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Jardiance

M

margow

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Relationship to Diabetes
Type 2
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Hi, fairly new to type 2 diabetes, around 4 months, trying to get to grips with changes and taking metformin am and pm. Following recent blood test HB a1C had been 112, now 61 which the nurse described as “wonderful”…BUT then prescribed Jardiance also.
The list of common and not so common side effects are toe-curling to say the least.
I’ve gone from feeling positive to very low and worried.
Wondered if anyone has been in a similar position? Thanks for listening
 
Jardiance is one of the gliflozins which many of us on here take. They are more in favour these days as a second level medication rather than gliclazide.

Personally I read the patient information leaflet and then get on and take medications on the basis that if I am one of the few whom it does not suit, I have been forewarned, can work out what is going on and stop taking it. Metformin was a problem to start with for me but being forewarned I got swapped to the the slow release version. Adding a flozin when my blood glucose began to creep up went without any problems at all and exactly as predicted, it brought my blood glucose down.

My thought for you is to just take the flozin on the basis that it will build on the progress you have made so far (and your DN's wonderful is a bit of an understatement) and look forward to getting down something near to the diagnosis level. In the unlikely event that they don't suit, there are other things to go at.
 
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Welcome to the forum @margow

There are several members here on various of the ‘flozins. As @Docb suggests, you can always review the situation if you don’t seem to be tolerating them well.

Well done on the improvements you have seen already. Try not to be disheartened by the recommendation to add extra medication despite the progress you have made… there is research that suggests that earlier, steady, resolution of elevated glucose can improve the chances of better long-term outcomes.

If your levels improve and then stabilise in the recommended ranges your GP/nurse may recommend reducing or stopping some medications.

We have members who have eventually come off all meds altogether, though that’s not necessarily an aim in itself.
 
margow said:
Hi, fairly new to type 2 diabetes, around 4 months, trying to get to grips with changes and taking metformin am and pm. Following recent blood test HB a1C had been 112, now 61 which the nurse described as “wonderful”…BUT then prescribed Jardiance also.
The list of common and not so common side effects are toe-curling to say the least.
I’ve gone from feeling positive to very low and worried.
Wondered if anyone has been in a similar position? Thanks for listening
Click to expand...
You have done amazingly well in just 4 months so I am a bit surprised that she doesn't feel that continuing with your dietary changes won't be sufficient to get your HbA1C down to normal.
It is of course always your decision whether to take any particular medication but do your own research before making a decision.
 
That is an incredible reduction of your HBa1C, well done.

In terms of side effects, remember that the lists on the patient information leaflets (PILs) are partly public information and partly legal cover, so they will be lengthy, allowing the drug company to claim they provided a warning.

I took another 'flozin, Canagliflozin, and did not get on with it at all and got a really bad case of thrush (hopefully not TMI) in spite of drinking huge amounts of water, so it is worth keeping an eye on how you feel after taking them and going back to the GP if you have a problem.
 
margow said:
Hi, fairly new to type 2 diabetes, around 4 months, trying to get to grips with changes and taking metformin am and pm. Following recent blood test HB a1C had been 112, now 61 which the nurse described as “wonderful”…BUT then prescribed Jardiance also.
The list of common and not so common side effects are toe-curling to say the least.
I’ve gone from feeling positive to very low and worried.
Wondered if anyone has been in a similar position? Thanks for listening
Click to expand...
Reading this I can't help wondering whether I've just been incredibly lucky or our Surgery has a truly brilliant team of DNs. HbA1c of 114 and prescribed Metformin, so pretty much on the same page as you. 3 months later HbA1c 56 and I was told I probably didn't need the Metformin and could stop taking it to see how I got on. DN never suggested or discussed adding another med, just told me to stick with my dietary regime as it was obviously working.

Well done on getting your HbA1c down. Shame your DN then took the shine off things.
 
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I’m in quite a similar position to you @margow. I was initially diagnosed with an HbA1c of 101 but, after a month of lifestyle changes and metformin, managed to get it down to 75. So it came as a bit of a surprise when my GP upped my metformin to 1000mg a day AND put me on dapagliflozin. I think that he wanted to maximise the gains (or losses depending on how you look at it) I had been making and to really flush the glucose out of every part of my body. I was quite worried, to be honest, and put off taking the ‘flozin having read dire warnings about DKA and various bits of you dropping off. I did eventually bite the bullet and have been taking it for just over a month now. I think it’s working in that my blood glucose levels are steadily coming down and I ‘feel’ a lot better, whatever that means.

The only things I would say is that a scrupulous attention to person hygiene ‘down there’ is a good habit to maintain. And I also test for ketones a couple of times a week to see if anything untoward is happening there. Apart from that, I seem to be doing quite well with it.

[Just a footnote, so feel free to ignore. I was at a local diabetes education session on Wednesday, run by the local NHS trust. There were eight of us there at various stages of diabetes. Five of us were on metformin but I was the only one on a ‘flozin and metformin. So it’s not a universal combination of meds by any means, but not uncommon.]
 
margow said:
Hi, fairly new to type 2 diabetes, around 4 months, trying to get to grips with changes and taking metformin am and pm. Following recent blood test HB a1C had been 112, now 61 which the nurse described as “wonderful”…BUT then prescribed Jardiance also.
The list of common and not so common side effects are toe-curling to say the least.
I’ve gone from feeling positive to very low and worried.
Wondered if anyone has been in a similar position? Thanks for listening
Click to expand...
I'm in a fairly similar position, initial HbA1c 113, did initially take Gliclazide for five weeks but currently Metformin only.

My next HbA1c is due in a couple of weeks and my GP has warned me that if it's below 75, the diabetes team will want me to take a 'flozin, don't know which one yet.

I'm also not keen, as you say the side effects look scary. I've just found out that my dad has been put on dapagliflozin for his heart condition, and has spent the last week weeing for England. That alone would be intolerable for me, let alone anything more serious. He, not being diabetic, is at least not at risk of some of the things you or I might worry about.

I am very biased and acknowledge that there are people who are happy to take 'flozins and have put up with any side effects experienced, or even not suffered any. I will say that if for some reason I  had to take one, I would insist on two things:

C-peptide test to confirm I was producing sufficient insulin.

Ketone strips for testing blood ketones.

Best wishes whatever you decide, your progress so far has been amazing!
 
debs248 said:
C-peptide test to confirm I was producing sufficient insulin.
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The OP is not going to get a cpeptide test given they can clearly manage their diabetes without insulin, given the drop in a1c from 112 to 61. A cpeptide test is funded when there is a suspicion the person may have type 1.
 
Lucyr said:
The OP is not going to get a cpeptide test given they can clearly manage their diabetes without insulin, given the drop in a1c from 112 to 61. A cpeptide test is funded when there is a suspicion the person may have type 1.
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I said I would insist on it, not that @margow needed one. I don't yet know how much my HbA1c has dropped, and so far I'm only assumed to be type 2, probably due to my age. No further tests have been done.
 
debs248 said:
I said I would insist on it, not that @margow needed one. I don't yet know how much my HbA1c has dropped, and so far I'm only assumed to be type 2, probably due to my age. No further tests have been done.
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Insist all you like but you won’t get one unless there are enough signs of T1 to justify it or you pay privately. Took me 15 years on 5 injections a day diagnosed age 20 to convince someone to approve mine
 
Lucyr said:
Insist all you like but you won’t get one unless there are enough signs of T1 to justify it or you pay privately. Took me 15 years on 5 injections a day diagnosed age 20 to convince someone to approve mine
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Oh and that includes when I had DKA within a week of starting empagliflozin, didn’t get a cpeptide test after that either. So when OP asks for reassurance on starting a flozin, I’m not sure saying well you’d insist on a cpeptide test is a useful piece of information, given they aren’t going to be able to get one.
 
Lucyr said:
Oh and that includes when I had DKA within a week of starting empagliflozin, didn’t get a cpeptide test after that either.
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That's the very thing I am trying to avoid by not starting to take a 'flozin without being sure I can produce sufficient insulin.

Not directly of use to the OP perhaps, but other people do read the thread.
 
Thanks to everyone for your considered responses, I really appreciate it. Lots to think about, guess I’ll quit feeling sorry for myself and “get busy living” as Dolly P would say!
 
debs248 said:
That's the very thing I am trying to avoid by not starting to take a 'flozin without being sure I can produce sufficient insulin.

Not directly of use to the OP perhaps, but other people do read the thread.
Click to expand...
I would want to know the logic of having another medication added when you have already been able to reduce your HbA1C with the medication you are already taking and the dietary changes, it seems an odd suggestion when blood glucose is already going down but on the other hand you are still seeing some quite high finger prick readings.
 
@margow welcome to the forum and congratulations on such an exceptional reduction in your HbA1c in such a short period of time. I managed to reduce mine by in 3 months and yours in 4 is way beyond that.
My understanding from talking to my local DN is that if you have a high HbA1c then the doctors will want to bring it down to a much lower level very quickly to minimise the risk of diabetes complications. However, based on my own experience, I found that when checking my results I needed to look at them all as my DN tried to put me on cholesterol and blood pressure pills at my three month check, despite reducing my HbA1c to 47. This was because my systolic blood pressure was over 120 and my cholesterol had come back as 6.5. This may be why you have been put on Jardiance which is also used for chronic heart and kidney problems so your tryglicerides reading would be important as would the microalbumin test result. Also check your blood pressure reading.
However as everydayupsanddowns says, even if they put you on medication now, they often take you off it when the evidence shows it is not needed.
 
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