T1D and weight-loss drugs

My endocrinologist and primary care provider suggest I consider using one of the newer weight-loss drugs – Ozempic, Mountjaro, Wygovey, Zepbound, etc. I’m 73, have had T1D for 50 years, hypothyroidism, hyperparathyroidism, high cholesterol, high blood pressure and am obese. Except for hyperparathyroidism and obesity, these are managed with insulin and medications. All these conditions could be improved if I lose weight. I haven’t been successful at that over the years.
In researching these medications, the majority seem to be directed to those with T2D. Using one for T1D would be considered off label, I think. Has anyone taken any of these? Thanks you.

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May I offer some info even though I haven’t taken one of these yet? I watched the TCOYD New Standards of Care in Diabetes TCOYD® LIVE PLUS | APR 17th last week. They talk about the drugs you mention and their usefulness due to secondary benefits. So for you not only could they help you loose weight but they may also reduce your risk of heart problems.

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Thanks for the question, I’ve been curious about that too as I’m sure others have. I’ve always tended to put on weight and I’ve always been better at the exercise than the diet half of the diet-n-exercise equation. Running kept me pretty slim for a while but then started having problems with osteo-arthritis. Switched to biking, which worked pretty well. Actually took off a lot of weight during the lockdown because being laid off meant more and longer bike rides. But as I get older it seems to get less effective and I’ve been trending back up again. Sure, there’s stuff I could try to give up. For me, crunch is an essential food group, and since chips and crackers were high on the T1 no-nos list back when I was dx’d I have always substituted nuts for that most critical part of my RDA. But even though they’re low in carbs, they are high in calories (why the squirrels love 'em!). I could probably do my waistline a favor by taking them out of my diet but quality of life would take a hit. Wouldn’t it be nice if I could get a little chemical assistance, my brain thinks. I eat just about zero of processed foods and sweets, gave up sodas and beer the day I was dx’d back in the 80s. By the time carb-counting and Novolog came along I was too deeply indoctrinated in Just Say No to really embrace “Eat what you want, just bolus for it!” But over the years I’ve gradually allowed myself a couple slices of bread, a modest intake of rice, pasta, or some other starch at dinner. All that seems to count harder against my exercise regimen than it did even a few years ago. And then my close friend, who I’ve known since forever and who has always been heavier than me, and who was Dx’d T2 about ten years ago and really struggled with it, has recently been prescribed Ozempic and taken off 30 lbs. I’ve always had far better numbers in our informal A1C competition, and yet he’s now ahead. Unfair to T1s! sez my brain. “Can I get me some a that stuff?” my brain answers back.

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My take on the manic adoption of Ozempic and similar drugs as a panacea raises alarms for me. The requirement to take these drugs for the rest of your life is daunting. I’m naturally suspicious of the purity of motives by big pharma.

I’ve tried to remain quiet on this issue as I attempt to learn more. I recently came across a Dr. Mark Hyman Youtube video that impressed me by its even-handed treatment of this emotionally divisive issue.

Dr. Hyman’s guests, author Calley Means and Naturopath Tyna Moore, both do a good job of representing, at times, opposing viewpoints. I appreciate the civil tone of this discussion and its ability to find some common ground.

One thing I learned from Tyna Moore is that semaglutide (the name of the peptide in Ozempic) can be inexpensively dispensed by a compounding pharmacy. Ozempic’s patent is on the delivery mechanism, not the peptide it delivers.

This video is long (2 hours) yet held my attention for the entire time. I highly recommend its content, especially for those who are thinking about using this medication.

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Thank you. I will check out the video.

Has anyone told you that you can get gastroparesis from using drugs like Ozempic? If not, talk to your dr about it and/or do research. Many people are getting it and it is not a good thing at all. I have a mild form of it and my food was sitting at the bottom of my stomach not going anywhere, but then at 4 in the morning my blood sugar soared as my food started to move. I also had malabsorption issues and started losing muscle mass, and started suffering from malnutrition. I now have to take nutritional drinks and that brought me back from the brink. My advise to everyone is to stay far away from those drugs as many people now regret using them, but gastroparesis can never be reversed.

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Wasn’t fully aware of this. I’d always wondered what the pancreas was doing in there if it isn’t producing insulin.

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Thank you for this info.

I also am concerned about these drugs.

From what I understand, they provide weight loss for a time, but then they become ineffective. And to sustain the weight loss you’ve achieved, you have to continue taking these drugs for the rest of your life!

Plus, remember Phen phen? I wouldn’t at all be surprised if we discover in 5 years that there’s some horrible side effect of these drugs that somehow slipped past the FDA. It’s happened before.

For me I’ve found that intermittent fasting of some kind is extremely effective at blood sugar stabilization, and then weight loss happens as a side effect. That is, if you can maintain it for an extended period. This would be something like not eating between 8pm-12am every day, or restricting your caloric intake to about 500-600 calories in two non-consecutive days per week. Even if I do it for one day, I find a huge boost in the effectiveness of my metabolism. Insulin works better and my blood sugars remain rock steady. I often do it for a day if I feel like my blood sugars are “stuck”. And if you skip a day, it’s generally not a big deal. I find that the stabilization lady’s for 2 days after fasting. It’s quite remarkable.

Just remember, insulin is a fast storage hormone. The more you body requires, the more weight you will gain/retain. I’ve identified that if I take less than 70 units for an extended period, I lose weight. More than 70 and I gain/maintain my current weight.

I’m not saying there’s an easy solution, but asxac diabetic you actually have a great insight into your weight loss/gain that normies don’t have :slight_smile:

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I’ve been using Ozempic for about 2-1/2 years. Over the first year, I lost 45 lbs (I was not obese) … am now about about 19% BMI. I do love the weight loss and am absolutely stable at this weight for the past 1-1/2 years.

My insulin needs are down 30% … some to Ozempic, some to weight loss.

Mostly, I am not hungry a lot. I used to just feel hungry.

I had been diagnosed with slow gastric emptying before I started using Ozempic … and things are probably a bit slower but manageable.

I have no issues with being on a hormone for long-term. After all, I’m on insulin, with no end in sight. My thoughts … we are missing more hormones than simply insulin. Lots about this in the literature.

I take the very minimum dose and it continues to work. With all the new research about cardiovascular and kidney protection, I feel very good about having access to this hormone.

I hope I’ve covered it all … feel free to ask me any questions.

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I took earlier GLP-1s Byetta and then Victoza (liraglutide), along with insulin for almost 10 years back when I was still misdiagnosed as T2. For much of that time my pancreas was still putting out a little insulin.

One of the three ways GLP-1s help is by delaying emptying of the stomach, which lessons hunger leading to reduced calories and weight loss. I wish someone had told me to cut the food I was eating by about a third. If I had reduced food intake in conjunction with starting GLP-1s would have lessened nausea and constipation.

Back then I felt not including more education with starting GLP-1s was a missed opportunity for optimized/increased weight loss.

There has been some concern with weight loss being partly loss of muscle mass. That was definitely the case for me.

Hope it works out for you.

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Hi Terry,
I’m type 1 too but am a regular weight - 5’3, 118 lbs.
I’ve used Semaglutide with B12 (a generic
Ozempic) and find it helps to stop my blood sugar from flying too high. No spikes over 160 when I use it.

Other than the slight stabilization, did not really notice anything when using it. Wish I could give you more advice that could help. It did not do anything drastic for me but many people have found good success with it for weight loss. Used it weekly for about 4 months and stopped for a few months. Just starting again. It really does help my blood sugar stabilize.

Hope you find someone who can help more!

Thanks,
Sheryl

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You don’t have to take these drugs for the rest of your life. I used semaglutide with B12 for 4 months, took a 2 month break and just after them again. No bad side effects at all. Just help to stabilize my blood sugars - minimal spikes at all.

Sheryl

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My PCP expressed an opinion that data could surface in 5-10 years about this kind of result. Thank you for this info.

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thank you.

@Terry10 , have you discussed the side effects if thisr meds with your endo? Mine prescribed Wegovy for me for weight loss. It was my understanding that Ozempic was not approved for Type 1. (Like you I have hyperthyroidism and hypertension that are well controlled with meds. Take Crestor as preventative.) Anyway, my insurance didn’t cover it, so I gave up the idea and continued on my weight loss/fitness journey with no med to help. I was already on my way at the time. On my own, I have lost about 75 pounds. Most of it since July of 2023. I never would have imagined it was possible, but it has truly been a great experience. I’m pretty sure people suspect I used injectables, but that’s ok. I’m not going to rule them out for the future, if their benefits are worth it.

I saw the results of Ozempic in my friend who is type 2. Going on Ozempic totally changed her life. She lost about 100 and had her a1c come down to normal levels. Of course, she also has a vigorous workout schedule and tight diet. She vows to stay in Ozempic, even though she does have some side effects, like constipation. She manages that with supplements.

In the meantime, I might talk with a nutritionist with your Endo’s office. Mine was very helpful and aided me with tips for when I hit plateaus. I also do intermittent fasting and a vigorous workout schedule. And, I got Medtronic 780 pump that helps with the overall situation.

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That only refers to the endocrine function of the islets which make up a very small part of the organ. The bulk is the exocrine part producing and routing digestive enzymes to the digestive system to complete the digestion of proteins, fats and carbohydrates.

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That sounds fabulous. Do you think it’s because your digestion is slowed so that it more closely matches the action of your insulin?

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You know, I’ve thought of those kind of things too due to my 54 very long years being T1D. Sometimes wonder if I have diabetic gastritis in my digestive system where my smaller veins are clogged with sugar and not operating well.

Think it’s likely to happen after this long but whenever I bring it up to my doc no solutions are devised. All in all I’m very lucky with few problems after this long.

But thank you for the suggestion - I do appreciate the thought as it’s something I’ve thought of myself.

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This doesn’t mean I NEVER spike but the spikes are low. Am also on a low salt diet due to a diagnosis of hyponatremia and only drink 34 ounces of fluids per day. Big drag as I used to drink probably 2 lites per day.

Do find Semaglutide to be slightly beneficial with no side effects at all. Would just be careful if you give it a try - you’ll likely be able to take some weight off so you’ll need to adjust your insulin as you drop some lbs.

Brother and friend use it too - have lost 8-10 lb within a month with no bad effects. They also take a week break after 3 weeks, this works well for them too.

S.

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