[SystemOut]

My story / anecdata.

About 6 months ago there was a posting about Ozempic and I had said something to the effect that it wasn't worth it watching some of the side effects my wife had from it. And then I went to the doctor for a check-up and lo and behold I had diabetes. Asymptomatic, but an A1C of 11. My doctor re-ran the test because he didn't believe it and it doesn't run in my family. My cholesterol had also jumped and he said he was going to put me on a statin after the initial 3 months of adjusting to the diabetes medication.

My Dr. puts me on Ozempic and I grumble about it but with that test results I had, I knew I had to do something. Fast forward 3 months, I dropped 20 pounds, and every other measurement is back in the green, including my A1C. Now, I made some serious lifestyle changes and ate a diabetic diet (limiting carbs, the types of carbs, etc), and have been keeping up with being more active but my entire relationship with food has changed because of Ozempic. Before I had a near compulsion to eat more than I should. Now, I don't because one, I feel fuller quicker and two, I know I'll feel horrible for hours if I over-eat. It only took one of those events to never want to do that again. I can't really explain why but I also don't have as strong of a desire to eat foods that are bad for me. I really thought I'd battle the cravings more after going cold turkey from "bad" foods. I can't say why it is but it's true. Side note, going to the grocery story was really difficult at first....there is so much sugar in the American food supply.

Energy wise I will say that I did struggle with low energy initially as my body adapted to lower calorie intake but I also learned that when I found the right balance of protein/complex carbs for me that my energy levels came back up and I now feel better than ever.

My doctor was shocked. I've never seen him that animated when I came back in for the 3 month follow-up. I didn't need to add any additional medications and they're slowly adjusting me back towards a single medication.

[justinclift]

Out of curiosity, do you drink much water each day?

I'm kind of wondering if the people having a bad result don't drink enough water each day to clear out their systems? Yeah, that's a simplistic take... but still, curiosity. :)

[SystemOut]

Yeah, most of the time I think I do. I suspect it has to do more with diet and maybe water as well. Since Ozempic slows down your digestive process my current thought is that fiber / gut bacteria might have more affect on things but I haven't done a food diary to try and track what impacts me more.

[riceart]

Has nothing to do with it. A1c measures the percentage of hemoglobin A1 in red blood cells bound to sugars (glycated hemoglobin). Since red blood cells normally circulate for months this gives a surrogate marker for average blood glucose levels over 3-6 months.

Dehydration is not a confounder for an A1c test since the percentage is relative to the hemoglobin present. The primary confounder to A1c are blood disorders such as hemolytic anemias that lower the normal lifetime of RBCs or proportion of HbA. And this tends to falsely lower the A1c.

A person with an 11% A1c is also likely drinking quite a bit (whether they notice it or not) because at that point the chronically elevated glucose is elevating serum osmolality to increase urination.

[rblatz]

Dehydration and kidney damage is a common side effect of Semaglutide, and they regularly test for that if you are on it. Drinking plenty of water is the way to prevent that from happening.

[riceart]

Perhaps I misunderstood what the GP was asking. Nevertheless GLP-1 medications appear to be kidney protective from a long term standpoint with an increased short term risk of AKI likely primarily related to GI losses with additional risk conveyed by concomitant use of “depleting” (diuretics) and nephrotoxic meds. Once on a stable dose there’s no current recommendation to monitor kidney function beyond what would normally be indicated for diabetes (usually yearly).

[r00tanon]

I have had a nearly identical experience. Thanks for sharing.