I had my endo appointment in September and we again discussed Invokana. Invokana is a relatively new drug (along with Farxiga) which is also a new class of drugs called SGLT-2 inhibitors. They act by making you excrete more glucose in your urine. I had brought this up before at a previous appointment and she initially took the position that it wouldn't help me. She still waffles about my diabetes type and said it isn't for type 1s. I always have to remind her that she has no evidence I am type 1, I'm just on insulin and am not overweight nor have the "hallmarks" of type 2 (whatever that means). Since Invokana was still a tier 3 drug for my insurance I put off the question. But before my last appointment I checked with my insurance and it is now covered as a tier 2 drug at $40 for a 90 day supply (Farxiga is still tier 3 and expensive). And there has been a lot more discussion about the use of Invokana for type 1s. So I decided to bring the topic up again thinking that it would be more acceptable.
And surprisingly my endo was more positive about it. I had initially been worried that it would be of little help to me. I thought the drug worked primarily by reducing your renal threshold from 160-180 mg/dl down to a lower range (like 120-140 mg/dl). If your blood sugar was already 100 mg/dl then it did nothing. So I thought it would do little except reduce my after surges. But I was wrong, it actually works actively at all blood sugar levels. Yes you get increased glucose excretion at higher blood sugar levels but even at blood sugars under 100 mg/dl you still dump glucose. And as I looked into it you dump about 70 grams of carbs a day this way. Yowza. 70 grams of carbs a day is a fair bit. That is 240 calories. And my endo pointed out that it might reduce my insulin requirements. In hindsight losing 70 grams of glucose certainly would be expected to reduce insulin needs. And the other benefit is blood pressure reduction and weight loss.
So now we get to my initial experience. I started two weeks ago. I started right off looking at glucose in my urine and sure enough it was at the upper end and quite dark signifying that I was dumping lots of glucose. And right off my insulin needs dropped. I would say a drop of between 20-30% in my daily needs both basal and bolus. And I may well have dropped a pound or two. And despite my belief that it only worked with higher blood sugars my urine tests suggest that you still dump quite a bit of glucose at blood sugars under 100 mg/dl. And in addition to the lower insulin doses my blood sugars are improved with a drop of 10mg/dl on average in my morning numbers. Pretty darn good.
So my experience is actually looking pretty good and I think I am going to try a longer course of Invokana.
Has anyone else had a good or bad experience with Invokana?