Farxiga- used to treat type 1 Diabetes?

#1

Hi all, I am a type one diabetic and have been the last 19 years. I am 21 years old, and have recently been treating pretty well with the Omni Pod & Dexcom cgm, keeping either at or below target with few highs.My last A1C was 7.6, but I am expecting to be low 7s come my next appointment.

My doctor recommended a trial of the drug Farxiga,which is currently only FDA approved for type 2 diabetics. My doctor is running a trial of the drug on type one diabetics, and was a huge advocate, stating it helps lower A1c significantly, and even helps in weight loss (I am a little overwight by about 15-20 pounds). Obviously I am excited by the possibility of weight loss, as well as improved A1c. But I am asking myself if this is really necessary, as I currently have fairly decent control of my levels. I am also concerned if my doctor is just interested in more statistics for his study (I have little history with this doctor).

Thoughts? Has anyone had experience in treating with Farxiga, or has the medication been recommended to you?

Thanks for your time!

#2

Farxiga is a drug of the SGLT2 class. I have taken Farxiga as wells as Invokana (note I am T2 on insulin). It causes you to excrete glucose in your urine and the result is that you mealtime blood sugar surges are blunted and your fasting blood sugar can be more easily controlled. Most people find that it reduces their insulin TDD, mine dropped about 20%. And because you excrete more glucose you have a tendency to lose weight.

There are two important side effects to be aware of. First is dehydration. Because you excrete more glucose you become friends with your bathroom. You need to drink plenty of water and remember to replenish your electrolytes. Second, if you become dehydrated you can be at risk of DKA, even at a normal blood sugar. If you stay properly hydrated your risks of dehydration and DKA are very small. Other side effects may include a tendency to more yeast infections and UTI.

Although this drug was approved for type 2s many doctors have been prescribing it for type 1 with good effect.

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#3

I’m pleased to hear this. I was not able to find much literature in regards to being used to treat type one, which was a little disconcerting. Thanks for your input!

#4

I’ve had Type 1 for over 25 years and did a trial of Forxiga, but stopped after six weeks due to the above side effects (two infections in a six-week period after having none for years). It did help lower my insulin doses, seemed to make highs easier to turn around, and I did lose a few pounds. I found the increased risk of DKA an added mental stress, however, especially because I’m on a pump and already develop high ketones easily when insulin gets too low (from illness, hormones, interrupted delivery, whatever). I was testing ketones daily plus any time I felt unwell on the advice of my endocrinologist.

#5

Understood, thank you! Did you immediately regain the weight after ceasing taking it? I can’t imagine it will be a long term medication for me, but if it could further me a bit in my weight loss journey I may as well use the free trial.

#6

Yes, I regained the weight plus more within a few weeks. I’ve since started eating a low-carb diet again, and limiting the number of low-carb “treats” I eat, and that seems to be working. I haven’t lost any weight in a couple of weeks even with the low-carb diet, though, so I’m going to start adding in more exercise soon.

#7

Ah, so really if I feel like my level management is well under control, I shouldn’t proceed with trying the medication for hopes of weight loss if I don’t plan on staying on it long term is what it sounds like.

#8

Yeah, it’s hard to say. I’m overweight and am on medication that causes (at least for me) weight gain, so it may be different for you.

#9

SGLT2 medications are undergoing widespread testing in the T! market. Testing is exactly what it is, testing. Several T! friends of mine are doing well. If you take the test we will be interested in how it works out.

#10

There are a number of studies either completed or being done on SGLT2 drugs for patients with T1. And example of this study. The “efficacy” (i.e. whether it improves control, causes weight loss or improves CVD) hasn’t really been a question. The real question seems to be safety. The real concern is whether the SGLT2 drugs might increase DKA risk. Most studies seem to find there is a higher rate of DKA, but often most if not all cases occur with other precipitating factors such as insulin pump failure, skipped insulin dose, or concurrent illness. My hypotheses that dehydration is one of those precipitating factors has unfortunately not been studied.

#11

Continuing the discussion from Farxiga- used to treat type 1 Diabetes?:

Trials set aside, the issue at hand is the acceptance of low7’s as an acceptable number. Evedice shows that there are immediate and long term benefits of a lower number. 6 is my goal and I am never be satisfied by 6.5. Yes there are issues with too low, but that is easily controlled by glucose monitoring and appropriate food to insulin ratios.

I notice that there is s big concern with the use of the medication that is being studied because of ketoacidosis. The study group is full of people with difficult blood sugars. This is the very population that is going to have this issue. Normal glucose levels don’t cause this. However, if it is damaging an organ you may see this??? Why does it not show up in type 2? [quote=“Koso1213, post:1, topic:62331, full:true”]
Hi all, I am a type one diabetic and have been the last 19 years. I am 21 years old, and have recently been treating pretty well with the Omni Pod & Dexcom cgm, keeping either at or below target with few highs.My last A1C was 7.6, but I am expecting to be low 7s come my next appointment.

My doctor recommended a trial of the drug Farxiga,which is currently only FDA approved for type 2 diabetics. My doctor is running a trial of the drug on type one diabetics, and was a huge advocate, stating it helps lower A1c significantly, and even helps in weight loss (I am a little overwight by about 15-20 pounds). Obviously I am excited by the possibility of weight loss, as well as improved A1c. But I am asking myself if this is really necessary, as I currently have fairly decent control of my levels. I am also concerned if my doctor is just interested in more statistics for his study (I have little history with this doctor).

Thoughts? Has anyone had experience in treating with Farxiga, or has the medication been recommended to you?

Thanks for your time!
[/quote]

#12

Hello,

Thanks for your response! As a heads up, I decided against doing the Farxiga drug trial, and continued to lose an additional 25 pounds since this time last year, and have lowered my A1c to 6.4 as of my last check up (March of this year) using just diet and exercise.

I was not satisfied with my 7s A1C but was proud of the improvement I’d made (as two years or so ago I was in the double digits with my A1C).

Anyways, just popped back here to say so glad I didn’t do the trail and just kept at it.

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#13

That is GREAT NEWS.

If you have discovered the magic key of diet, &exercise, you. Are on your way to a happy future. Keep it up. Test often or get on a continuous glucose monitor.

You should feel so much better, more energy and less hangey. Keep it up

Kyle Delp

#14

Congrats!!! :clinking_glasses:

Sounds like you’ve put in a lot of effort, and you’re seeing good results. Man, that must feel good :grinning: