mentally.
Click to expand...
trophywench said:
Just a question.

Are you 100% certain that your body and bodily reactions to this that or the other have not changed due to the cumulative effects of your age? Has taken mine quite an extended time to demonstrate that effect to me - and I have and am still struggling with some of that effect, both physically and mentally.
Click to expand...
 
That is certainly a possibility.

Confirmation bias aside I am sure that mass prescribing of these drugs will demonstrate emergent effects. Unfortunately psychiatric side effects do not receive the attention that they deserve. This is true for many drugs. To this end I would encourage people to use the online 'yellow card' adverse drug reaction reporting system that is available to the public.

These new drugs are likely affecting reward centres in the brain and will possibly be prescribed for that basis alone for example in addiction treatment. Therefore it is not beyond credibility that they could cause undesired psychiatric symptoms. Like all medication its balancing the pros and cons and rechallenging after stopping a drug for a period, after adverse affects, can lead to positive results.

I am persevering with semaglutide hoping that my perceived effects will abate with time. Next HbA1c is due in June.
 
Ouch the dreaded anxiety. Yes it's possible you might live with it, or suddenly realise your living with it. I mean but hopefully nothing worse. Does it seem easy to manage the anxiety, like its not turning into depression or physical aches and pains. I hope not. I think mine was natural, but it got me pretty stressed out until I realised what it was.
 
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Recognising that you are suffering from the effects of anxiety was half the battle. However, managing it is the other half.

For me anxiety and depression have been inextricably linked. Medication has helped from time to time I no longer use it because of the unpleasant side effects including on my diabetes. However, I accept that I may at some time have to go back on to it.

Today it's a mixture of mindfulness, exercise, diet etc.
 
Zeegoman said:
60+ year old, Type 2 since 2000. Various oral medications and 'life style' management.

Have managed to control reasonably well over the years until last 8 months. Since when have deteriorated and am now polypharmcy dependant. Metformin, Gliclazide and Semaglutide.

Often it has been side effects of drugs I have been prescribed that have been my biggest bugbear. Currently it's the possible side effects of Semaglutide that are trying my patience. Otherwise I'm reasonably healthy.
Click to expand...
Have started a trial of Freestyle 2+. OK so far although alarms showing high glucose for me do are not reflected in finger stick monitoring. About 3 mol higher on the remote.
 
Last edited by a moderator:
some of us find that our body has a responds to a foreign object being fired into it and it can take a day or two for this reaction to settle down. Foe this reason some of us, apply the sensor a day or two before we activate it, to give that reaction time to settle down.
Also Libre is factory calibrated to be most reliable in range but can over estimate above and under estimate below range, so if you are double checking a high reading above 10 then the sensor may be further adrift from BG than when in range. Likewise if levels are rising or falling significantly Libre will often over egg that rise and similar with a sharp drop.

I tend to double check my sensor with a finger prick when my levels are steady for about 30 mins in the 5s or 6s with no food or insulin active. Usually I will find it is within 0.5mmols of my BG meter in those circumstances and for me that means it is easily reliable enough to calculate doses from, but even 2 mmols is workable as long as it is reasonably consistent ie always 2mmols above or below BG reading. If it is more than 2mmols out for 3 double checks then it gets reported to Abbott and they will usually replace it.

It is important to ensure that you are well hydrated as dehydration will often cause it to give a higher reading as blood takes water from the interstitial fluid and that means that the glucose concentration of the interstitial fluid becomes higher.
I was out all of yesterday afternoon and didn't have a drink with me and when I got home I was developing a bit of a headache and my Libre reading was 8. I had a large glass of water it dropped to 5.9 in a bout half an hour as a result of rehydrating,

Hopefully your sensor will settle down soon and you will learn to identify and interpret some of it's little quirks and foibles.

We have a thread about the limitations and quirks of CGMs which I will link below. It is useful to give you more insight into when to trust it and when to double check.
H

Thread 'CGM limitations and precautions'

Moderator Note: This helpful reply was copied from another thread as it details some of the commonly experienced limitations of continuous glucose sensors.

MarinaDE said:
My blood sugar has been in perfect range for days now, but although I haven't changed anything, I'm starting to get very short periods of hypos while I sleep and this morning I had a hypo alarm.
Click to expand...
If these are very short periods of lows and occur overnight, they are more likely to be compression lows - when pressure is applied to a sensor, it will report a false low. The reason I say this is more likely to happen at...
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rebrascora said:
some of us find that our body has a responds to a foreign object being fired into it and it can take a day or two for this reaction to settle down. Foe this reason some of us, apply the sensor a day or two before we activate it, to give that reaction time to settle down.
Also Libre is factory calibrated to be most reliable in range but can over estimate above and under estimate below range, so if you are double checking a high reading above 10 then the sensor may be further adrift from BG than when in range. Likewise if levels are rising or falling significantly Libre will often over egg that rise and similar with a sharp drop.

I tend to double check my sensor with a finger prick when my levels are steady for about 30 mins in the 5s or 6s with no food or insulin active. Usually I will find it is within 0.5mmols of my BG meter in those circumstances and for me that means it is easily reliable enough to calculate doses from, but even 2 mmols is workable as long as it is reasonably consistent ie always 2mmols above or below BG reading. If it is more than 2mmols out for 3 double checks then it gets reported to Abbott and they will usually replace it.

It is important to ensure that you are well hydrated as dehydration will often cause it to give a higher reading as blood takes water from the interstitial fluid and that means that the glucose concentration of the interstitial fluid becomes higher.
I was out all of yesterday afternoon and didn't have a drink with me and when I got home I was developing a bit of a headache and my Libre reading was 8. I had a large glass of water it dropped to 5.9 in a bout half an hour as a result of rehydrating,

Hopefully your sensor will settle down soon and you will learn to identify and interpret some of it's little quirks and foibles.

We have a thread about the limitations and quirks of CGMs which I will link below. It is useful to give you more insight into when to trust it and when to double check.
H

Thread 'CGM limitations and precautions'

Moderator Note: This helpful reply was copied from another thread as it details some of the commonly experienced limitations of continuous glucose sensors.

MarinaDE said:
My blood sugar has been in perfect range for days now, but although I haven't changed anything, I'm starting to get very short periods of hypos while I sleep and this morning I had a hypo alarm.
Click to expand...
If these are very short periods of lows and occur overnight, they are more likely to be compression lows - when pressure is applied to a sensor, it will report a false low. The reason I say this is more likely to happen at...
  • Like
  • Star
  • Love
Click to expand...
Thanks for this. I'm using the introductory free one, might continue for a few months. No hypoglcaemia warnings as yet.

I don't take insulin so it's simply a monitoring process for me. My next hba1c is due soon so that'll determine progress of treatment.

As an aside, I'm not particularly impressed with data output so far. Can't really export from app in useful format. Logging on to account seems to be pdf format although I'll need to investigate that further. Even my pretty basic blood monitor can export in csv.
 
Zeegoman said:
Thanks for this. I'm using the introductory free one, might continue for a few months. No hypoglcaemia warnings as yet.

I don't take insulin so it's simply a monitoring process for me. My next hba1c is due soon so that'll determine progress of treatment.

As an aside, I'm not particularly impressed with data output so far. Can't really export from app in useful format. Logging on to account seems to be pdf format although I'll need to investigate that further. Even my pretty basic blood monitor can export in csv.
Click to expand...
As a matter of interest, I'm finding that high reading alarms are not corresponding with finger readings. Haven't had any low alarms but lower readings seem to be more in keeping with finger readings.
 
Which is one of the things that I said in my post above and to be expected. What do you have your high alarm set at?
 
The period of time outwith range 12mmol is of interest. Can't obviously monitor this without remote.

Highs often don't appear to be relative to intake. Possibly caused by the by dumping.
 
Zeegoman said:
The period of time outwith range 12mmol is of interest. Can't obviously monitor this without remote.

Highs often don't appear to be relative to intake. Possibly caused by the by dumping.
Click to expand...
I've done a bit more blood monitoring particularly after high alarm and am finding up to 4mmol discrepancy.

The remote sensor is an experiment for me but I'm coming to the conclusion it's not of any real value to me.
 
Zeegoman said:
I've done a bit more blood monitoring particularly after high alarm and am finding up to 4mmol discrepancy.

The remote sensor is an experiment for me but I'm coming to the conclusion it's not of any real value to me.
Click to expand...
I got my first low warning the other day sub 4mmol. Not visible on the historical record on the app. Have downloaded data from libreview and can't see it.
 
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