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.
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.
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.
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.
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.
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!