Trulicity

[Nannyann77]

I was taken off Trulicity by my doctor, she told me the NHS had withdrawn it for diabetics. Since then my appetite has grown and grown. My recents bg was high and she blamed me. I have been told to get a review done, which I requested but it’s been weeks and I’ve heard nothing from the surgery. I feel as though nobody cares and I’m disappointed by my doctors attitude.

 

[rebrascora]

Hi and welcome.

Sorry to hear that you are struggling to manage your weight without Trulicity. I don't believe that the NHS have withdrawn it as such, but just that it is in very short supply because of all the social media attention causing a massive demand for it from the private sector for slimming. There is a new similar injectable medication called Mountjaro which people are getting prescribed on the NHS now and managing to obtain, so perhaps you can discuss that at your review.

My concern with these injectables is that people need to be on them for life to suppress appetite and lose weight because like you have found, appetite returns when you stop them and whilst I do really sympathise with how difficult it is to overcome this problem, I do feel that people are perhaps not given the right dietary advice and support to help with managing it.
I was a binge/comfort eater pre diagnosis and I had no "off" switch" My lifestyle and metabolism probably saved me from becoming morbidly obese but I was carrying 2-3 stones due to my eating. For me the answer was following a low carb way of eating. The less carbs I eat, the less I crave them and then when I lost the weight, adding fat to my diet, means that I feel satisfied with smaller meals because it is calorie dense and provides slow steady release energy without spiking my BG levels, which is what the carbs do and it is the spiking up and down of BG levels which can trigger the hunger. So I have real double cream in my coffee every morning with thick creamy natural Greek style yoghurt, seeds and berries for breakfast but I don't eat bread or cakes or cereals or pasta and potatoes only occasionally and a small portion. I have a nice chunk of good quality cheese for lunch with half an apple and maybe some olives or a few slices of ham with some coleslaw and lettuce and tomato rolled up inside them, so the ham acts as a wrap. Or an omelette is really low carb and I can have whatever I like or needs using up inside it. fried in a knob of butter and served with a large salad and a dollop of full fat coleslaw.
Evening meal last night was some bolognaise sauce on a bed of mixed microwaved veg. carrots, green beans broccoli and baby corn I think. Make chilli or curry and serve it on a big bed of shredded cabbage cooked in the microwave for 3 mins with a knob of butter and the chilli is usually served with a big dollop of coleslaw again. I have steak and chips occasionally and the steak is a juicy, fatty rib-eye but the chips are made from celeriac instead of potato and I have it with a salad and again coleslaw. I will be having bangers and mash tonight but the mash is mashed cauliflower instead of potato. Doesn't need peeling, cooks and mashes quicker and with a good dollop of full fat cream cheese and a teaspoon of mustard, it works really well (you do have to drain the cauli REALLY WELL before mashing. It works great as a topping for cottage/shepherd's fish pie as well with a generous topping of grated cheese. Butternut squash also makes a good potato alternative, either roasted or mashed or in soups and stews.

It takes time to get your head around eating low carb and particularly reducing or avoiding bread because it is a carrier for so many foods, but once you get out of the habit of relying on bread and find other tastier things to replace the high carb foods, it all becomes so much easier. I used to love bread but on the odd occasion I have it now, I am rather disappointed as it seems a bit bland and definitely not worth the BG upheaval it causes me.

I think what has been a real revelation to be about changing to low carb and eating normal fat products rather than low fat, is just how little food I need and mostly I don't feel hungry, when I was always ravenous before. My idea of a health lunch was a whole tin of baked beans on 4 slices of wholemeal toast and a couple of hours later I would be hungry again. Now a half an apple and a chunk of cheese is enough and I am quite physically active, but that provides me with plenty of energy. Some days I just have breakfast yoghurt and berries and seeds with my coffee with cream and then my evening meal because I am busy and not hungry at lunchtime.

This is a way of eating for life. If I go back to eating carb rich foods, the cravings start again and I binge and this is very detrimental for my health, but I don't feel deprived with my current diet and I eat nutritious healthy food which involves some treats but mostly they are low carb treats. For me, going against NHS advice and eating more fat is what makes it sustainable and gives me energy and keeps me from feeling hungry. There have been a number of health benefits to eating this way including less joint pain and better skin and no more migraines and most importantly I feel I have so much more control over my eating and I don't need to battle those cravings or hunger.

I will also say that exercise helps enormously too. It doesn't have to be anything overly exertive. Walking is great if you can manage that but push yourself to walk a bit faster than you normally would, so that it gets your heart rate up and bit and breathing more deeply. Start small and gradually build it up. If you can't walk, try seated exercises a couple of times a day for 5 mins and build it up gradually to 10 mins twice a day and then 10 mins 3 times a day etc.
I find when it is horrid outside, walking up stairs several times on the trot works great. I gradually build it up and currently I can run up and down stairs 20 times on the trot. That really gets my heart racing and my lungs working and a bit of muscle burn but only takes 10 mins. Not suggesting you do that, but just that you can find ways of exercising around the house without needing to invest in equipment.

 

[Nannyann77]

Thank you for your reply. I’m 74 with arthritis and have had type two for 16 years. It runs in my family. I’m following the Carbs and Cals app and find it helpful. I do try to exercise but it’s not always possible. I’m getting really despondent. My diabetes is controlled by tablets, I’m the only one not on insulin in my family and I’ve had it the longest.

 

[Inka]

How high is your blood sugar @Nannyann77 ? I know GP surgeries are very busy, but if it’s been weeks since you requested a review and you’ve still heard nothing, it might be worth contacting them again.

Re exercise - anything can help. Even things like doing household choirs after a meal rather than sitting down, taking things upstairs one by one rather than in a pile (that will add extra stair walks), standing up and walking on the spot while you watch a 5 minute news bulletin. Every little thing can help.

 

[Nannyann77]

Hi, my bg is 62. I do my own gardening, walking the dog and walk everywhere. I recently had Covid for three weeks. We recently lost a family member to heart disease and diabetes, he was 57. All these things have had an effect on my mental health. This isn’t taken into consideration at all. Some days I am a bit lazy if the weather isn’t nice.

 

[Inka]

I’m sorry to hear about the loss of your family member - my condolences. It’s completely understandable that that’s caused you stress and upset.

I had Covid recently @Nannyann77 and it played havoc with my blood sugars. Give yourself time and go along slowly. Sometimes we just have to tune out other people if their advice isn’t appropriate. You know you. Do the best you can in the circumstances.

 

[goodybags]

I was taken off Trulicity by my doctor, she told me the NHS had withdrawn it for diabetics. Since then my appetite has grown and grown. My recents bg was high and she blamed me. I have been told to get a review done, which I requested but it’s been weeks and I’ve heard nothing from the surgery. I feel as though nobody cares and I’m disappointed by my doctors attitude.

Hi @Nannyann77
yes Trulicity has had supply problems (from earlier this year) so I’m not suprised you can’t get it
I do hope your GP or your DSN can get you on an alternative, there there are other similar (but not the same options) it might be worth asking if they feel you would benefit from Mounjaro

why I suggest this, for a few months after Trulicity wasn’t available to me, I was offered a Tablet version of what my GP suggested might be a good alternative, however that wasn’t, it was a phone call from my DSN we were discussing my latest Hba1c and she suggested Mounjaro
I had to jump through a few hoops to get it, but TBH it is I’m sure actually better than Trulicity for me

I’m told the supply problems with Trulicity are related to the supply problems with Ozempic, after it became a popular weight loss drug on private prescription (for non-diabetics)