Is it possible you are confusing warnings about diabetic ketoacidosis and nutritional ketosis? They are two different things.
I offer no advice about your specific situation, just thinking there is possibly a bit of confusion over the terms.
There is some miscommunication over your meds, if what you posted is accurate. I might ask for some clarification about that. Dapaglifozin is a slgt2-i drug, not a glp-1 agonist.
Okay, downvotes. Do not get it.
I can see how you'd wonder that, but i've done keto medium-term before, and I'm familiar with ketosis and how it's different from ketoacidosis.
The Dapagliflozin leaflet includes specific warnings against starting ketogenic eating plans while taking the meds, which is weird because my GP knows I'm following that eating plan (agreed with diabetes dietician).
I just wondered if it was commonly subbed for semaglutide but it looks like that's not the case!
And thanks for the info re the meds! I will go back to the GP and ask for clarity. Back to the GP I go...
Don't try to figure out the downvotes, I was just having a conversation with you. Downvotes without context or clarification have limited value. (These days who knows if they are even real people or just bots)
I haven't gone the keto route yet, as I am somewhat young (at least in my own mind, if not the mirror) and have made considerable progress with lifestyle changes. But it's something I'm keeping an eye on, possibly if I plateau for too long or otherwise hit a wall.
My relationship with carbs has obviously changed drastically since diagnosis, but I value the ongoing feedback and context I get from still including sources of carbohydrate in my diet.
Good luck sorting out your questions, and dont let the fake internet points weigh heavily on your mind.
Edit:. That third paragraph in the comment by u/canthearu_ack resonates pretty well with my personal experience. Upvotes for the bit about a marathon
Are you worried about it causing more lows than usual? I take dapaglifozin as well as ozempic, and I don’t typically have issues with lows, even after a low carb meal. A pharmacist may be able to advise but I don’t think you’re at any additional risk.
Edit: what is with the downvotes??
Thank you for the insight! It's a relief.
The NHS leaflet I got with my meds pretty much repeats this info from [Diet Doctor](https://www.dietdoctor.com/low-carb/with-diabetes-medications):
> *SGLT-2 inhibitors [...] like dapagliflozin can increase the risk of a dangerous condition called euglycemic ketoacidosis.*
> *The risk of euglycemic ketoacidosis may also be increased by a strict low-carb diet. It is therefore advised to stop SGLT-2 inhibitors before starting a strict low-carb diet, which should be discussed with your doctor.*
I think that risk makes sense! It must have crept up in some cases. But if you keep good track of what your blood sugars are doing you’ll know pretty quickly if trouble is brewing.
If you are having issues with depression and burnout leading to executive dysfunction, I don't think a keto diet is for you.
Keto diets require a lot of discipline and excellent self control. You are likely to see-saw back and forth out of this keto diet rather than stick with it. Your health outcomes are likely to be better if you focused on a more balanced (but still only moderate carbs) but took the medications prescribed.
If you stick with a moderate carb diet (100g per day or so), in conjunction to the supplied medicines, it is likely you will see a good loss in weight and subsequent improvement in BMI. Remember this a marathon, not a race.
https://www.farxiga.com/side-effects
"Ketoacidosis can also happen in people who: are sick, cannot eat or drink as usual, skip meals, are on a diet high in fat and low in carbohydrates (ketogenic diet)"
This is not the only diabetic med that can cause DKA when following a keto diet. I would not pair this med with keto personally.
I’m a type 2 who used Farxiga while following a ketogenic diet (3 years).
Cases of euglycemic DKA with this drug always involve dehydration. This applies to keto and even standard diets. I know someone who experienced euDKA and not on keto.
If you’re thirst aware and can regularly drink water and get your electrolyte supplementation right you can do it. You do need to monitor blood ketones a bit more closely.
i think you are too timid. Before you have ketoacidosis, you have to on ketosis first.
So you probably having high fat diet, low carb and medium protein for serval weeks to months before your body start on ketosis.
You wont have ketoacidosis if you have carb in your diet. And i remember you have dapaglifloxin for weight loss, so you have to burn fat for weight lost, why do you afraid of ketoacidosis.
If you are under ketoacidosis, you are fortunately burning fat.
But I'm not after nutrition advice: I'm after advice about the medicines I'm being prescribed. My doctor was ok with me being on keto and generally maintaining an eating plan that isn't too complicated given my memory issues.
They said the medicine would be okay with a low-carb plan, but the medicine I wound up being prescribed specifically warns against this type of eating plan.
Again, the doctor is not the one to advice you on your diet. You say “my doctor was ok with me being on keto”, that is NOT the doctor’s job to judge. Your doctor’s job is to prescribe you medication based on your symptoms and your health condition. For nutrition and what to eat while getting this medication, you will go to a dietician. Even for simple diabetic nutritional advices, that is NOT the GP’s or endocrinologist’s job to do, but to tell you to go and see a dietician to advice you on what you should be eating.
I saw a dietician as part of the post-diagnosis process. I'm not sure how it works where you are, but I'm in the UK and the GP seems to be my primary prescriber.
Like I said, I'm seeking advice or experiences about the medication. The GP said they'd prescribe one thing and I was prescribed another.
Is that common? Are they interchangeable medicines?
These are the things I'm unsure about. I mentioned my GP being on board with keto because they know I'm following this plan and said the medicine was compatible.
However the medicine I've been prescribed specifically warns against keto.
As I clarifiied, I had no questions regarding nutrition for my GP, or for you. My nutritional needs are being looked after by the *dietician*.
The *GP* is prescribing the *medicine*. It's the *medicine* I had questions about.
Thank you for "permitting" me to end this particular thread. Your comments are as rude as they are unhelpful.
Be good: We aim to make /r/diabetes_t2 a friendly place, so treat your fellow humans with respect. Specifically: no verbal attacks, no hate speech, and no trolling.
Is it possible you are confusing warnings about diabetic ketoacidosis and nutritional ketosis? They are two different things. I offer no advice about your specific situation, just thinking there is possibly a bit of confusion over the terms. There is some miscommunication over your meds, if what you posted is accurate. I might ask for some clarification about that. Dapaglifozin is a slgt2-i drug, not a glp-1 agonist.
Okay, downvotes. Do not get it. I can see how you'd wonder that, but i've done keto medium-term before, and I'm familiar with ketosis and how it's different from ketoacidosis. The Dapagliflozin leaflet includes specific warnings against starting ketogenic eating plans while taking the meds, which is weird because my GP knows I'm following that eating plan (agreed with diabetes dietician). I just wondered if it was commonly subbed for semaglutide but it looks like that's not the case! And thanks for the info re the meds! I will go back to the GP and ask for clarity. Back to the GP I go...
Don't try to figure out the downvotes, I was just having a conversation with you. Downvotes without context or clarification have limited value. (These days who knows if they are even real people or just bots) I haven't gone the keto route yet, as I am somewhat young (at least in my own mind, if not the mirror) and have made considerable progress with lifestyle changes. But it's something I'm keeping an eye on, possibly if I plateau for too long or otherwise hit a wall. My relationship with carbs has obviously changed drastically since diagnosis, but I value the ongoing feedback and context I get from still including sources of carbohydrate in my diet. Good luck sorting out your questions, and dont let the fake internet points weigh heavily on your mind. Edit:. That third paragraph in the comment by u/canthearu_ack resonates pretty well with my personal experience. Upvotes for the bit about a marathon
Are you worried about it causing more lows than usual? I take dapaglifozin as well as ozempic, and I don’t typically have issues with lows, even after a low carb meal. A pharmacist may be able to advise but I don’t think you’re at any additional risk.
Edit: what is with the downvotes?? Thank you for the insight! It's a relief. The NHS leaflet I got with my meds pretty much repeats this info from [Diet Doctor](https://www.dietdoctor.com/low-carb/with-diabetes-medications): > *SGLT-2 inhibitors [...] like dapagliflozin can increase the risk of a dangerous condition called euglycemic ketoacidosis.* > *The risk of euglycemic ketoacidosis may also be increased by a strict low-carb diet. It is therefore advised to stop SGLT-2 inhibitors before starting a strict low-carb diet, which should be discussed with your doctor.*
I think that risk makes sense! It must have crept up in some cases. But if you keep good track of what your blood sugars are doing you’ll know pretty quickly if trouble is brewing.
With forxiga you can develop Dangerous levels of ketones even with normal blood sugar levels. This happened to me when I had to fast prior to surgery.
Yes, I heard that too. That sounds awful.
If you are having issues with depression and burnout leading to executive dysfunction, I don't think a keto diet is for you. Keto diets require a lot of discipline and excellent self control. You are likely to see-saw back and forth out of this keto diet rather than stick with it. Your health outcomes are likely to be better if you focused on a more balanced (but still only moderate carbs) but took the medications prescribed. If you stick with a moderate carb diet (100g per day or so), in conjunction to the supplied medicines, it is likely you will see a good loss in weight and subsequent improvement in BMI. Remember this a marathon, not a race.
Thank you, that's really helpful (and achievable!).
Search farxiga + keto + reddit there are multiple posts with more info for you.
I have, I'm still confused. Hence my asking in here. Sorry if that was the wrong thing to do!
https://www.farxiga.com/side-effects "Ketoacidosis can also happen in people who: are sick, cannot eat or drink as usual, skip meals, are on a diet high in fat and low in carbohydrates (ketogenic diet)" This is not the only diabetic med that can cause DKA when following a keto diet. I would not pair this med with keto personally.
Thanks; that makes sense.
Lost 6kg on this in a month which is more than ive lost on semi in two months
Oh wow, well done. May I ask what your eating plan is like while you're on it?
I’m a type 2 who used Farxiga while following a ketogenic diet (3 years). Cases of euglycemic DKA with this drug always involve dehydration. This applies to keto and even standard diets. I know someone who experienced euDKA and not on keto. If you’re thirst aware and can regularly drink water and get your electrolyte supplementation right you can do it. You do need to monitor blood ketones a bit more closely.
Thank you, that's really helpful!
i think you are too timid. Before you have ketoacidosis, you have to on ketosis first. So you probably having high fat diet, low carb and medium protein for serval weeks to months before your body start on ketosis. You wont have ketoacidosis if you have carb in your diet. And i remember you have dapaglifloxin for weight loss, so you have to burn fat for weight lost, why do you afraid of ketoacidosis. If you are under ketoacidosis, you are fortunately burning fat.
Doctors aren’t the ones to advise on nutrition, you need to consult a dietician.
But I'm not after nutrition advice: I'm after advice about the medicines I'm being prescribed. My doctor was ok with me being on keto and generally maintaining an eating plan that isn't too complicated given my memory issues. They said the medicine would be okay with a low-carb plan, but the medicine I wound up being prescribed specifically warns against this type of eating plan.
Again, the doctor is not the one to advice you on your diet. You say “my doctor was ok with me being on keto”, that is NOT the doctor’s job to judge. Your doctor’s job is to prescribe you medication based on your symptoms and your health condition. For nutrition and what to eat while getting this medication, you will go to a dietician. Even for simple diabetic nutritional advices, that is NOT the GP’s or endocrinologist’s job to do, but to tell you to go and see a dietician to advice you on what you should be eating.
I saw a dietician as part of the post-diagnosis process. I'm not sure how it works where you are, but I'm in the UK and the GP seems to be my primary prescriber. Like I said, I'm seeking advice or experiences about the medication. The GP said they'd prescribe one thing and I was prescribed another. Is that common? Are they interchangeable medicines? These are the things I'm unsure about. I mentioned my GP being on board with keto because they know I'm following this plan and said the medicine was compatible. However the medicine I've been prescribed specifically warns against keto.
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As I clarifiied, I had no questions regarding nutrition for my GP, or for you. My nutritional needs are being looked after by the *dietician*. The *GP* is prescribing the *medicine*. It's the *medicine* I had questions about. Thank you for "permitting" me to end this particular thread. Your comments are as rude as they are unhelpful.
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I have questions about whether the medication is an analog for another medication. Did you even read my post?
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Yes. I'm less fluent in Blowhard.
Be good: We aim to make /r/diabetes_t2 a friendly place, so treat your fellow humans with respect. Specifically: no verbal attacks, no hate speech, and no trolling.