Triannual Visit

[Tamra11]

This was originally posted to my blog, Diabetes Odyssey.

I had my last triannual (every four months) endocrinologist visit of 2015 today. It went better than expected.

First, I was expecting my A1c to have skyrocketed considering the terrible time I’ve had keeping my blood sugar down lately. I was happy to hear it only rose from 7.4 to 7.7. I can live with that.

Second I was very happy to hear I do not have Hashimoto’s (an autoimmune thyroid condition). The tests came back in great range.

My liver and kidneys look good as well.

Then the doctor asked me “How have you been doing?”

I responded honestly (it does no good to lie, even if you feel bad, ashamed, guilty, or whatever) by telling her I haven’t been doing good at all. I have been having a ton of trouble keeping my BG’s down for multiple reasons. I told her about the unexplained very stubborn highs throughout October and half of November. But, I explained, my worst trouble is the deep depression I have fallen into due to the extra weight I’ve packed on this year. It has totally ruined me emotionally. I have all but given up on good BG’s because of the insulin resistance and weight gain.

“I eat about 1100 calories a day and keep my carbs below 20 for the most part. I may not get enough exercise, but there is absolutely no reason in my lifestyle that I should be this heavy and not be able to lose anything.” I told her.

“I absolutely agree.” She then agreed to raise my Metformin dose. And she went on to suggest to me three other options on treating my insulin resistance and help to lose weight.

One is a pill that is made for weight loss, treats depression, and helps with insulin resistance. Contrave I think is what it’s called.

Another pill she mentioned is made for type 2 diabetics but can be used by type 1’s as well and can help with weight loss. It works by forcing the body to spill more sugar through the urine. Farxiga, I think is what it is called.

The third is an injected medication formulated for type 2 diabetics (insulin resistance). “But it can be used off label for type 1’s to help with weight loss and insulin resistance.” She explained. Victoza, I think is what she was talking about.

Don’t quote me on the drug names above, a lot of names were being tossed around and I may have gotten confused.

She did not prescribe any of these, yet. She first wants to see how well I respond to the increased dose of Metformin.

Things are looking up. Hopefully I can kick this resistance and weight problem in the butt now.

[busybee]

Hi @Tamra11,

I have to share that after my third child’s birth, I gained a lot of weight during my daughter’s pregnancy but I also consumed more calories for breastfeeding. The problem was, I wasn’t really keeping track and I was eating too much. I have Hashimotos Hypothyroidism too. During that time, my thyroid decided to go crazy slow.
I had the worst insulin resistance I’ve ever encountered. It was so bad that I went through 3 different types of infusion sets for my pump. I also went back to shots and nothing seemed to get my blood sugar down.
I was baffled why all this was happening to me. My BGs during pregnancy were fantastic- my alc was 5.7.
I love working out and nothing helped. I was killing myself. I first changed insulins. I was on Novolog and changed to Humolog. That helped a little but still needed tons of help. I went on Symlin, that didn’t work.
My endo finally suggested Farxiga, but I did research and requested Invokana. In the research, I found very small but evidence of bladder cancer in patients who took Farxiga. I did not find the same thing for patients who took Invokana. These meds were a miracle for me. I lost 25lbs in 4 months. I kind of took a break from working out during this time to see how the meds would react with my body chemistry. I wasn’t working out and I was losing weight. It helped out my thyroid, which eventually came back into range. My alc was 7.5 before I started the meds and I dropped to 7.0. My insulin basal and bolus intake reduced a little too. I had way more energy.
You have to drink a lot of water should you decide to take it, but I truly hope that it helps you as much as it helped me. It was exactly what I needed at the time. Let us know how things unfold with whatever you decide to take.

Busybee

[Tamra11]

Thanks, your experience gives me hope!

[Sally7]

Tamara- So happy to hear your doctor actually asked how you were doing and than actually listened and had a conversation with you about it. So very refreshing to hear after some of the stories told here.
Just to let you know I also had one of those conversations with my endo. I also want to lose some weight, and to try and get rid of those post meal spikes. I asked about Invokana and he was not to sure about it and some of the DKA issues and yeast infection problems. But he suggested maybe we could try Victoza. So I got some samples and gave it a try. Much better results than Smylin that I had tried earlier. Been using it for about 4 months. I’ve lost about 10 pounds and that is mainly because I’m just not hungry. Many times I have to force myself to eat. Also feels like my stomach is smaller because a full sandwich use to be ok and now all I can handle is a half a sandwich. Post meal spikes are better and I am taking less overall insulin. My A1C has dropped .4 % to one of my lowest numbers post pregnancies. Not sure if the Victoza is the answer for you but it seems to be working for me. Dropped a pant size also. Yippee! I know many have had good luck with Invokana with some big weight loses. Good luck with which ever way you and your doctor decide to go. No right or work until you try it.