Semaglutide Meets The VA

Because of the rules, those little hurdles in life ofttimes placed by bureaucrats with things in their mind far loftier than your best interests, the VA would not prescribe GLP1 Agonist medication to treat my diabetes. Even though that was originally the use approved by the FDA, they thought it should only be used as a weight loss drug. To get a prescription one needed to enroll and complete a 16 week behavior modification. Fine. I had already signed up. But I still had these blood glucose readings that were a little on the alarming side.

For years I had teetered on the edge of type 2 diabetes. When they decided to start calling me a diabetic, which stung a bit like an insult, I started managing my numbers with diet. I went to a ketogenic way of eating, bringing the dreaded A1C and fasting blood sugars down to a high but non diabetic level. I had fallen off the wagon for a couple years but had come back as the numbers became high again. I went even further as to eat completely carnivore. No carbs other than the few I picked up from eggs or cheese. It was not helping. It wasn’t even moving the needle a little. I guess I had better get some help.

Instead of GLP1 Agonist medication I was prescribed a SGLT2 Inhibitor medication. It was much cheaper than the GLP1 stuff. I was prescribed a half dose, given a supply of test strips and a blood monitor, and sent on my merry way.

I researched the SGLT2 Inhibitor and found not nearly as much information on it as the GLP1 Agonist stuff. The information that I would was positive, though. It was well tolerated by most people with minimal negative side effects. Because it worked by removing sugar from your blood through the kidneys, the side effects were usually caused by the sugar content in the urine. The positive effects were that the blood sugars were normalized rather than just lowered, it was connected to improved cardiac help and other organ functions. There were also studies centered around weight loss that sometimes compared them favorably with the GLP1s.

After a month of half dose, my blood glucose levels were high but much lower. I still continued my carnivore way of eating. When I had my follow up appointment I pointed that out. I suggested that since I was prescribed half the recommended dose, perhaps that would be an indicator that the recommended dosage guidance, provided by the folk that produced this stuff, might be followed. That’s a negative. The VA has rules. In order to keep costs down the providers were only allowed to prescribe half dosages of the medication.

After an appeal to an anonymous board, based upon my physicians recommendations, I was finally granted the full dose.

SGLT2 Inhibitor medications are working for me in the area of my diabetes. I don’t think they are much of a part of my weight loss. My progress seems mostly tied into my diet and exercise. It took me a while to get used to a normal blood glucose level. My body had adapted to being so high that normal felt terrible. It took a couple of weeks. I now feel normal with levels from 82 to 102. If someone were to take these medications while still consuming carbohydrates I can see how they would be effective, removing from the blood a lot more fat producing sugars. They don’t have any effect on appetite or digestion. This might make them better for some people who have difficulty tolerating GLP1 meds. I’m not sure.

I personally find anecdotal information, stories, a lot more reliable than studies. Studies are mostly faceless. Stories have flesh on them. They have feelings too. Stories are different. Some have different outcomes than the ones we want. Some even differ from what the powers that be would have us believe are true. I am sharing my story to add to the ones you’ve already heard. That way you can take all of this, and what you are told by the professionals, and weight it in your heart to make a decision that is right for you.

I am not enjoying writing these snippets of experience much. I am writing them because I do believe that these experiences will help someone and must be recorded so that we can all remain powerful by our knowledge of the world outside of control groups.

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