Are you aware of the newer injectable medications for type 2 diabetes* that can also help you lose some weight? Are you ready to ask your healthcare provider if one of these medicines is right for you and your diabetes care goals?
The Role of Nutrition with the Newer Injectable Type 2 Diabetes Medications
These newer medications can help lower glucose levels and A1c, help you lose weight more easily than you may have in the past, and improve other health indicators. They’ve also been shown to reduce the risk of cardiovascular events like heart attacks and strokes for those with type 2. While these medications offer important benefits to diabetes management, they can reduce your appetite significantly and cause some loss of muscle mass. These medications can also cause some people to have gastrointestinal (GI) side effects. Read on to gain nutrition know-how so you may take one of these medications successfully, manage your diabetes, and healthfully keep lost pounds off long-term.
To successfully take one of these medicines, here are four points to keep top of mind:
- These medications reduce your appetite and induce satiety, meaning you feel full faster.
- Take the medicine as prescribed by your healthcare provider. This medicine, typically taken once a week, is purposely started at a low dose with small dose increases over time applying the “start low, go slow” approach to minimize GI side effects.
- Inject the medication on the same day and at the same time each week. Set up a schedule that works best for you and stick to it week to week. Speak with your healthcare provider about what to do if you miss a dose.
- Learn how to inject the medication properly. If you have questions or want someone to make sure you are taking the medication accurately, ask your healthcare provider, their staff members, or your pharmacist.
How to Manage Reduced Hunger and Appetite and Stay Hydrated
On this medication, you will likely be less hungry and have less of an appetite. In the past, you may have let your hunger and appetite be your guide for when and how much to eat. On this medication make sure you eat meals and snacks (if you need them) regularly. Do not let many hours go by without eating. Plan for, prepare, or purchase, healthy meals and snacks.
Stay hydrated to minimize a potential problem with constipation. Drink an ample amount (at least 8 ounces) of a hot or cold beverage that contains no calories with your meals and snacks. Use a splash of lemon, lime, or orange to flavor still, sparkling water, or iced tea. Get in the habit of regularly sipping liquids.
How to Maintain Your Muscle Mass
A reality of losing weight is that a portion of the weight you lose will be muscle, more accurately referred to as lean body mass. The loss of a lot of lean body mass, particularly in older individuals, can negatively impact muscle strength and function.
Two key actions can help you maintain lean body mass as you lose weight:
- Focus on eating enough lean/low in fat protein in your meals and snacks. Also plan to spread the protein you eat throughout the day. The amount of protein you need will depend on your body size. Some experts recommend a minimum of 60 grams per day, while others recommend more. For a frame of reference, an ounce of cooked fish, one egg, or 8 ounces of milk contains roughly 7 grams of protein. Talk to your healthcare provider or ask to be referred to a Registered Dietitian Nutritionist (RDN) if you have questions or need more individualized guidance. The main sources of high-quality protein are eggs, seafood, poultry, red meats, dairy foods (milk, yogurt, cheeses), and beans and peas. It’s best to choose lean or low-fat sources of protein and prepare them in healthy ways, such as grilling, baking, broiling, or poaching. Beyond eating enough protein, prioritize the protein on your plate to make sure you eat the whole portion.
- Get and stay physically active. Specifically, do strength training exercises at least two days a week on non-consecutive days (not one day after another). Strength training translates to doing a series of exercises that work all your major muscle groups with eight to 12 repetitions each.
How to Prevent or Minimize GI Side Effects
Some people who take one of these medications may initially and/or when the dose is increased, experience one or more GI side effects that range from nausea to vomiting, acid reflux (heartburn), bloating, diarrhea, and/or constipation. These medications can cause these issues because they act on the GI tract to decrease appetite and increase the feeling of fullness (satiety) by slowing the pace at which the stomach empties food into the small intestine.
Don’t suffer with GI side effects or discontinue the medication prior to seeking guidance from your healthcare provider. Typically, these side effects can be prevented or minimized by putting a few tips into action. In many people, these GI side effects resolve as the body gets used to the medication and you make changes in your eating habits, amount of food you eat, and food choices.
Helpful Tips:
- Eat smaller portions of food than you are used to. You will get full faster due to how the medicine works.
- Eat more slowly than usual and stop eating at the first sign of fullness.
- Avoid eating meals late at night and then lying down. This can increase the likelihood of acid reflux (indigestion or heartburn).
- Order a take-home container in restaurants when you place your order. Put away half your portion so you eat less. Or keep portions small by choosing from healthy salads, appetizers, and/or sides rather than ordering a main course. Or split and share a main course.
- Limit high-fat and greasy foods. They can take longer to digest and cause more GI symptoms.
- Limit spicy foods if you regularly have heartburn/indigestion.
- Use ginger or peppermint tea to settle your stomach if you experience nausea.
- Eat enough high-fiber foods – fruits, vegetables, and whole grains – to minimize constipation.
How to Maintain the Diabetes and Health Benefits You Achieve Long-Term
As you consider taking one of these newer type 2 diabetes injectable medications, do not think of it as a short-term fix for weight loss and improved glucose management. Research generally shows that when people discontinue the medication after significant weight loss, they regain some of the lost weight. That’s particularly true if they return to their former eating habits and level of physical activity. This happens because this medication is replacing a hormone or hormones normally made in the body that no longer work effectively or are made in sufficient amounts. For this reason, and due to other changes that occur in the body of a person living with overweight or obesity, it will likely be best for you to stay on the medication long term to assist with maintaining a lower body weight and optimal glucose levels. Some experts make the analogy to chronically needing blood pressure medications long term to manage high blood pressure.
Along with taking one of these medications, it is also critical to maintain healthy changes in eating habits and food choices and to integrate regular physical activity. It is the combination of medication, healthy eating, and regular physical activity that helps people manage their weight, glucose levels, and other related measures of health.
In Conclusion
Work closely with your healthcare provider if you choose to take one of these newer type 2 diabetes medications. Ask questions and report side effects quickly if they occur. Also, be open and honest about your ability to afford one of these medications. They can be expensive, but there are resources available to help you cover their cost.
If you would like individualized nutritional guidance, ask your healthcare provider for a referral to an RDN who specializes in weight management and diabetes care. These services, which may be referred to as Medical Nutrition Therapy (MNT), may be covered by a private health plan or Medicare Part B if you have a diagnosis of diabetes.
*The newer injectable type 2 diabetes medications include two brand names: Ozempic and Mounjaro. Their generic names are semaglutide and tirzepatide, respectively. One oral FDA-approved formulation of semaglutide is called Rybelsus. Generic medications that contain semaglutide are also currently FDA-approved for weight loss. Brand names for these medications are Wegovy and Zepbound. Several slightly older FDA-approved GLP-1 medications include: Trulicity (generic name dulaglutide) and Byetta and Bydureon (generic name exenatide), Victoza and Saxenda (generic name liraglutide).
Editor’s Note: Lilly Diabetes was an active partner of Taking Control of Your Diabetes® at the time of publication, but TCOYD® maintains control over editorial content. Please consult your healthcare team before making any changes to your diabetes care regimen.
This article helped me understand the importance of getting enough protein. My husband and I are both on these medications. While we were aware of the importance of fruit, vegetables, and fiber and constipation!) I wasn’t thinking so much about the reduced protein with our smaller portions. Thank you!
Glad it helped, Hope!
How can I get help with the cost of Ozempic if I’m on Medicare?
My doctors office does not do anything to help patients in this area.
I know some people pay nothing for Ozempic but I’m on Medicare and the cost is $112.00 for not quite 3 months. This adds up if you need to use the medication for a long time.
You might try reaching out to Novo Nordisk’s financial assistance program here to see if they can help:
https://www.novocare.com/diabetes/help-with-costs/pap.html
Dianne
I’m on Ozempic & I am on Medicare & want to know why I am paying $257.00/month for it & why Shelly above is only paying $112.00 for the same medicine? What determines what an individual pays for this same medicine. It can’t be less income, as I am on NovoNordisk Patient Assistant Program for 1st 4 months that they give it to me free. I am grateful & thank God for them. However, shouldn’t I get it for the lowest price since I meet low income requirements? Please explain this to me. Thank you in advance. After 4 months free I have to pay $257.00/month & I get under a month’s supply taking 0.5mg dosage. Doctors can prescribe these high cost medicines that I’m told I will be on for life & this is only one of 27 medications that I have to take every single day. What good is high priced medications if you can’t afford to take them? It is a big hardship & my husband works at over age 70 to pay for both our medicines. I can’t work. We both take a lot of RX’s. Please e-mail me with your answer & any suggestions that would help me. Why am I paying more per month than someone else taking the same medication? Please help. Thank you in advance. 🙏🏻
The rules and regulations are crazy and extremely complicated. There are ways to try to get it cheaper, but we are not specialists in this area. You might try reaching out to the Diabetes Leadership Council here: https://www.diabetesleadership.org/ to see if they have suggestions for you or other resources to try.
There are different types of Medicare coverage. Some are on Medicare Advantage and some are on traditional Medicare.
It depends on the drug insurance coverage you have chosen to purchase with your insurance supplement
I’ve tried three of those injectables already, Trulicity, ozempic and Treshiba, made me very sick, nauseous and just feel like vomiting, they were great for weight loss, now I’m on lantis, which is not really doing anything for me but just gives me a lot of pain on my hips, i cannot take 20units every night because i walk around with a hunch back, can’t straighten up. I take between 10-14 units and i still get some hip pain.I’m worried about my kidneys now. I have to take 600mg of ibuprofen every 4hrs. Not good. See what’s the next move on my next endo visit. Never a dull moment.
Hi Norma,
It sounds like you are sensitive to the weight loss drugs, which is unfortunate. Sometimes if you titrate them super slowly, starting at a super low dose, people can tolerate them. Regarding your hip problem, I would bet the life of my firstborn child that Lantus is not related to it. Go see an orthopedic surgeon.