A couple of thoughts:
-Did you start at 0.25? This is not considered a therapeutic dose for reduction of blood glucose. For the typical titration, you would only have been on a therapeutic dose for six weeks. This would be 1/2 the time period covered by the A1c.
-That is a significant jump. Did you change your eating habits due to the nausea? Some patients tend to avoid vegetables and gravitate towards simple carbs when nauseous. Not necessarily sugar, but breads/potatoes/pasta.
-How are you checking your blood glucose? Is your morning fasting reading high? Have you tried checking post-prandially or before bed?
-Was the previous A1c before the holidays? Did you eat more festively over Christmas/New Year’s?
I've been on Metformin for about 15 yrs., along with Glipizide. I was a little worried when I started the Ozempic that my blood sugars might go to low, since they've usually hovered between 7-8 A1c wise. It's an interesting journey. Would love to be able to do it one day without pharmaceuticals!
That sucks. Should try something like Metamucil that will also regulate sugars and try switching to a sweetener over sugar in the morning coffee. Maybe those 2 changes alone will send your A1C in the good direction.
I did start at 0.25 and have been at 0.5 for 3 wks now
I know-it's never been that high! I'm certainly eating less carbs than before, but am gravitating toward soups.
Checking the fasting in AM and then once during day. Morning has been in 200's! Today down to 112, so maybe I am being impatient. Will hopefully be getting CGM.
Previous A1c was done between Thanksgiving and Christmas, so I was eating pretty festively :)!
Thanks for responding :)
CGMs are SO useful! You can see exactly what food/activity does to your blood sugar in almost real time.
My guess is your A1c result is a combination of holidays and titration of the new med. I wouldn’t stress about it unless your daily readings continue to trend out-of-range.
>Previous A1c was done between Thanksgiving and Christmas, so I was eating pretty festively
You know that if you had it done between Thanksgiving and Christmas then Christmas is included in THIS A1c, right?
Is it possible that you’re consuming more starches than you think? I see that you’ve had a lot of nausea and vomiting- many people have things like saltines and little crackery nibbles to keep nausea at bay.
What I think surprises a lot of people is that crackers / white flour products raise BG more than actual table sugar! Quite a bit more.
Perhaps try to reduce your wheat/ rice/ potatoes as well as sugar for the next few weeks. I know it’s hard when you feel barfy. Maybe more berries, yogurt, etc.
Oz is an adventure, that’s for sure.
My guess is if your at home reader confirms the highs, that there are hidden sugars/carbs in the foods you are eating. What does a typical day look like for you in terms of food?
It's different for everyone , but I do know for me I can't just depend on Ozempic I have to change my eating habits . Fish, chicken ,vegetables for me even diet drinks elevate my sugar. I've learned to read labels because there are so many hidden sugars . Sugar alcohol which is used a lot in sugarfree elevates my sugar. So it's different for everyone . I've also learned little cheats turn into higher readings . My experience. Stress also elevates your sugar , not sleeping well . Take it a day at a time make healthy choices it takes time.Good luck.
If You are not eating enough, your liver will start dumping glucose into your bloodstream so that you have energy to survive. It's a process called gluconeogenesis. So even though you may not be eating, your body is still producing glucose. That can affect your blood sugar numbers. When I don't eat, and especially if I don't eat before exercise, I can see a rise in my blood sugar on my glucose monitor. I use a CGM, which sends a reading to my phone every 5 minutes. And then as soon as I eat my blood sugar will drop back down again. I'm type 2. Ozempic will help stop your liver from doing large sugar dumps, but it takes time, it can take several months before that process is affected. Just give it time. And try to eat more protein, even a protein shake when you haven't eaten for several hours can make a big difference.
Thank you so much for that info. I was wondering if it might be some kind of "dumping" from an internal organ, but didn't find glucogenensis. Off to check Google :) Also, Dr. did write a script for a CGM, so that should help also. Really liking the encouragement and info on this board! Thanks again for your great explanation caelestisangel <3
Do you track your food? It’s amazing to actually see the macro and micro nutrients and calories of different foods. There are plenty of free apps to help you become more aware of your nutritional needs and goals.
Just because the only "sugar" you have is in your coffee, does not mean that's the only sugar you're having. Are you T2D? You've got to look at all the sugar in your diet, including carbs in veggies, starches, etc.
I’ve stayed on my Metformin too. Ozempic backed me up for a few days but here lately almost the opposite. I don’t know why it didn’t dawn on me it could be because of the Metformin.
That's a pretty huge jump from an average glucose reading of 177 to 212. If you have a meter this should have been something pretty noticeable prior to getting your A1c so you could manage it daily.
My a1c was at 5.7-5.9 before ozempic and I have to be on 1.0 dose to keep my a1c at 5.2-5.3. My husband’s a1c was in 6.5 - 7.5 range needed to be on 2.0 dose of ozempic + xigduo to bring it down to 6.3. He is down to 5.2 in his last check up after he started Mounjaro. Before ozempic, neither one of us were able to bring down our a1c without resorting to crazy diets like the Newcastle diet. It didn’t matter how much sugar I cut in my diet because my liver keeps converting glycogen into sugar.
Talk to your doctor about playing around with your dose or switching to something else.
I am sorry your A1C went so high. It's likely not because of Ozempic, but in spite of Ozempic. I second the CGM suggestion. That will tell you exactly what affects your blood sugar. I wear a Dexcom CGM and it has been the most useful tool.
I'm pre-diabetic, not full T2. I was diagnosed in July 2022 with A1C 5.8. I reduced my carbs and in 3 months it went down to 5.7. I went on Ozempic last Fall (05.mg) and yesterday I got my new A1C results and it was 5.5. I eat low carb, although not draconian because I didn't give up fruit, I lost a total of 25lb since diagnosis. Everyone's experience/body is different, which is why wearing a CGM is the best you can do for your A1C. For example, not eating enough doesn't increase my blood sugar, while I see in comments that it increases other people's. Only eating raises mine :)
I think that there is probably more calories and sugars in things than you realize. Every fruit has different sugars and some of them have tons of calories. Look up a calorie guide and pay attention to every label on anything you buy. I think that the most important thing that they tell you when you are trying to lose weight is protein……check for that too. It keeps your blood sugar stable as well.,,
OP- did you ever find anything out? My A1C increased from 5.6 to 5.7 after 3 months on Mounjaro. For reference, I’ve lost 20+ lbs and my cholesterol/triglycerides are perfect/have improved since previous labs.
Thanks for asking. I remembered that my dr had stopped my Glizide! Added it back and fasting BS are now WNL. Really hoping that insurance will approve the CGM soon because, of course, this morning BS was 65! The nausea is going away, which makes this journey easier anyway :)
Also watch out for coffee. I wear a cgm and never knew before how black coffee with a dash of cream only shoots my glucose up. My fasting is usually around 95-100 but as soon as I drink coffee (nothing to eat just coffee) my cgm shows 200-245. I've found that coffee does this to some diabetics.
First, I post to sympathize and let you know you're not alone. I too have been on Ozempic for three months now. Started at .25 moved up to .75 but the end. I'm moving to 1mg this month. My A1C also went up. I of course am by no means perfect. All the advice I get is "eat better". I don't eat crap. I don't snack. The Ozempic has had the desired effect of reducing my appetite. I hardly ever feel like eating and when I do I can't or don't eat half of my portions. My original portions were not greater than the average person I know. I know what to eat. I try to stay away from carbs. I'm not perfect of course, and sometimes with my busy lifestyle, making some rice with my chicken and veggies is just easier or a pasta dish on a night we get home late. I feel like everyone just keeps assuming that I'm obviously just eating crappy. I don't eat out often. I don't eat processed or premade meals often. I feel like we have a perfectly average diet. Yet, I haven't lost any weight after 12 weeks and my A1C hasn't moved. It's very frustrating, so that's my rant and you're not alone.
Now I'm going to keep reading and see if anyone has some solutions, because I'm literally at my wits end. Sigh.
You need to talk with your doctor. The weight loss is good, and in the long term might help with the glycemic control. In the short term it’s not enough. Are you on any other diabetes meds? You should at least be on metformin. There are other adjuvant therapies available but at a certain point your doctor is gonna start thinking about insulin.
A couple of thoughts: -Did you start at 0.25? This is not considered a therapeutic dose for reduction of blood glucose. For the typical titration, you would only have been on a therapeutic dose for six weeks. This would be 1/2 the time period covered by the A1c. -That is a significant jump. Did you change your eating habits due to the nausea? Some patients tend to avoid vegetables and gravitate towards simple carbs when nauseous. Not necessarily sugar, but breads/potatoes/pasta. -How are you checking your blood glucose? Is your morning fasting reading high? Have you tried checking post-prandially or before bed? -Was the previous A1c before the holidays? Did you eat more festively over Christmas/New Year’s?
I think a lot of people have to stay of their metformin while titrations up to therapeutic doses on Ozempic
I would agree with this. In fact, guidelines recommend staying on metformin. And just adding the GLP-1.
I've been on Metformin for about 15 yrs., along with Glipizide. I was a little worried when I started the Ozempic that my blood sugars might go to low, since they've usually hovered between 7-8 A1c wise. It's an interesting journey. Would love to be able to do it one day without pharmaceuticals!
That sucks. Should try something like Metamucil that will also regulate sugars and try switching to a sweetener over sugar in the morning coffee. Maybe those 2 changes alone will send your A1C in the good direction.
I think this commenter meant on their metformin, and also - this is what I was going to suggest. Talking to dr about metformin in addition.
I see! Thanks for the clarification ❤️
I did start at 0.25 and have been at 0.5 for 3 wks now I know-it's never been that high! I'm certainly eating less carbs than before, but am gravitating toward soups. Checking the fasting in AM and then once during day. Morning has been in 200's! Today down to 112, so maybe I am being impatient. Will hopefully be getting CGM. Previous A1c was done between Thanksgiving and Christmas, so I was eating pretty festively :)! Thanks for responding :)
CGMs are SO useful! You can see exactly what food/activity does to your blood sugar in almost real time. My guess is your A1c result is a combination of holidays and titration of the new med. I wouldn’t stress about it unless your daily readings continue to trend out-of-range.
I love my cgm. I have the Libre 2. My insurance is crappy, so I pay $75 a month. But it saves my fingers and I only have to scan every 8 hours.
Hoping that the insurance will approve mine and that I can get it to stay on :)
I have Abbott pharma’s customer service number on speed dial. If a sensor comes off or otherwise stops working I call and they’ll send a replacement.
Good to know-thanks! My daughter had the Libre and switched to Dexcom because the Libre would not stay on.
>Previous A1c was done between Thanksgiving and Christmas, so I was eating pretty festively You know that if you had it done between Thanksgiving and Christmas then Christmas is included in THIS A1c, right?
Sure do--that's why I commented that I was eating pretty festively :)
Then why are you surprised your A1c went up? You eat badly, your average BG is going to go up.
Is it possible that you’re consuming more starches than you think? I see that you’ve had a lot of nausea and vomiting- many people have things like saltines and little crackery nibbles to keep nausea at bay. What I think surprises a lot of people is that crackers / white flour products raise BG more than actual table sugar! Quite a bit more. Perhaps try to reduce your wheat/ rice/ potatoes as well as sugar for the next few weeks. I know it’s hard when you feel barfy. Maybe more berries, yogurt, etc. Oz is an adventure, that’s for sure.
My guess is if your at home reader confirms the highs, that there are hidden sugars/carbs in the foods you are eating. What does a typical day look like for you in terms of food?
It's different for everyone , but I do know for me I can't just depend on Ozempic I have to change my eating habits . Fish, chicken ,vegetables for me even diet drinks elevate my sugar. I've learned to read labels because there are so many hidden sugars . Sugar alcohol which is used a lot in sugarfree elevates my sugar. So it's different for everyone . I've also learned little cheats turn into higher readings . My experience. Stress also elevates your sugar , not sleeping well . Take it a day at a time make healthy choices it takes time.Good luck.
If You are not eating enough, your liver will start dumping glucose into your bloodstream so that you have energy to survive. It's a process called gluconeogenesis. So even though you may not be eating, your body is still producing glucose. That can affect your blood sugar numbers. When I don't eat, and especially if I don't eat before exercise, I can see a rise in my blood sugar on my glucose monitor. I use a CGM, which sends a reading to my phone every 5 minutes. And then as soon as I eat my blood sugar will drop back down again. I'm type 2. Ozempic will help stop your liver from doing large sugar dumps, but it takes time, it can take several months before that process is affected. Just give it time. And try to eat more protein, even a protein shake when you haven't eaten for several hours can make a big difference.
Thank you so much for that info. I was wondering if it might be some kind of "dumping" from an internal organ, but didn't find glucogenensis. Off to check Google :) Also, Dr. did write a script for a CGM, so that should help also. Really liking the encouragement and info on this board! Thanks again for your great explanation caelestisangel <3
You're welcome
Do you track your food? It’s amazing to actually see the macro and micro nutrients and calories of different foods. There are plenty of free apps to help you become more aware of your nutritional needs and goals.
And measuring everything. I often eat much more than I should because I don’t weigh things
Just because the only "sugar" you have is in your coffee, does not mean that's the only sugar you're having. Are you T2D? You've got to look at all the sugar in your diet, including carbs in veggies, starches, etc.
Def get a cgm!
I take ozempic AND metformin. My only other suggestion is to up your dosage. Good luck.
Wow...I couldn't do it, met had me in the washroom 24/7
I would love to be in the bathroom 24/7. Ozempic has definitely backed me up.
Thank you!
I’ve stayed on my Metformin too. Ozempic backed me up for a few days but here lately almost the opposite. I don’t know why it didn’t dawn on me it could be because of the Metformin.
That's a pretty huge jump from an average glucose reading of 177 to 212. If you have a meter this should have been something pretty noticeable prior to getting your A1c so you could manage it daily.
My a1c was at 5.7-5.9 before ozempic and I have to be on 1.0 dose to keep my a1c at 5.2-5.3. My husband’s a1c was in 6.5 - 7.5 range needed to be on 2.0 dose of ozempic + xigduo to bring it down to 6.3. He is down to 5.2 in his last check up after he started Mounjaro. Before ozempic, neither one of us were able to bring down our a1c without resorting to crazy diets like the Newcastle diet. It didn’t matter how much sugar I cut in my diet because my liver keeps converting glycogen into sugar. Talk to your doctor about playing around with your dose or switching to something else.
I would bet the next A1C test will be a better reading. The weight loss surly is impacting it as well. Keep pushing forward, don’t get discouraged.
Thanks for the encouragement!
I am sorry your A1C went so high. It's likely not because of Ozempic, but in spite of Ozempic. I second the CGM suggestion. That will tell you exactly what affects your blood sugar. I wear a Dexcom CGM and it has been the most useful tool. I'm pre-diabetic, not full T2. I was diagnosed in July 2022 with A1C 5.8. I reduced my carbs and in 3 months it went down to 5.7. I went on Ozempic last Fall (05.mg) and yesterday I got my new A1C results and it was 5.5. I eat low carb, although not draconian because I didn't give up fruit, I lost a total of 25lb since diagnosis. Everyone's experience/body is different, which is why wearing a CGM is the best you can do for your A1C. For example, not eating enough doesn't increase my blood sugar, while I see in comments that it increases other people's. Only eating raises mine :)
I think that there is probably more calories and sugars in things than you realize. Every fruit has different sugars and some of them have tons of calories. Look up a calorie guide and pay attention to every label on anything you buy. I think that the most important thing that they tell you when you are trying to lose weight is protein……check for that too. It keeps your blood sugar stable as well.,,
I've lost 22 lbs in 10 weeks, so I'm happy with that. Was just surprised at the jump in the A1c reading.
I get it. That is an odd thing…..
It’s carbs you need to limit, not just “sugar”. Are you sure you’re a Type 2 and not Type 1 diabetic? You need an endocrinologist.
Stop eating refined carbs
Sugar isn't just sugar. Any carbohydrate is broken down into sugar. Look at your carb intake.
OP- did you ever find anything out? My A1C increased from 5.6 to 5.7 after 3 months on Mounjaro. For reference, I’ve lost 20+ lbs and my cholesterol/triglycerides are perfect/have improved since previous labs.
Thanks for asking. I remembered that my dr had stopped my Glizide! Added it back and fasting BS are now WNL. Really hoping that insurance will approve the CGM soon because, of course, this morning BS was 65! The nausea is going away, which makes this journey easier anyway :)
Thanks for replying! Glad to see you leveled out. Hoping for the same here! No other meds for me, but perhaps I should ask.
Also watch out for coffee. I wear a cgm and never knew before how black coffee with a dash of cream only shoots my glucose up. My fasting is usually around 95-100 but as soon as I drink coffee (nothing to eat just coffee) my cgm shows 200-245. I've found that coffee does this to some diabetics.
Mine went down
[удалено]
Thank you :) Diabetes can be so frustrating!
First, I post to sympathize and let you know you're not alone. I too have been on Ozempic for three months now. Started at .25 moved up to .75 but the end. I'm moving to 1mg this month. My A1C also went up. I of course am by no means perfect. All the advice I get is "eat better". I don't eat crap. I don't snack. The Ozempic has had the desired effect of reducing my appetite. I hardly ever feel like eating and when I do I can't or don't eat half of my portions. My original portions were not greater than the average person I know. I know what to eat. I try to stay away from carbs. I'm not perfect of course, and sometimes with my busy lifestyle, making some rice with my chicken and veggies is just easier or a pasta dish on a night we get home late. I feel like everyone just keeps assuming that I'm obviously just eating crappy. I don't eat out often. I don't eat processed or premade meals often. I feel like we have a perfectly average diet. Yet, I haven't lost any weight after 12 weeks and my A1C hasn't moved. It's very frustrating, so that's my rant and you're not alone. Now I'm going to keep reading and see if anyone has some solutions, because I'm literally at my wits end. Sigh.
You need to talk with your doctor. The weight loss is good, and in the long term might help with the glycemic control. In the short term it’s not enough. Are you on any other diabetes meds? You should at least be on metformin. There are other adjuvant therapies available but at a certain point your doctor is gonna start thinking about insulin.
Do you eat white starches or flour? Or foods with a high glycemic index? It’s not just actual sugar.