I’m using Levels for my blood sugar monitoring app and they have a new feature that looks at the shape of the average glucose spikes.
I started empagliflozin in July and Rybelsus in November and we can clearly see a huge improvement in the average height but even more in duration which shows an improved insulin sensitivity.
Pretty cool feature IMO!
How are you tracking your glucose?
I use the Dexcom G6 which I calibrate with a finger prick glucose meter (Contour Next ONE) which has a repeatability of 1.8 mg/dl.
So it improved once you started Empagliflozin, then improved more once Semaglutide was added to the Empa? What dosages of each are you using?
Cool stuff right here. Thanks for sharing.
Yes, SGLT2 inhibitors decrease the threshold for when the body starts dumping glucose in urine, otherwise it would be at very high blood glucose levels.
The beneficial effects is probably not related to this lowering however since other similar drugs don’t have it.
(You could just eat different or amount of foods otherwise).
I’m using empagliflozin 12.5 mg/day (25 mg pills split in 2) and Rybelsus 14mg every 3 days (eq to 3.5 mg/day).
BTW even though I’ve been using empagliflozin for more than 4 months my A1c is still 5.9~6.0 that’s why I recently added a GLP1a. I plan to switch to low dose Tirzapetide when I get it.
Are you a diabetic and is that app designed for a diabetic?
I’m not diabetic and the app is Levels. They provide GCMs (Dexcom G7 or Abbott FreeStyle Libre 3) without prescriptions to non-diabetic users.
Wow fascinating just as canagliflozin doesn’t decrease my hemoglobin a1c but I definitely pee out glucose
This is interesting. I have been looking at the SGLT2i’s for a while and like the kidney protection, and this could be another benefit. I am not type 2 and currently take tirzepatide. My concern is my fasting glucose runs about 77-78 and I have seen as low as 70 on a CGM. Would an SGLT2i be likely to lower my blood sugar too much, or would it just tamper down the peaks?
You will be peeing up to 100 grams of sugar per day depending on the dose.
That’s for diabetic, it’s usually really lower for non-diabetic people
I’ll share my limited experience.
My A1C levels are fine, but with no treatment, my spikes easily go to 180-240.
I’ve switched from metformin (which never did so much) to acarbose (that I often forget to take), and now I’ve been on an sglt2 for a month. For me, according to my cgm, it seems to work at blunting my spikes, but when I wake up, I’m still around 100, as always.
I might still be between 120-140 during a large part of my day while eating, but now I might only shoot through 140 once every day or two, vs several times per day, and it doesn’t go much higher than that, which brings me so much peace!
It will just tamper down the peaks. The glucose excretion is non linear with a threshold. If the blood glucose is below the threshold, the excretion will be minimal.
For instance in my N=1 case my A1C stayed at 6.0 with empagliflozin 12.5 mg because my liver thinks my glucose should be around 110 but, if I eat carbs, the excretion kicks in and the peaks are greatly reduced as seen in the first post.
BTW the main benefit of SLGLT2i is hypothesized to be the increase in ketones production and that’s indeed the case for me. The base glucose stays mostly the same but because there is a little bit of glucose excretion, that forces the liver to burn more fat and increase ketones.
Thanks for sharing your experience, it is helpful. Great to see it is mostly controlling levels to 140. My levels only go to about 160 when I eat muesli cereal. Most other foods I stay under 140. I am going to try it mostly for kidney benefits.
Thanks for your response. Very informative. I was just doing some research, and I am starting to get a basic understanding of SGLT2i’s. I am still trying to lose weight, so the fat burning would be a positive, along with kidney benefits, and minimizing glucose curves. Seems like another truly amazing family of medications for many reasons.
