Endo suggested Mounjaro

Doctor was very clear there was risk. It was my choice. Doctor said safety from tests, so far, that it was very safe. Not for Type Ones.

Has a pen that looks science fictiony. Injected first time three days ago, Friday 8-5-2020. This comes in step up graduated doses, so person can acclimate, and I guess safety, determine correct dose level for the specific individual.

My thought on that being, the first month at minimal dose is not going to give me much in terms of weight loss. And I have a tough diet I have agreed to follow forty carbs per meal. Including,, eat only within a small set periods for each meal. Also included a small reduction in Novolog from 28 units three times a day in, to 20 Units Insulin. In fact, I had in mind a more restricted diet, that would have involved reducing insulin more.

For a normal person, they are concerned with calories in versus calories burned. and the dietician added also depends on the quality of food eaten.

For me it has been about I am taking so much insulin, by order of doc, and eating to match that amount of insulin to keep my blood glucose number down. Dietician seemed more willing for my Blood Glucose to be over two hundred.

Several years ago, I was told by an individual, who, told me a study revealed that of those classified as Type Two Diabetics were actually Type one. By how the drug Mounjaro works, it should be fatal to Type Ones.

What I remember reading is that there is a long titration period for ramping up to the max dose of Mounjaro. Probably for safety and giving time to acclimate. It's always good to research and understand the risks and benefits of your meds.

LADA (Type 1.5) is often early on misdiagnosed as Type 2 because insulin production has not been noticeably affected and BG levels aren't skyrocketing. There are set of antibody tests that can help determine if LADA

From the JDRF article

Less common T1D tests

Click to expand...

Because each case can be as unique as the individual, some doctors may employ the following tests to find markers of T1D to ensure the optimal treatment plan:

• C-Peptide
  While most tests check for antibodies, this test measures how much C-peptide is in a person’s blood. Peptide levels typically mirror insulin levels in the body. Low levels of C-peptide and insulin can point to T1D.
• Insulin Autoantibodies (IAA)
  This tests looks for the antibodies targeting insulin.
• Insulinoma-Associated-2 Autoantibodies (IA-2A)
  This test looks for antibodies mounted against a specific enzyme in beta cells. Both the IA-2A and GADA tests are common T1D antibody tests.
• Zinc Transporter 8 (ZnT8Ab)
  This test looks at antibodies targeting an enzyme that is specific to beta cells.
• Islet Cell Cytoplasmic Autoantibodies (ICA)
  Islet cells are clusters of cells in the pancreas that produce hormones, including insulin. This test identifies a type of islet cell antibodies present in up to 80 percent of people with T1D.
• Glutamic Acid Decarboxylase Autoantibodies (GADA or Anti-GAD)
  This test looks for antibodies built against a specific enzyme in the insulin-producing pancreatic beta cells.

Click to expand...

My understanding is that GAD Antibodies may or may not be present initially but may be there later, same may be tru with some of the other antibodies. I think upon diagnosis of type 2, they should run a C-peptide test and if low, run the antibody panel tests. I think they should also run those test for patients whose BG averages are over 140 mg/DL (7.8 mmol/L). But that's just me thinking.

Now well into using Mounjaro, dosage this week is 7.5, the third level of Mounjaro. I have lost thirty pounds or so. I am on a plateau of weight being, just out the shower and dried, to 272, for several weeks.

Diabetic/Educator, who is my go between to my Endo right now said that usually Plateaus are resolved by increasing exercise. I am pretty weak. Heart problems and three hypertension medications. Guessing I will feel even more weak as I lose more weight.

I am about to get new instructions on, Insulin Injection levels, and frankly I am not doing the diet so well. The Diabetic Nutritionist/Educator said, "No one loses weight if they drink diet soda."

Important point: "The Diabetic Nutritionist/Educator said, "No one loses weight if they drink diet soda."

One of several mistakes i have been making. I have also been consuming Glucerna (protein 30 Gram). Which from my experience, I do not lose weight. But the stuff seems to help keep my heart strongish. I will keep using it, even if it slows weight loss.

The biggest problem I have is crashing low Blood Glucose. I wake up with the alarm saying your BG is about to go to 55, better do something. So I am taking in straight carbs as opposed to dialing 911. Diabetes Educator said to maybe get some orange juice.

For a diabetic, being told by a professional to keep juices, like Orange Juice is like high comedy. One of the first things I was told one becoming a diabetic is, "If you have any juice, throw it away."

Now I have in my fridge, Grape Juice, Cranberry-Pomegranate Juice, Orange Juice, chocolate (I still insist, chocolate is one of the basic food groups.) But don't eat chocolate to make blood glucose go up. The brain really likes chocolate. (and yes, I come from a long line of alcoholics. )

At least I will get some anti-oxidants in me while this is going on.

What is happening; I need to consume so many calories to keep up with the amount of Insulin I inject. I am trying to avoid overeating, and going the other way sabotages losing weight.

For those who do not know Mounjaro keeps one from desiring food, as well as something to accelerate - something. there are three different drugs in Mounjaro. I never researched it.

I went by my doc saying, "Don't do a gastric bypass. This drug will give the same effect. This is considered to be the safest of those drugs associated with weight loss." For me it is like lose weight or start picking out my casket. Wasn't a hard decision.

The problem for Mounjaro for most people is the cost. When I started it was $1150.00 a month. There are two ways to get it without cost to me. A coupon from manufacturer. or my Medicare Part D paid for it. (I have a twist for my Medicare Part D which pays a lot of money for things. I have Traditional Medicare, with what Medicare calls 'Extra Help." Which is why I did not try to pick up some kind of other Medicare Advantage Plan, in the last year go around.) I was never told which paid for my Mounjaro Prescription. What I am referring to with the cost thing, my Endo told me after I started that most of those who apply to have their Mounjaro paid for do not get help paying for it. Obviously, only a very rich person could pay for Mounjaro out of pocket.

Mounjaro Injections do not hurt, well not much, usually.

I guess less than Insulin Injections. Which usually do not hurt at all, well I have a lot of body fat. (if you let the alcohol dry. If you don't hit muscle, or hit a blood vessel. If you don't hit a hair (an drag it down with needle) Maybe I have killed off all the nerves in the area where I usually inject.

Tomorrow I will get back to the program. Create an accurate three day list of what I eat when, what I inject when, what pitiful little exercise I do when. And will get back a reduction in Insulin suggestion.

What the Diabetes/Educator told me, that I wish was not true. Only inject Insulin once every three hours. Else it is what she called Stacking Insulin. That is in contradiction to the time honored Insulin correction dosage after meals. Like inject an amount of insulin before one eats. After an hour, do a stick, and do a second Injection for a correction dosage. No more correction dosage.

Went on to say a Blood Glucose of 250 is safer than, "Stacking Insulin." "Stacking Insulin is new to me, but she gets paid to give advice."

This is my report on using Mounjaro. Feel free to tell me what I am getting wrong, or miss understanding.

Cheers.

Now April 7, 2023.. Mounjaro dosage still at 7.5. Weight is at 250 lbs, I weigh at shower time in the morning, when my body weight is at lowest.


FYI:

One of the things which helped drive weight loss is to reduce Insulin, as before I was eating to keep my blood glucose in a above critical number. Above 90 anyway.

I recall the traditional method of weight loss is to take in fewer calories than one burns off. Taking in more insulin and thereby more carbs is not going to help lose weight.

Although, as I said elsewhere in the forum. Seems like I lose weight at night by dumping fluid from kidneys. Now I wonder what the real state of my kidneys is.

I have gone through so much frustration to get to 250 pounds, down from 300 something. Knowing the next loss of weight will be more difficult than anything before. Knowing I need to get down another 80 pounds. I do not feel real inclined to suffer more I have a lot of clothes I will need to replace. All the pants I have need a tighter belt, or they fall down. My T-shirts now fit me like a dress, going down to my thighs, rather than just below my waist.

I still do not know why my weight loss looks more like water weight, rather than fat. Or what the real state of my kidneys is.

I keep wondering when the un-expected side effect disease of Mounjaro will start, what it will be. Endo said she will not increase dosage of Mounjaro.

I keep thinking I should take less Insulin, and thereby eat less food.

Endo, and nutritionist said, "No one loses weight if they much drink Diet Coke. Drink water, or iced Tea. No artificial sweetners." I am guilty of drinking Diet Coke. Tap water is not drinkable in my house. I don't like water. My innards rebel against ice tea.

I know eating anything from a restaurant or eating frozen prepared entrees keeps my blood glucose up. i must suspect my diabetic blood glucose levels sensitive to food preservatives.

I am a lazy cook, person. Microwave or sandwich.

Nutritionist said that a weight plateau is solved by more exercise. Yeah. a little exercise. ten minutes slow on a stationary bike. Left hand side of my chest hurts, later in the day.

My choice of Cardiology is very limited because of Medicare payment rules. No one wants 80 percent of Medicare payment amounts for full payment for services.

Problem is frustration. In the last year of suffering. I have lost less weight than I still need to lose.

I used to know this guy who was depressed. He told me: "I hate success stories. Everyone thinks they can help me by telling me about someone who overcame their circumstances by effort and hard work. Success stories are just are really saying I have not been trying. If you are going to be my friend, keep that [email protected]#p to yourself."

For those using calories in / calories out method to lose weight, it only equal weight loss if the mass of calories in is less than the mass of calories out. Michael Eades explains that best here. If cutting food, cutting carbs would be biggest benefit to reduce insulin. But if doing that give s you less energy, you probably are also being less active. You could add some healthy fats to increase energy without an increased need for insulin.

Increasing exercise does increase calories out, if you can increase exercise. If you can't increase exercise, you can still burn more calories by spending more time up on your feet doing anything than spending time just. sitting and moving around burns more calories than just standing.

Would the reduced costs of buying diet sodas over time cover the cost of a Pur or Zero Water or other brand of a decent water filter to make your tap water more palatable?

mbuster said:

Would the reduced costs of buying diet sodas over time cover the cost of a Pur or Zero Water or other brand of a decent water filter to make your tap water more palatable?

Click to expand...

That's something I thought of as well. Or buy bottled water. What the hey; diabetes costs us so much already; what's one more accommodation if it helps us avoid some side effects?

As for the weight loss, I lost 60 pounds on keto fairly quickly. The remaining 30-40 pounds? It's been a tough road, partially because of COVID lockdowns leaving unappealing exercises like walking around in 5* F weather or using a treadmill or bike-on-trainer (which my wrists and hands hate) and partially because I've gotten a little burned out on my usual diet and I started "experimenting." The resulting stall then had me trying different things: eat a bigger breakfast but a lighter dinner, eat some foods that contained less-keto-friendly ingredients but at least weren't much the same meal as yesterday and the day before, eat an earlier dinner and a snack before bed (good for BG; not so good for calorie intake).

I'm still losing weight but it's more like a pound or two a month, not four or five. I tell myself that at least I'm not gaining it back and that I'm better off for the 60 pounds I lost. That I haven't lost those last pounds could be my metabolism speeding downhill as I hit my mid-60s or my body is just at some stasis point because almost nothing I do seems to make me gain or lose weight like I did. Or something else I haven't discovered yet. I'll stick with the healthy outlook that I've lost a lot of weight, which is good for me, and lean a little on the Law of Attraction to maybe shed some more. You can only do what you can do.