Semaglutide anxiety

[jimbob99]

@Zeegoman I have a bmi of over 30 with plenty of weight to lose. My HbA1c was 47 so at top end of pre diabetic. bmi now 39. I pay for Mounjaro using a reputable online pharmacy, as I didn’t qualify for free prescription.

 

[Zeegoman]

I'm in Scotland but don't think the criteria for prescription varies much across the UK. These things are usually set by NICE for the UK and SIGN in Scotland.

Everyone that I know who is taking injectables for weight loss pays for it. I assume that cash costs to the NHS plays the biggest part in this.

The latest research that I have read is that Monjaro is the most effective at achieving weight loss.

I have actually lost a few pounds and am now at the lower end of my normal weight range. I have been highly restrictive in my food consumption for some time now.

I don't feel hungry in the first part of the day, 10 to 12 hours post semaglutide. I do however have to eat sensibly during this period to stop potential hypoglcaemia.

This lack of appetite may be driven in part by semaglutide side effects of nausea and bloating. It is also supposed to slow gastric emptying. This is not a side effect that I need as I have gastroparesis due to surgery I had years ago.

This in turn can cause gastric dumping which leads to some bizzarre blood glucose spikes from time to time.

Well as the old highlanders used to say age doesn't come alone. Neither does diabetes. I must have been really bad in my past life.

 

[rebrascora]

So the gastroparesis may perhaps be the cause, or a factor in your bad hypo experiences. I am guessing that you didn't have a Constant Glucose Monitor (CGM) at that time, since you mention trialling one now. I certainly think that might be helpful.
You mention having had gastric surgery and that makes me wonder if you might be Type 3c rather than Type 2 as you don't seem to fit the typical profile for Type 2 although it is now believed that Type 2 is probably a broad spectrum of sub types. It is also possible that you are a very slow onset Type 1 or LADA (Latent Autoimmune Diabetes in Adults)
There is no specific test for Type 2 diabetes, so people can be misdiagnosed simply because they are a more mature adult when they develop diabetes. There are many here who were misdiagnosed at first, myself included.
Have you had a C-peptide test to check how much insulin your body is actually producing. I am guessing from your description of your diet and lifestyle that you are probably quite insulin sensitive and this may have lead to you being able to manage for so long on lifestyle changes and oral meds even with compromised insulin production.

Just wondering if the semaglutide is a sustainable option long term if you don't have any weight to lose, especially as it is slowing gastric emptying when you already have an issue with that. Do you ever finger prick test when you wake up with this anxiety as it can be a sign of both high and low BG. Hopefully the CGM trial will shed some light if that is the issue.

Once again I have deviated somewhat from the main topic and I apologise for that, but perhaps some of my thoughts might pertinent to your situation.
Hopefully you have taken advantage of the free 15 day Freestyle Libre 2Plus trial for your CGM.

 

[Zeegoman]

So the gastroparesis may perhaps be the cause, or a factor in your bad hypo experiences. I am guessing that you didn't have a Constant Glucose Monitor (CGM) at that time, since you mention trialling one now. I certainly think that might be helpful.
You mention having had gastric surgery and that makes me wonder if you might be Type 3c rather than Type 2 as you don't seem to fit the typical profile for Type 2 although it is now believed that Type 2 is probably a broad spectrum of sub types. It is also possible that you are a very slow onset Type 1 or LADA (Latent Autoimmune Diabetes in Adults)
There is no specific test for Type 2 diabetes, so people can be misdiagnosed simply because they are a more mature adult when they develop diabetes. There are many here who were misdiagnosed at first, myself included.
Have you had a C-peptide test to check how much insulin your body is actually producing. I am guessing from your description of your diet and lifestyle that you are probably quite insulin sensitive and this may have lead to you being able to manage for so long on lifestyle changes and oral meds even with compromised insulin production.

Just wondering if the semaglutide is a sustainable option long term if you don't have any weight to lose, especially as it is slowing gastric emptying when you already have an issue with that. Do you ever finger prick test when you wake up with this anxiety as it can be a sign of both high and low BG. Hopefully the CGM trial will shed some light if that is the issue.

Once again I have deviated somewhat from the main topic and I apologise for that, but perhaps some of my thoughts might pertinent to your situation.
Hopefully you have taken advantage of the free 15 day Freestyle Libre 2Plus trial for your CGM.

In my case gastroparesis causes dumping which gives bizzarre high readings not related to recent dietary intake. This is the reason for trying remote sensing. It may ultimately require cessation of semaglutide but it is not a contraindication for its use.

My poor experiences of hypo were related to insufficient monitoring, excessive weigh loss and overly strict carbohydrate restriction.

I've been T2 for 25 years. Mostly well controlled by oral antidiabetics and lifestyle measures. Any previous aborations had straight forward explanations.

I have to use a finger test every time before driving. I also check randomly, if I feel unwell, before I take medication, after taking medication and whenever I feel like it. I have just received a trial remote sensor today which I will give a go.

There is no direct correlation with early morning wakening, anxiety and blood sugar levels. Although over the years I have experienced higher blood sugars in the morning which is

When I started semaglutide I experienced reflux and a bit of esophageal spasm, known side effects. Both of these I initially credited for sustained anxiety. I was unable to take antacids for an hour or so after taking the semaglutide so vagus nerve irritation was a distinct possibility. However that is no longer the case as that side effect has resolved.

As to the deterioration of diabetes control I think it is just a function of age and the natural progression of my disease. I am no angel but do take it seriously mostly! Moving from NIDDM to IDDM is something I am familiar with from my clinical days. Time will tell.

 

[Zeegoman]

So the gastroparesis may perhaps be the cause, or a factor in your bad hypo experiences. I am guessing that you didn't have a Constant Glucose Monitor (CGM) at that time, since you mention trialling one now. I certainly think that might be helpful.
You mention having had gastric surgery and that makes me wonder if you might be Type 3c rather than Type 2 as you don't seem to fit the typical profile for Type 2 although it is now believed that Type 2 is probably a broad spectrum of sub types. It is also possible that you are a very slow onset Type 1 or LADA (Latent Autoimmune Diabetes in Adults)
There is no specific test for Type 2 diabetes, so people can be misdiagnosed simply because they are a more mature adult when they develop diabetes. There are many here who were misdiagnosed at first, myself included.
Have you had a C-peptide test to check how much insulin your body is actually producing. I am guessing from your description of your diet and lifestyle that you are probably quite insulin sensitive and this may have lead to you being able to manage for so long on lifestyle changes and oral meds even with compromised insulin production.

Just wondering if the semaglutide is a sustainable option long term if you don't have any weight to lose, especially as it is slowing gastric emptying when you already have an issue with that. Do you ever finger prick test when you wake up with this anxiety as it can be a sign of both high and low BG. Hopefully the CGM trial will shed some light if that is the issue.

Once again I have deviated somewhat from the main topic and I apologise for that, but perhaps some of my thoughts might pertinent to your situation.
Hopefully you have taken advantage of the free 15 day Freestyle Libre 2Plus trial for your CGM.

My gastroparesis causes dumping and bizarre high BG readings not related to recent dietary intake.

My bad hypo experiences were caused by poor monitoring, excessive weight loss, extreme exercise and restricted carbohydrate intake. For which I claim full responsibility.

There is no obvious connection between my BG and early morning wakening/anxiety although I have experienced Dawn Phenomenon and possibly the Somogyi effect.

I have to test my BG before driving. I also test before meals, medication, after meals, when I feel ill and at other random times. I have received a trial remote sensor and will give it a go.

Semaglutide is not for me a weight loss drug, it's for blood sugar control.

I have been NIDDM for 25 years and the deterioration in control is highly likely to be a function of my age and natural progression of my disease.

Back to semaglutide anxiety. When I first started taking it I had refux and oesophageal spasm. I was unable to take antacids for an hour after taking semaglutide. I put the extended anxiety down to vagus nerve irritation. However, that side effect has abated but the anxiety has not.