Trulicity glp 1 for a TYPE 1.5 LADA Diabetic

Type 1 and LADA
1

Hi everyone, ive been a 1.5 LADA diabetic for about 8 years… my numbers are OK- my endo mentioned me trying Trulicity (GLP1 shot x1 week). I’ve been reading that it could kill of my beta cells quicker and make me more insulin dependent… so basically have you heard this HURTS or PRESERVES your pancreas, beta cells. Any reviews or knowledge about it. I don’t know if I should go to a 2nd endo for another opinion.

2

There isn’t hard peer-reviewed evidence on this, and while some inevitably disagree, a great many experts are convinced that the harder beta cells are made to work, the sooner they will become exhausted. Again, this is only anecdotal, but I am personally convinced that 15 years of those pills are one of the reasons I have virtually no endogenous insulin left now. I’m sure others will chime in with other opinions. FWIW.

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I’m a big believer in starting insulin once a maximum of two oral medications lose efficacy (or sooner if oral meds were never effective enough). Why delay the inevitable and why have out-of-range BGs during the delay? Makes no sense to me…

I think viewing insulin as a “last resort” for anyone with diabetes, regardless of Type, is not wise.

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+1

I have inveighed passionately and at length against the “last resort” mentality, so I won’t repeat myself here. IMO it’s pernicious, harmful, outcome-changing ****.

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I think you mean endogenous? But either way as a T1 LADA I agree with what you and @rgcainmd say.

6

The GLP-1 class of drugs are thought to preserve beta cells. This effect is thought to apply whether you are totally insulin dependent or not. For LADA there may also be a benefit if you are in the honeymoon phase and supplement your insulin with a GLP. The thought is that if you have varying insulin production, the GLP-1 may actually smooth things out.

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Correct. I can’t type today. Or any other day.

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I think the jury is still out on this. One of the things that GLP-1 does is to stimulate the beta cells to release more insulin, so absent good empirical evidence (of which there isn’t any that I’ve seen), there is still room for debate. From where I sit, it remains an open question whether they save beta cells, or stress them.