I don’t think they prescribe these meds to type 1 s. The commercials make a point of that at least.
I have seen promotion of SGLT-2 inhibitors for “off-label” use in T1D, in particular at a TCOYD type one conference. It wasn’t conveyed as a blanket overly-enthusiastic endorsement of this class of drugs but the suggestion was to talk with your doctor to see if these meds might be able to help you.
I’m glad that I wasn’t enticed by this info as my glucose control without added meds has been good. This euglycemic DKA issue is daunting to me. I can’t envision many doctors willing to take the risk in this off-label Rx.
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Yep, there’s been a pretty big push for Type 1s and SGLT-2s recently. They’re actually approved in Canada for Type 1s, just not the US because of that euglycemic ketoacidosis thing. I’m not sure about other countries. The risk is actually pretty low. I was more concerned about the potential risk of UTIs than DKA. There are whispers that they might try again to get some of the SGLT-2s approved for Type 1s here in the US again, because there’s a mentality shift in the agency, and they think there’s a better chance now.
I tried Jardiance myself recently. Unfortunately, I seem to have been allergic to it. I developed horrible mosquito-bite like rashes all over my legs that I’m still scarred from, and general increased inflammation and stubborn BG because of it. And I didn’t really find it effective for reducing my TDD. I think if I was more prone to elevated BG levels and not allergic to it, it may have done more good. I just don’t think it lowers the glucose spill threshold that much. Even in the 150s, I wasn’t seeing glucose in my urine. Only once I was in the 160s, which I thought was normal anyway.
I just started Trulicity instead about 3 weeks ago, and thankfully no side effects. I haven’t titrated up from them lowest dose yet, though, so have yet to see how effective it really is. My 7, 14, and 30 day average TDD are 48.78, 51.11, and 54.41. Day 30 having no Trulicity on board, and started about a week later. I’m already seeing lower insulin doses, but haven’t done the math to see if it’s clinically significant. I wish I had written down earlier numbers, as my pump doesn’t show a delivery summary longer than 30 days.
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The spill point is for glucose into urine is 180 mg/dl. I’m pretty sure that’s why they set the high limit to180 for diabetic control.
I think it’s pretty spot of for me. But I try to stay under 160 I would target 90 but my pump is set higher. I’m usually in the 115 range most of the time.
Type 1s are not just at higher risk of DKA, but also at higher risk of kidney disease. If we are encouraging our kidneys to dump glucose, it’s also going to overwork our kidneys.
I guess it’s helpful to some, but for me it doesn’t make a lot of sense to use it.
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Does your t:connect web-based program give you total daily dose history going back longer than 30 days?
I have no clue. I can’t use Tandem’s computer software because we run Linux in this house… Because it’s safest. But Tandem didn’t support it.
I’ve borrowed a computer to run software updates.
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You can use the mobile ap. I use that.
Yes, I use it too. But the app doesn’t show delivery history. It’s mostly limited to the last day.
I’m confused. You should be able to use web access to Tandem to display your data in any supported operating system such as Linux. What won’t work are applications which need to be specifically coded for Linux.
If you have a link to something that doesn’t require me to plug my pump into the computer, I’m all for seeing it. The only computer/web-based interface I know of requires you to install the device uploader software… Which I can’t do.
You can use the Mobile ap to upload the data. Then you can see it on the website.
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I’ll ask again, link please? I know of no website for data. I don’t see it in the patient portal.
When I’m on the main Tandem website, and go to the software and apps page, then select “web application”, it redirects me to the device uploader software page… Which I can’t run.
If there’s a page that bypasses this download instruction, I’ve never been able to find it.
Edit: Oh man, strike all that out. I’ve been having the mother of all “blonde moments”. There’s just no direct link to get there anywhere on the Tandem website, just “get started” links. But I simply edited the web address to remove everything after the “.com” and it took me right to a login screen. For anyone else interested:
Since I seem to have hijacked the thread, and finally got the info I wanted… If anyone is curious: after 3 weeks of using the 0.75mg Trulicity, my average total daily dose is down by 11.14%, from 55.37 units to 49.2 units for those 3 weeks. I go up to 1.5mg on Monday, and will see if it still gets better.
Back to your regularly scheduled programming…
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Now, now, Robyn_H, since I began this thread, don’t I get a say in who hijacked it. I’ve been enjoying the somewhat tangential discussions. As my Irish in-laws would say, “Good craic” even if it wasn’t all fun and games.
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Too true! I tend to enjoy hijacked threads myself, because they can lead to interesting discussions.
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I use ketone test strips that I dip in urine in an emergency. Works for me. I was in the hospital 2 weeks ago. I had my appendix out n they were going to keep me overnight. The hospital refused to give me insulin and my blood sugars were over 400. I left the hospital and stopped at CVS on my way home and bought ketone strips. I was in crisis. I had a lot of ketones in my urine bc my highs were left untreated at the hospital. The best way to deal w ketones is not to get any. Get a CGM, I have the dexcom G6 and I love it. Keep your sugars in range and you don’t have to worry yourself about ketones.
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Did they give any reason for putting your life at risk? I feel for you. When I had a prostatectomy, I was in the hospital from Friday until Monday. I was not allowed to manage my BG. They would test a couple of times a day and if it was greater than 190mg/dl they would inject a couple of units of rapid insulin. By the time I got discharged I had blurry vision. The diabetic food wasn’t helpful either.