I am a Type 1 for 50 years, on a pump for 35, using Tslim and dexcom since 2013. I’m also a retired CDCES. In 2021 I switched to Lyumjev insulin and added Ozempic a short time later. That regimen, along with Sleep mode 24/7 has worked so well for me. Last year, Medicare Part D stopped approving Ozempic because of my Type 1 diagnosis. Prior authorization was refused. I got by most of the year on samples and a stash my sister had and wasn’t using. But I ran out in October and started having issues. Without Ozempic, very rapid rising and falling with the Lyumjev. The rapid changes made the hunger even worse. I recently started using generic Liraglutide through Good Rx and that seemed to work for a few weeks but then appetite suppression wore off and delayed stomach emptying was erratic which led to a lot of lows and more erratic sugars. In addition I was running out of sites with Lyumjev. I’ve tolerated the itching and burning but sites were only lasting me 36 hours. I needed a break. I’ve been back on Humalog for a few days without Liraglutide and really struggling. I’m bolusing 15 minutes before meals but still having spikes post meal and then going low 4-6 hours later. Have had lows 11p-1am last three night even though my last meal bolus was 5-6 pm. Adjusted basal nd still went low last night. Today I’m going to try going out of sleep mode. During the day and evening. I understand insulin timing and my own body. But I’m so frustrated I’m open to any ideas folks may have.
Would you be able to get a different GLP-1 type drug under approval in another way, such as the ones that are prescribed for weight loss??
I have type 1 and use Ozempic so am very aware of how much it helps. I used others in the past, including Victoza and Trulicity. You have some options with all of these new meds coming out.
I’m sorry that Insurance issues has compromised instead of helping with your health!
If you don’t mind sharing, could you give us your body weight, total daily dose of insulin, and a brief description of your eating style? These facts could help me comment.
Try this, it worked for my wife. Denied first time then just get your doctor to call.
Check it out!
I have a pretty good kick of insulin working at the 5-6 hour mark. I have recently switched to total MDI because I was having so many issues with my pods. I had been doing some with my pod and some with MDI for basal and MDI for all bolus.
But because of that kick on my pods, I usually tried not to take any bolus insulin after 6-7 pm. But I also switched my basal on my pod to it’s lowest amount from 11 pm to 1 am. Because I was not willing to stay “higher” waiting for that kick, I would take the same amount of insulin, but then have a snack around 9-10 that would boost me some, along with the lowered basal in my pods.
So maybe try reducing basal after about 2-3 hours after that last bolus insulin and then a small snack, for me the snack is only around 6 carbs. A small tangerine or a couple of crackers.
Interesting enough, after switching to total MDI, 2 different unit amounts of basal insulin shots a day, 12 hours apart, my numbers have stayed very stable at night. Knock on wood, as I can have bad DP and have the 2nd basal shot (Lantus) timed before bed so it’s at it’s highest peak when DP starts.
19-25 units TDD. basal 12 units on average. Weight 172. 5’7. Lost 18 lbs on Ozempic. I have a large frame and am not insulin resistant or overweight at this point. I eat the same thing for breakfast everyday most days a protein, usually an egg and 2 slices of toast. I take. I take no insulin and go directly to the gym and work out for 45 minutes. Usually leave with a normal sugar. On Ozempic II was a grazer until dinner and would take only small doses of Lyumjev if I saw my sugar starting to go up. Dinner is a salad with a protein and a starch and then some sort of sweetness. I would not bolus until I started to see my sugar rising, did not really use a carb ratio, it was all based on instinct and past experience. And the extra basal from sleep mode kept me well controlled. Obviously none of that will work without GLP1 and Humalog so I’ve switched to 3 squares. And trying to bolus at least 20 minutes before eating which is the hardest part, along with no spontaneous snacks.
Is she on Medicare? To my knowledge Medicare patients can’t participate in financial help programs and my income wouldn’t qualify me I don’t think. But I will look into it. Thanks
She is on medicare. The money limit is 4x the poverty limit which is about 70K or more. Approx
Thank you
The whole GLP 1 class requires prior authorization for coverage and because it does not have FDA approval for use in Type 1 they won’t approve.
There are other drugs specifically labeled for weight loss, like Wegovy and Zepbound. I was wondering if you could try one of those.
Thanks for the details. How long has it been since you stopped Ozempic? Have you regained any of the lost weight since then? Do you have any idea how many grams of carbohydrates you consume, on average, every day?
I don’t have a lot of insight. You and I are the same height but while you weigh more than me, you take less insulin. Your recent eating style switch from grazing balanced out by small bolus doses of Lyumjev to three square meals with pre-bolusing is interesting. Your ability to transition to new routine impresses me.
Eating “an egg” with two slices of toast seems like a small meal to me. One large egg only contains about 6 grams of protein. I try to eat at least 67 grams (1 gram of protein per kg of ideal body weight) of protein each day. If I eat eggs, a typical serving would be four. I’ll sometimes make an omelet with 2 full eggs plus 4 yolks. Eating more protein each day should help control the appetite while helping nutrition.
I wonder if you used a therapeutic carb reduction (< 50 grams per day) would help with appetite suppression and possibly more weight loss. Do you think that 172 pounds is your ideal body weight?
Are you happy with your blood glucose levels post-Ozempic? I realize that this whole equation can be complicated and I am definately no expert. Good luck with your choices going forward!
I think DPAC is working on this.