Type 1 and GLP-1 RAs

I’m really interested in lowering my total daily dose of insulin without excessive diet modifications. I’ve gained about 10 lbs in the 4ish years I’ve been on a pump, and I’m sure it’s because of all the insulin I’m taking and not lifestyle choices. I’m becoming quite insulin resistant despite my small size. I’m not interested in a ridiculously low-carb diet. I do best with moderate amounts of carb, and usually come in under 100g per day.

For about 18 months I’ve been taking Metformin, and it does seem to help, but minimally so and it doesn’t seem consistent. I’ve been reading up on GLP-1 RAs, and think I’d like to switch, but I’d love feedback from other type 1s who’ve tried them… And hopefully some who have tried more than 1! The data is virtually non-existant for Type 1s, but I know some practices are recommending them.

Is there a preference? Rybelsus sounds by far the best, being oral, but it’s not preferred by my insurance and I’m not even sure I could get the prior authorization after trying all the preferred ones under deeper scrutiny, being type 1. My options are pretty much between Victoza (once daily injection) and Trulicity (once weekly). The other option is getting discounted. I’m all for reducing the number of injections, but I’m concerned that some people actually gained weight in Trulicity’s clinical trials… but maybe they’re exceptions to the norm?

Thanks!

Did you look at the video on new oral meds for type 1’s hitting the market? Let me see if I can track it down again…hold on.

Here it is…Fight Night: An SGLT SmackDown - YouTube

I did see that. They’re actually the ones who have me hyped up about the GLP-1s after participating in the TCOYD virtual conference last week. There was a lot of focus on the GLP-1s moreso than the SGLTs because of the higher risks associated with them. Nearly everyone who presented at that conference was very pro GLP-1 for Type 1s and wishy-washy about the SGLTs.

I found this interesting and may discuss with endo at next appt.

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@Robyn_H Victoza was tough for me for the first few weeks, then great for 2-3 months followed by what felt like ineffectiveness. Went off Victoza for a month and started again. I did this cycle for 2 1/2 years with little to show for it. Currently I’m trying Ozempic off label. This has been much more effective and I use a copay card to reduce my cost since it’s a Tier 3 insurance item for me and not financially feasible otherwise. Efficacy-wise I much prefer it to Victoza or Byetta.

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Thanks @El_Ver! Unfortunately that’s another unobtainable one for me thanks to my weird insurance. (An “in-house” option through my Med Center to help the farmers and ranchers in this area who don’t qualify for state assistance, but otherwise couldn’t afford medical insurance.)

I have a wonderful doctor who one day asked me what the 3 things that frustrate me the most right now about my diabetes. Mine were trying to lose some weight, post meal spikes and insulin levels. We talked about all the different type 2 drugs and discussed pros and cons. I went with Victoza. I didn’t do pills because the possibility of yeast infections just really turned me off. Peeing out all that sugar and causing those yeast infections brought back horrible memories of my early years. So we went with Victoza. I have no problem with a shot every day. so it was easy. Many have stomach issues but mine were very mild and I haven’t looked back. Over the few years using it on and off due to clinical trials I have lost almost 40 pounds, reduced my insulin levels and CGM graphs have smoothed out. I love it because I have a very reduced appetite with it. I am just not hungry.
There are a lot of options out there and it is great when I hear of doctors willing to give something else a try. I hope you can find something that works for you.

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