Zyprexa - Saxenda masking diabetes?

[jarn]

So I take 30mg of zyprexa, at night.  3mg of Saxenda to control the munchies and try and help the weight gain be mitigated.  I've been on zyprexa about a year.  I gained about 22lbs (was already obese), I've now lost 7.9lbs (whee!) since late January.  I am really focusing on eating well, in part, because my lipids aren't great, and that freaks me out.  

My pdoc says I'll just have to deal with the high lipids, that they're a side effect of the zyprexa, but it works well enough we haven't passed the bar that would mean I can be taken off of it.  I am not a fan of this, but I get he knows I've had violent thoughts pre-zyprexa, and most other APs either haven't worked or crapped out.

Could I have developed Type 2 diabetes from the zyprexa that the saxenda is masking?  At first I took metformin but holy upset stomach.  I had my last fasting glucose ages ago, but I have had two a1c tests more recently and everything's always been normal.  

 

[jarn]

Anyone?  I think @Iceberg @browri and @notloki are the smart med people?  I won't be surprised if this is more medical than medication.  I have googled to no avail.

[Iceberg]

It’s not unheard of to gain the weigh but still have reasonable blood sugar... it happened to me on zyprexa as well. If you had diabetes, I would think that your A1c would be higher... I believe (but am no endocrinologist) that once you contract type 2 diabetes your a1c tends to linger in the high range 

[jarn]

Thanks @Iceberg I was wondering if I'd have a high a1c if I stopped taking the Saxenda.  Realistically probably not.  I see my pdoc on March 10th and am struggling with not wanting to stay on zyprexa while knowing he'll be unwilling to take me off of it.  I have started to lose weight again, so I should probably give it a bit longer.  Ugh.  The lipids thing bothers me, and then I thought - oh god, what could this also be doing?

[Iceberg]

Yeah but (sorry for the preceding beating of a dead horse) you have to take into account what else your unchecked MI could be doing off the med 

[jarn]

Oh absolutely.  I was going to ask to go on another med...though I've been through most of them (I believe clozapine is next in line, and I can't imagine that'll be any better from a side effect profile) and zyprexa works the best any have worked in a long time.  

[yarnandcats]

i was on victoza (the lower dose sister of saxenda) for type 2 and weight control (along with metformin, funnily enough). it will bring your a1c into a more normal range, for sure. the only way, to my knowledge, to be properly assessed for type 2 is to stop any meds that will interfere with whatever testing is being done (a1c and/or glucose tolerance) beforehand. i also know that some AAPs can cause metabolic syndrome and high lipids are one sign of that but that those can be partly mitigated via diet/lifestyle (if i'm remembering right). if any of this is incorrect, just ignore; this is what my doc's have told me.

[Iceberg]

24 minutes ago, jarn said:

Oh absolutely.  I was going to ask to go on another med...though I've been through most of them (I believe clozapine is next in line, and I can't imagine that'll be any better from a side effect profile) and zyprexa works the best any have worked in a long time.  

I have actually had less weight issues with cloz than with zyprexa ... but it really is a commitment to get and stay on it 

[jarn]

Thanks @yarnandcats and @Iceberg

Yarn, the zyprexa is screwing with my lipids.  I'm trying to eat high fiber (easy) and low fat (hard).  I used to take Victoza for depression!  I will ask my pdoc about this too I guess.  It just freaks me out.  I'm also hoping if I eat healthy vegan food that will help.  I ate great yesterday until I had a big bag of chips, sigh.  I've always had binging issues - I wasn't hungry, just psychologically I do it.  

Iceberg, if I were going to go on clozapine, now's the time to do it as I'm working from home.  But I think the side effects on it would be bad too (even if weight isn't THAT bad).