Mounjaro Update: Covid-19, CGMs, and Weekly Progress

Greetings, fellow Type Twos! I am back once again to describe my weekly progress on Mounjaro, and to provide some collateral information and observations for anyone interested in monitoring and improving their metabolic health. I should note that I do not offer medical advice, and I am not a doctor (thank God). Neither am I a paragon of metabolic health, offering leadership by example. Taking advice of any kind from me is a fool’s errand. Nevertheless, I might throw out an idea or two that might inspire you to do some research on your own. Opinions, I’ve got, already!

As you might have read in last week’s Post-Vacation Update, I returned from my “JOURNEY” (a real one, not the metaphorical kind the YouTube weenies take on their GLP-1 medication of choice) replete with cold symptoms, a fever, and a positive test for Covid-19. For a couple of days after testing positive on Wednesday, my symptoms worsened, but now I have settled into a flu-like state, in which I feel like I am in the Twilight Zone and lack energy. However, writing doesn’t require much energy. Also, it provides relaxation for me, so welcome to my weekly rant.

In this week’s column (if I might use that archaic newspaper-oriented terminology), I will describe the effect of Covid-19 on my weight. I will tell you about a new continuous glucose monitor (CGM) I am testing, one that has been approved for non-prescription use. Finally, I will wrap up with the week’s progress, albeit distorted by my unintended viral visitors.

Covid Weight Loss

I gave my doctor some advice. I told him that his cosmetic weight loss patients would love him if he treated them with Covid-19. The disease gives them the effortless avoirdupois reduction solution folks of that ilk crave. While this was obviously a facetious suggestion, I based it on my current experience since contracting the virus. In last week’s update, I had reported a two-pound weight loss while on vacation. I now believe that drop was due to Covid.

My weight had been holding steady until the last couple of days on the road. Now back at home, between September 11 and today, September 16, I have lost 9.2 pounds. If I count the other two pounds during the vacation, that is over eleven pounds lost over a week’s time. Again, I attribute the dramatic drop to Covid, not Mounjaro.

This is certainly not a sustainable formula for weight loss, and I strongly recommend against attending Covid parties with that aim in mind. Shedding pounds in this manner is stressful to the body. I try to stay hydrated, but I pee a lot, too. I must conscientiously avoid dehydration. Because my kidney function is impaired due to age and metabolic syndrome, dehydration is a dreadful thing, especially in conjunction with the Mounjaro and other medicines I am taking.

If I experience an uncomplicated recovery from Covid, my hope is that I regain some of my ill-gotten losses. How’s that for a twist?

Throw in Sciatica, too!

When it rains, it pours. During our vacation, I tweaked my lower back, which has long been a ticking time bomb. A CT scan a couple of years ago characterized “moderate to severe multilevel degenerative disc disease within the lumbar spine predominantly involving the mid and lower lumbar spine”. In conjunction with taking Mounjaro, I had ramped up my exercise program, which seemed to result in less back pain. However, on vacation, awkwardly tossing around a fifty-pound suitcase, I messed something up.

So, now I need to deal with the back, too. The lower back pain radiates to the right-side butt and down the right leg. I cannot stand in one place for long. I eschewed an ER visit on the trip so I could get home quicker. Of course, that meant dealing with pain while driving for three days. Undoubtedly, the seated position while driving did not help the situation.

My self-treatment options are limited to Extra-Strength Tylenol, which doesn’t work. I need to get the damn thing evaluated and seek some treatment for it, because it is destroying my sleep. My hope is that I can avoid opiates and surgery, as I would prefer corticosteroids, muscle relaxers, and physical therapy. A visit to a local ER might be needed to get the ball rolling. I was tempted to go there last night while tossing and turning and not achieving any relief from the pain. We’ll see…

Stelo Glucose Biosensor

I discovered that the FDA had approved a new product from Dexcom, a wearable device like a continuous glucose monitor that does not require a prescription, is self-paid, and is available to anyone. Previously, I had eschewed CGMs, such as the Dexcom G7, because our Medicare regulators would not cover their cost for a Type 2 diabetic unless 1) on insulin, or 2) had documented hypoglycemic episodes. Even if my doctor were to prescribe a CGM, the out-of-pocket cost would have been over $300/month. Everybody has his price, and for that kind of money, I’ll endure finger pricks a few times per day. However, this new product offered by Dexcom for less than $100 per month piqued my interest.

Dexcom, makers of the flagship G7 CGM, saw the need for people in my category who want to track their glucose variations, so they developed this dumbed-down product, called Stelo. It is available directly from the company for under $100 for a month’s supply, or $90 for a monthly subscription. Each monitor is good for fifteen days, during which it communicates with the Stelo app on my phone with a graphical update every fifteen minutes. The Stelo cannot be integrated with an insulin pump, so the granularity of its measurements is coarser than that of the G7. It is just intended as an informational device. Dexcom labels Stelo as a “glucose biosensor”, not as a continuous glucose monitor.

Get It Quickly!

Interestingly, although I ordered Stelo directly from Dexcom through their website, the product was delivered the next day by Amazon. Amazon now makes deals with third-party companies wishing to avail themselves of Amazon’s rapid and diffuse distribution network. I suppose this form of distribution applies in selected areas where Amazon has a strong presence. That’s everywhere, right?

The Stelo cannot export information (yet) to share with a doctor or with readers of my column. In fact, I wanted to send an SMS to my wife with a screenshot of the glucose graph, but I could not do a screenshot. The message was that screenshots were prohibited due to security restrictions. WTF? I hereby request that Dexcom at least give us the capability to download information so we can analyze it in Excel if nothing else. Furthermore, show-and-tell with the doctor would be a good thing. I am assuming that the FDA approval might have been contingent on restricting the use of data to personal amusement, but I sure hope there’s a way around this restriction.

[UPDATE: There IS a way around it, in the form of the “Clarity” app from Dexcom. I’ll tell you more in next week’s update.]

(This is an entertainment device, not to be confused with a serious medical device, and you may not base your medical decisions on its readings under penalty of being acknowledged as being as stupid as the FDA and Dexcom’s lawyers want you to be). Oy vey!

Playing with My Biosensor

I have been wearing the Stelo “biosensor” for two days and have experimented with glucose-spiking ingestion, like eating several types of meals, as well as taking one Mounjaro injection. It is interesting to observe the glucose rapidly increasing, then falling off slowly after a carb-laden meal, a graphical depiction of insulin resistance. The readings are biased about 10-12 points higher than my Contour Next glucometer, which has tracked very closely with lab blood testing in the past. But the real benefit I will derive is in viewing the ups and downs. Absolute numbers are not as important, so long as they stay in range. And I will continue to use my glucometer at least once per day.

I cannot yet say whether I will be sticking with the Stelo once the novelty wears off. I signed up for the $90/month subscription, which is cancelable anytime. We’ll see whether Dexcom keeps that promise when the time comes. In the meantime, I will provide further observations and conclusions as time goes on and I find undiscovered features or deficits.

Asking whether I am wearing a glucose monitor or a glucose biosensor is like asking whether that thing in the sky is a hawk or a bird.

Weekly Mounjaro Results Recap

Undaunted by Covid, I will now present the skewed results for the week in the usual manner. As I mentioned, shockingly, my weight loss since last Wednesday is 9.2 pounds. Glucose average for the period was 104. However, my blood pressure has been running high, about 140/80. I attribute that to the illness and the back pain I have been experiencing for the past ten days.

I’ll be back next week, hoping to be in a better frame of physical and mental health.