Gain Nutrition Know-How to Successfully Take a Newer Injectable Type 2 Diabetes Medication

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:

1. These medications reduce your appetite and induce satiety, meaning you feel full faster.
2. 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.
3. 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.
4. 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.