Victoza for People with Type 1 Diabetes? (Continued)

When I finally started in August, I was a little nervous.

There are three approved doses with Victoza: 0.6, 1.2, and 1.8 milligrams (mg). I was motivated to lower my A1C, to reduce the variability in my blood glucose, to feel better, and to lose weight. But I never dreamt that all those things would actually happen — and in my case, so fast.

At any rate, I took my first Victoza dose of 0.6 mg. I felt nothing. No change in my blood glucose.

Though the instructions said to take 0.6 mg for one week, I ignored that and the next day I took 1.2 mg. What can I say? I'm an impatient patient. Well, I threw up the entire night!

I guess I'm stubborn as well, because when I looked at the pen the next day, I noticed I could take 0.6 mg again or that I could take a tiny bit more — there were five clicks to the pen between 0.6 mg and 1.2 mg. Presumably, the first click was 0.7 mg, the following 0.8 mg, etc. My doctor had told me to take 0.6 mg for a week, so I did that for several days and then feeling no nausea, I took 0.7 mg — although this contradicted the "official" titration schedule (titration means how you move up from a low dose to a higher dose), I couldn't help but notice on the pen that it was possible to make smaller "increases" than officially recommended. And, I assumed (correctly) that moving up more slowly prompted less nausea. I felt a little bit of nausea that first week but nothing that was a big deal.

By the time I got to a 0.9 mg dose, my glucose numbers were evening out. I was actually waking up with hypoglycemia and kept reducing my basal rate. By the second week, Gary Scheiner, my across-the-country Skype educator asked me if I was taking less insulin. I said I didn't know, and he said, "Um, one way to find out. Check your total daily dose on your pump."

I did and I gasped! Before taking Victoza, I had been routinely taking about 40 units a day, and sometimes as much as 45 units a day. But the pump told me that for the previous two weeks, I had taken between 25 and 30 units! Now, after a couple of months, my insulin intake is typically between 20 and 25 units, only higher if I have really big, high carb dinner.

I am worried about waking up high — and of late that hasn't been a problem. My numbers in the morning are often low (my CGM wakes me), or they are around 70-80 mg/dl — this is amazing!

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Last Modified Date: April 23, 2013

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by Brenda Bell
Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...
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