As I mentioned last week, the endocrinologist I saw suggested starting Victoza to help with my insulin resistance. Victoza was designed with type 2 diabetics in mind, but some people with type 1 are still insulin resistant. They just happened to be insulin resistant to the insulin they inject, rather than the insulin they make.
Victoza’s main role is that it stimulates the beta cells to make insulin. Now obvious, that only works in type 2 diabetes because people with type 1 diabetes don’t make any insulin at all, even with Victoza. So why would someone with type 1 take it?
Well, research also shows that Victoza decreases the amount of glucagon produced by the liver, as well as delaying the emptying of the stomach. These are similar to what drugs like Symlin and metformin do. Victoza, however, is a once daily injection, not a pill and it doesn’t need to be taken at every meal.
My doctor wasn’t sure if my insurance would cover it, but lo and behold, when I filled it at Target on Friday, it was approved and my copay was only $40! The prescription had me taking 1.2 mg via the Victoza pen, but I had read some reviews about side effects so I decided to start with the lower dose of .6 mg on Friday.
I didn’t notice any significant changes on Saturday. Erik and I had gone on a dinner cruise Friday evening and then I had a botched run because of the rainy weather, so blood sugars were crazy high most of the day. I don’t attribute this to the Victoza, of course, just poor planning. But it made me think that I might need a higher dose to see any kind of impact.
On Saturday night I decided to try 1.2 mg, just to see what happened. My overnight blood sugar level was perfect. I stayed within my threshold the entire night, which was refreshing but I don’t often get a full night of uninterrupted sleep! Sunday morning I tried another run, which went okay but then my blood sugar skyrocketed when I was done. I’ve seen this happen before, and I’m trying to figure it out. Anyway, Erik and I split a frozen pizza from Trader Joe’s as lunch, and I bolused for the 60g. But by the time I arrived at work about 90 minutes later, my blood sugar was 65 mg/dl and I still had 4.40 units on board! The rest of my shift (I work in the kitchen at a nursing home a few nights a week) had me eating and eating, and not bolusing a bit.
I knew based on some Facebook conversations with friends that my insulin intake would change, but I wasn’t sure how much to adjust my settings on my pump. My CDE Jenny Smith said that typically the basal and then the bolus ratios need to be modified. I made some small modifications last night, changing my bolus ratio from 1:6 to 1:7, my correction factor from 1:35 to 1:45 and my day-time basal from 1.4 to 1.3 units an hour. I left my overnight basal alone because it was so perfect. I didn’t want to do anything too drastic and have the opposite reaction, but I also knew that Victoza was causing a lot of changes.
This afternoon, however, I had the same problem. I had lunch with a D-friend and bolused using the new insulin-to-carb ratio. This time I went low with 2.6 units of insulin on board! Not as much, but still quite a bit of insulin that I didn’t need. We were in the middle of a long walk when it happened, and I started crashing again about twenty minutes later and had to use her juice box. Thank God I’m friends with so many diabetics!
Now, it would be awesome to eat and not have to take insulin. But as someone who has had a non-functioning pancreas for twenty years, it’s damn right freaky to eat so much food and not have a peep from the blood sugars. It was almost spooky to see my blood sugar flat-line in range last night despite not taking any insulin and eating a ton of carbs.
This afternoon I changed my insulin to carb ratio again, this time from 1:7 to 1:10! We’ll see what happens. I’m not going to change my basals again because right now I can see that my low blood sugars are directly related to my mealtime bolus.
As for the side effects that I read, so far I haven’t experienced that any. My appetite has definitely dropped significantly. I haven’t really been hungry the last couple of days, but I haven’t been nauseated enough not to eat. I probably feel the most nauseated right after I take my shot, but I do my shots at night and not in the morning as was recommended. I decided it didn’t make much sense to take the shot right before a meal if it was going to cause nausea and since it’s a 24 hour drug, it didn’t seem like it would make much of a difference when I took it.
Mostly I’m just not as hungry or interested in food, which is nice but kind of rough when you’re low and need food! Hopefully once my insulin intake balances out everything will be fine. I have had some mild headaches. But overall I feel fine, so that’s good.
While I know several people with type 1 diabetes who are on Victoza, I have had a hard time finding a lot of personal experiences. Victoza is still off-label for T1D, although there is some research — and anecdotal evidence — that Victoza could be really good for people with type 1. But I’ve seen a lot of people asking about it lately, so I’m going to share my experiences with you on a weekly basis.
You’re welcome. ;)
To know where I’m starting from, and to have some continuity, here are my current “stats”: my A1C last week was 8% (womp womp), my 7-day BG average is 212, and my weight is 214 lbs. (give or take).
I’m still learning a lot about Victoza myself and I certainly don’t have a lot of answers, but I’m happy to do investigating! I’ll be at the ADA Scientific Sessions this week, and I’m hoping to pepper the Novo team with some questions about type 1 diabetes and Victoza and see if they can tell me anything. I’ll also have access to plenty of medical professionals, so if you have questions, please ask and I will report back!