Victoza for People with Type 1 Diabetes?
In my 24 years with type 1 diabetes, things have gotten better each year. There were great years — when rapid-acting insulin analogs were invented; when lancets changed from 25 gauge to 27 (and then 31!); when I finally realized how great wearing a pump would be; when next-gen CGM emerged — and other years when the improvements were quite small. But the trend line has always been for the better.
So I'm not really sure why this year the whole diabetic enterprise has been harder than usual. My frustration is growing. I'm more tired. I'm trying to fix things more. My blood sugar is too high, then too low, then too high.
One of my worst moments occurred when my five-year-old, Coco, was telling her friend a secret. They were in the back of the car, and Coco leaned over and whispered, "Don't worry if my mom gets frustrated. It is her diabetes and she's trying hard." She peeked up, not realizing that I heard, and said, "Mommy! Please drive! Don't worry about us."
Yes...there's just not very much I can say about that one.
But just when you think things can only get worse, something quite unexpected pulls you out. In my case, it was Victoza.
In January, the FDA approved Victoza, a once-daily injection, for use in people with type 2 diabetes. The product is part of a class of drugs known as GLP-1 receptor agonists that are best known for their ability to help the pancreas produce more insulin after eating, but have been implicated in a wide variety of other important bodily functions not necessarily related to blood glucose control. Another drug in this class is Byetta.
We have written about Victoza for diaTribe a number of times, as well as in other newsletters that Close Concerns publishes. I received an email after one of these pieces.
"Kelly, got your story about Victoza results. I have a couple friends who have type 1 who are using Victoza with astonishing success. Their sensor data show essentially normal blood sugars for days on end. Have you heard of this?"
I had not, but I promptly called my doctor and said that even though I knew that Victoza was not approved for type 1 patients, I wanted to try it. This would be "off-label use," as the jargon goes.
I want to stress that if you ever consider taking anything not approved for a specific use, you have to talk to your doctor. Your doctor can approve it, but only with careful thought and with a full discussion about the possible benefits and risks.
I was fortunate. My doctor knew the safety background of Victoza very well, and she knew that I had a hard year with my diabetes. I was thrilled that she approved my use of this new drug.
Thrilled, but also cautious, I delayed starting Victoza for some time because I had heard that this type of medicine causes nausea. I also had major work commitments, and then we were going on vacation.
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As I mentioned in an earlier post, one of the benefits that made it cost-effective for me to go with the real healthcare (HSA) plan rather than the phony (HRA) plan is that my company is now covering "preventative" medicines at $0 copay. The formulary for these, as stated by CVS/Caremark (my pharmacy benefits provider), covers all test strips, lancets, and control solutions. I dutifully get my doctor to write up prescriptions for all of my testing needs, submit...