What to eat

[CoolShot44]

Hi everyone ,
I have a question any advice or anything information about forziga , I have read that I shouldn’t be fasting as I’m on dapafliflozin so I’ve stopped fasting but what can I eat .Im confused tbh as I had been limiting carbs etc and fasting for 16 hours , when I’ve looked into this drug for diabetes treatment it advises against this as it can cause ketosis ,so my question really do I have to limit carbs as it might affect the way this drug works .Any advice or recommendations I don’t know much about this so still learning about what I can eat and what I can’t eat I’m currently counting carbs etc and my levels seem to be at a descent level but now I’m re thinking ie: if I’m only eating fats and protein and around 150g carbs a day then this drug might not be working like it’s supposed too so thinking should I go back to just eating carbs again and not counting them anyway just a bit confused tbh as to what I can eat and what to avoid when on this medication

 

[rebrascora]

I am pretty sure that 150g carbs a day will be fine with a "Flozin" Generally we talk about less than 130g being low carb, so you are not even at that "low carb" level. The drug works by encouraging the kidneys to remove glucose from the blood into the urine at a lower level than they normally would.... so it is important to have plenty of fluids to prevent dehydration and give the kidneys plenty to work on. It would be pointless to increase your carb intake from where it is now, as that would just give your kidney's more work to do in my opinion.
I believe dehydration may be the main trigger to Diabetic KetoAcidosis (DKA) with this drug which is why fluid intake is important, so do try to aim for 2 litres a day minimum, probably 3 maximum.
Those would be my thoughts, but like most of us here, I am not medically trained.

 

[JITR]

I am pretty sure that 150g carbs a day will be fine with a "Flozin" Generally we talk about less than 130g being low carb, so you are not even at that "low carb" level. The drug works by encouraging the kidneys to remove glucose from the blood into the urine at a lower level than they normally would.... so it is important to have plenty of fluids to prevent dehydration and give the kidneys plenty to work on. It would be pointless to increase your carb intake from where it is now, as that would just give your kidney's more work to do in my opinion.
I believe dehydration may be the main trigger to Diabetic KetoAcidosis (DKA) with this drug which is why fluid intake is important, so do try to aim for 2 litres a day minimum, probably 3 maximum.
Those would be my thoughts, but like most of us here, I am not medically trained.

Glucose into the urine at a lower level or higher level? Isn't the aim to get rid of it?

 

[rebrascora]

Glucose into the urine at a lower level or higher level? Isn't the aim to get rid of it?

It is removing glucose from the blood (into the urine) and normally that happens above 10mmols/litre, but the flozins start removing it at lower levels than normal.

 

[JITR]

It is removing glucose from the blood (into the urine) and normally that happens above 10mmols/litre, but the flozins start removing it at lower levels than normal.

Ah, I see, a higher level of glucose into the urine as removal starts at a lower level of glucose in the blood. My knowledge was limited to explanations like this, Flozins through inhibiting SGLT-2 provide lower glucose reabsorption in the kidneys and therefore lower glycaemia

 

[CoolShot44]

Thank you for your reply @rebrascora ,as I’ve been doing well in keeping my time in range levels at a descent level during the day mainly due to diet and fasting I thought I’d ask for advice thanx I’ll be sure to increase my fluids

 

[PerSpinasAdAstra]

Here's a link to discussion of Euglycemic diabetic ketoacidosis (EDKA) which lists the risk factors: Link

Fasting and a keto diet are listed as risk factors independent of SGLT2 inhibitors like dapafliflozin. There's also a list of factors which may be triggers while on the medication, which includes reduced food intake.

My non medically trained opinion is that 150g carbs per day is high enough not to cause problems, but perhaps it might be less risky to spread those carbs out over the day a bit more rather than fasting for 16 hours. You'd have to talk to a doctor to get good advice on whether 16 hours counts as 'fasting' in terms of being a risk factor for EDKA.

 

[JITR]

Not sure why you need to be on Dapagliflozin with A1c at 49 mmol/L. I aim for 100g protein per day, make sure I have enough healthy fat and get most of my carbs from vegetables. The carbs come at 50-110g/day, average about 75g/day, from 2 meals per day.

 

[rebrascora]

Not sure why you need to be on Dapagliflozin with A1c at 49 mmol/L. I aim for 100g protein per day, make sure I have enough healthy fat and get most of my carbs from vegetables. The carbs come at 50-110g/day, average about 75g/day, from 2 meals per day.

That is a very good point. With an HbA1c of 49 Metformin plus Dapagliflozin seems like a bit of overkill. Perhaps that isn't a recent HbA1c result and it is higher now?

 

[CoolShot44]

I’m on the flowzin meds because of previous heart problems history by my dr as she thought I’d benefit from taking * it , the 49 hba1c is from 2023