Over the past four months, in the dessert department, I’ve had a grand total of two brownies, one truffle and zero cookies. My eating these past months has been super clean and very healthy. I feel really good about my focus on portion control and food management. I’ve been tracking my calories in MyFitnessPal diligently.
Sadly, the pounds are not coming off. My top weight as I mentioned in an earlier post, was 180 pounds. As of this morning, my weight is 170 pounds. Given my focus and my attention, dropping only 10 pounds in four months is discouraging.
In my favor, I am resourceful. I reached out to Integrated Diabetes Services, which is owned by the Think Like a Pancreas author and amazing human Gary Scheiner, and my longtime TeamWILD friend Jennifer Smith, RD, LD, CDCES to see if she had any ideas about who I might work with for help losing weight.
Having type 1 diabetes and weight loss is not simple. Jenny suggested I work with Dana Roseman, RD, CDCES, RDN, LDN who has a deep background in type 1 diabetes and weight loss strategies.
After my first consultation with Dana I cried.
Tears of joy combined with the deep relief of finally talking with someone who understood the daily challenge of diabetes, athletics, and weight management. Dana asked me all kinds of questions about my weight over the past 15 years, along with probing questions about my diabetes management, my exercise habits and my eating.
Positive affirmations
Telling Dana about how much I consistently exercise and about how much attention I pay to what foods I put in my mouth was affirming. In the telling, I realized I do eat well. I do have a consistent exercise routine that is year round. I pay a lot of attention to my diabetes management.
And all that said, type 1 diabetes is a difficult condition to manage. I often feel very alone with my diabetes. Having Dana listen so attentively and then offer spot-on insights made me realize I am not alone. The aloneness hovers around because diabetes is something I think about nearly every hour of every single day that I’m awake. It’s not something I discuss very often, it just is a constant continuous conversation I am having within myself.
Find help to untangle
Talking to Dana reminded me there are people who can support me in untangling the challenges of living well with diabetes. Dana herself lives with type 1 diabetes AND she is an endurance athlete! Perfect combination of understanding.
Dana took a look at my insulin pump and continuous glucose monitor reports and she correctly noticed that I was having a lot of low blood sugars followed by rebound high blood sugars. I agreed, this is something I regularly struggle with.
She also asked me if I’d ever taken Victoza. Victoza is a medication that mimics the hormone GLP-1 in the body. GLP stands for glucagon-like peptide. Victoza is marketed as a type 2 diabetes drug, however over the past ten years it has become an acceptable drug for people with type 1 to take.
More Time-In-Range
As a person with type 1 diabetes, my body doesn’t make insulin or glucagon. The idea with taking Victoza is to gain more time-in-range. Time-in-range means more time in a 24 hour period that my blood sugar is in the range I designate. My ideal range is between 70 and 145 mg/DL.
A positive side effect of more time-in-range is it allows the body to drop weight, in part because the body can more effectively use the insulin in circulation. In addition, Victoza is an appetite suppressant, which is handy in the desire for weight loss.
I had taken Victoza for about 8 months about five years ago and it worked well for me. Then my health insurance stopped covering it and Victoza is not an inexpensive drug, so I stopped taking it.
Victoza works
Dana suggested I see if my current health insurance would cover it. Together we realized that my weight five years ago was better than it is now. We hypothesized that my weight hasn’t creeped up more in those five years because I pay so much attention to what I eat and to how much I exercise. But I’ve been fighting an uphill battle after going off the Victoza. Realizing this was a relief. I felt like a rock was lifted off my shoulders. The light at the end of the tunnel flicked on.
I found out that my health insurance will cover Victoza and a day later, I got a prescription for it and started titrating slowly up to the designated dosage of 1.2 mg as a daily injection. As of today, I’ve taken Victoza for one month. I haven’t lost any more weight yet, but I can tell that my appetite has decreased. I’m taking almost 20% less insulin via my insulin pump and best of all, my blood sugar is time-in-range 70% of the time and that’s, so far, a 2% increase from the month before.
Once a week or daily – I pick once a week
The goal is to work my way up to the maximum dosage of 1.8 mg. The reason for that is that when I get to that amount, I can more easily transition to the once weekly injection of essentially the same drug that is called Ozempic. I don’t hate taking a daily shot, but I confess, I don’t love it. Taking one shot a week is a much better idea to me! After all, ease and comfort in life is worth quite a bit in my humble opinion.
Side effects
I feel fortunate that I have very few side effects. I have a small amount of nausea, but nothing terrible and it usually passes with ease. Some people do struggle with Victoza. Many people who do struggle, say that the struggles are worth it as Victoza really works. Here’s a post by Amy Tenderich where she discusses the various discomforts of Victoza.
Low blood sugar danger
The other big challenge with Victoza is that it can make treating low blood sugars more challenging. I experienced this last week when I met my friends to go on a 5 mile run. My fractured rib felt okay, which I was very happy about, but my blood sugar was just too low and despite eating a bunch of Smarties (for the dextrose) and a bag of Jelly Belly Sport Beans, and walking more than running, my blood sugar wouldn’t come up. I was super nervous about the low blood sugar and I only ran/walked 4 miles.
This was one of my questions for Dana when we talked last Monday.
30 day report of my continuous glucose monitor More two day reports like this are in my future! This was the tracing for my 5 mile run using strategies below!
How can I run and manage my blood sugar while taking Victoza?
Here’s the strategy I tested this week and it was a huge success! Tomorrow, I’m going to run 7 miles! YES! Half marathon here I come!
Victoza/Food Strategy for run days
Action 1: Two hours before the run will start, turn the Activity setting on, on my Tandem t:slim X2 insulin pump that uses Control-IQ technology.
Action 2: Eat my normal 32 gram carbohydrate breakfast of chia seeds, flax seeds, protein powder, cinnamon, cardamom, coconut flakes with fresh blueberries on top about 1.5 hours before the run will start. Take ZERO insulin for this meal!!! The idea being to have as little insulin-on-board as possible.
Action 3: Monitor my blood sugar during the dog walk I do with Sam before departing for the run. Eat Smarties if needed. Carry a juice box just in case.
Action 4: Go run with confidence, extra Smarties and a small water bottle in my fabulous Flipbelt! Enjoy every step of the run!!
Thanks for reading this very diabetes focused post today. Writing this reminds me that the conversations I have in my head every day about navigating my diabetes can feel lonely OR I can invite you in every now and again!
If you have ever taken Victoza, please leave me a comment! I’d love to know how it’s worked for you!
And, as always, ALL comments are greatly appreciated!!
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So glad you are working to figure this out. Weight as we age becomes so much more than just weight! This is a marathon for sure! I love that you are sharing these stories and connecting to people who can so benefit from your wisdom and knowledge! I’m so grateful you are in my life for so many reasons!
Marie,
You get it and you are so correct! I also am super glad you are in my life. I’m rooting for your healing as you navigate a broken ankle. Thank goodness for your athletic strength and courage! Hang in there! And thanks for all your love and generosity!
Hi Mari,
I too struggle with weight. I’ve been on for Invokana for 3-4 years which helps a little, but I’m actually going to start Ozempic next week. I haven’t heard others starting with Victoza; that’s interesting. Hopefully my body can handle it at the lowest dose.
You should be very proud of your 10 pound weight loss!! The slower you lose it, the less likely you’ll put it back on!!
I also noticed you have a very tight TIR. You might want to reconsider so that you’re not beating yourself up so much! Most have theirs set from 80-180. I have mine at 65-160 and my TIR is about 82%. But maybe it’s more attainable with the Victoza as your 2 day TIR indicates!!
I was originally misdiagnosed as T2D due to age and weight. But thankful for the misdiagnosis because it motivated me to lose 100 pounds!! But after the weight came off my numbers were still high, and was then rediagnosed T1D.
I still want to lose about 20 more pounds, but been stuck at this weight for many years despite tons of exercise and watching what I eat. Hoping the Ozempic will help me get to my goal.
Good luck reaching yours, and thank you for this article!! Helps to know I’m not alone in the struggle!!
Gayle,
WOW!! Thank you SO much for telling me so much of your amazing story. That’s wild that you got misdiagnosed at first, lost 100 pounds (dang woman, AMAZING!!) and then got correctly diagnosed with type 1. I wish you the very, very, very best with the transition to Ozempic. For sure take it easy as the side effects at first can be kind of intense! I am grateful you took a moment to connect here!!!
Mari
I don’t have an issue with weight, but definitely with the up and down of my BGs and going low at night. Thankfully, I almost never go low on a run or bike ride, but nights are tough. I have adjusted my pump basal for nights to a very low amount, and that doesnt seem to help. I am hoping that once OmniPod comes out with their closed loop system, I can spend more time in range. A bigger breakthru would be for insulin to be truly fast acting, like if I eat 20 grams of carbs in fruit, I wont get the spike before the insulin kicks in. 20 ,minutes is NOT fast acting. Fast acting should start going to work as soon as my pump puts it in my body.
Cabe,
I 100% agree with you! I would love a truly fast acting insulin too! And yes, the closed loops are coming. Maybe a cure one of these days??!! So sorry you’re having a rough time with nighttime lows. That’s difficult for sure. Glad you are lowering your night time basal rates, sounds super smart. I will tell you the people at Integrated Diabetes Services are amazing. They are some of the best diabetes coaches out there. You might give them a call!
Thank you! This is so encouraging!
I struggle with so many of the same issues. The longer I’m type 1 the harder it seems to be, even when doing everything the right way! Ugh!
Thanks again, I’m going to talk to my doctor about the possibility of starting this regime.
Blessings to you. You Rock!
Darlene,
I’m so glad you found this post helpful!! And yes, talk to your medical people about the Victoza options for you. They might not really know about it for type 1’s, but push them to learn as info is out there describing how and why it works for us! I wish you the best and blessings to you too!
Mari! You really laid out how freaking complicated weight-loss with T1D is here. I wish more people were offered Victoza! But I’m impressed alone by the first two paragraphs in which you only ate dessert a half dozen times in 4 months! 10 pounds ain’t easy! Hope Victoza rewards your efforts more!
Ginger,
Fantastic to hear from you!!! And thanks, I too was rather impressed when I realized how clean I’ve been eating the past few months!! I am super committed to bringing my weight down and dang, it is SO complicated compared to people who don’t have diabetes!!! I will keep folks updated on how my Victoza/Ozempic experiment works out!!
So glad you are fine-tuning your approach and getting good results, Mari. I’m thrilled to be running those 7 miles alongside you tomorrow!
Jenny,
YES YES and YES!!! Those 7 miles tomorrow will be good ones! Grateful to be running with you!!!
Hi Mari! I love keeping up with you via your blog now that I’m not seeing you at Thursday intervals. What I particularly love about this post is that the complexity of what you are doing in order to stay in range/stay active is totally on point! This is so the reality of a day in the life of T1D. I’ll be eager to hear more about your trials with Victoza. xoxo Meg K
Meg,
Fantastic to hear from you! I too miss seeing you at the YWCA Thursday Intervals class!!! Yeah, diabetes is indeed quite complex! I will for sure keep folks posted how things progress with the Victoza/Ozempic strategy I’m trying!!
Great to hear from you! Keep on keeping on my athlete T1D friend!!!