September 10, 2025 my new primary care had a metabolic and lipid panel run for me for the first time in five years. The results were stunning.
A1c of 12.2%. Blood glucose (not fasting) of 238 mg/dL. Triglycerides 414.
I went in because my life was falling apart mentally, at home because of politics and at work for all the reasons work is hard for anyone like me, I’ll let you guess.
I wanted treatment for ADHD. A previous doctor in 2018 had denied me care after I missed 2 early morning follow-ups to a $900 neuropsychiatric eval that declared I needed the treatment. Think about that. Punishing a patient for the exact symptoms of the exact disorder they sought your care for. Denying them the exact cure. At least I still had the write-up from that very expensive examination. I got a non-stimulant drug, this time around it didn’t work. In fact, the opposite, I had to stop taking that drug eventually because it had deleterious effects.
September 11th I was back in the office. A rush appointment to get me on the medicine to treat my very concerning presenting condition:
- 50 units Inulin (Basal, Lantus (insulin Glargine))
- 2000 mg Metformin ER
- 40 mg Lipitor (Atorvastatin)
- 2.5mg Mounjaro (Tirzepatide)
And an explanation of why, and some questions got answered about needles. I used up my HSA money very shortly, like in the coming days. Things that come to mind that really surprised me with the cost include insulin needles and blood glucose test strips. CGMs are optional for me now that I’m off insulin, but I was denied while on insulin so I’m still fighting the PA denial.
In the following weeks I managed to start all the medications one by one with minor complications:
The insulin was really difficult at first because I kept it cold and 50 units of insulin is a lot to get through a 31 gauge needle cold.
The Metformin taught me over and over to take it in the middle of a meal or not at all, and I never got past 1 gram.
Cutting the Atorvastatin in half and taking coQ10 made it unnoticeable. And upon learning about how it blocks coQ10 I started supplementing that and Omega-3.
Just a week and a half from my 1-month follow up I finally took the first dose of the Mounjaro.
My blood sugar was as high as 283 mg/dL in those first couple days. In two weeks it fell to around 145 mg/dL on average. I think the insulin was doing some of that work, but my fiance and I also started exercising, changed our diet at home, stopped eating out, and so much more. I stopped the habit of smoking tobacco occasionally and I started adhering to my long-neglected CPAP therapy.
But the Mounjaro kicked by BG levels down to normal and gave me the capacity to keep them there easier and easier as I tapered off of insulin.
I never ever wanted to take a GLP-1 drug, let alone a dual-agonist. I hadn’t researched the drug and so I started. The first podcast I listened to really helped a lot. I had read Mel Robbin’s book “let them” recently and it was her podcast with Dr. Salas-Whalen. It was so incredible that it became a book that I also just read shortly after release, “Weightless”. There’s also Dr. Joseph a youtuber who is also a glp-1 medication patient, for weight loss. Tirzepatide Unlocked by Dr. Montrose is also good, if somewhat of a slog for listening.
As I learned about these drugs, it became apparent that for me, the type 2 diabetic, this therapy is nothing short of miraculous. At that first follow up appointment I was also given a trial CGM they had on hand, and that massively amplified my ability to get feedback and tune everything I did. I became sad, thinking back on my father and his mother.
My Grandma Betty was a wild one. She was forced by her parents to put my father up for adoption after they had already started helping raise her other two. He Met her at 24 years old, after she had already lost her leg to type 2. He was diagnosed around 30 but here’s the real kicker: I think type 2 killed my father unnecessarily early.
I’ve been told anecdotally that my dad did not manage his diabetes well, not wanting to take the insulin. I believe this because I have no memory of seeing him do it, and I do have that memory of my Grandpa Tom. I also remember learning that he would refuse to urinate at night because it made waking up easier. And because it was blamed as the proximate cause, it’s not hard to remember that he started smoking at only 7 years old, and only stopped at 35.
I started thinking about these things in close proximity and it’s slowly dawned on me what likely happened: After my mom died, tragically, abruptly, my dad’s immune system would have been suppressed. The cancer may have already been old, but it was finally unleashed, having been incubated for a long time in a very high glucose environment, making it an aggressive stage 4. He fought it with surgery, radiotherapy, and chemotherapy over and over until he died 5 years later.
The ultimate survivor’s guilt is realizing you’ve just been handed the tools that your whole lineage may have killed for, if not for it killing them first.
So I haven’t taken any of it for granted.
I’ve been getting an average of 150 grams of protein a day and less than that in carbs, usually half. I’ve been resistance training for muscle retention and building the glucose sink. I’ve been stretching to stop from hurting myself while training. I walk and move enough to close my 1000/90/12 apple rings. I’ve done more than 2 months of intermittent fasting, and I’m always striving to make these habits easier to maintain, modifying as needed.
But here’s the thing: I’m getting blasted with cultural noise now. Every ad is another sketchy compounding pharmacy bragging about prices, or worse, a chinese lab selling “peptides” for “research use only”. Or even just the average Novo Nordisk or Eli Lilly ad. I hate knowing how much my insurance is paying for these ads. Nobody is in the dark about these drugs. This is a cultural cancer and it’s warburg effect is our dietary environment.
I’m a type 2 patient. I was losing weight because I needed to, to try and put my metabolism back in place. I lost weight while I was on insulin and before I started taking the Mounjaro, which is just not a thing that happens, ask an endocrinologist. I had a lot of room to work with because my onset was the result of high carbs and sedentary lifestyle.
Now that I’m losing weight because of the drug, I don’t even know if I want to. The blood-sugar modulating effect is incredible, but when you lose weight too fast, as I have (closing on 50 lbs in last 90 days, finally slowing) it causes orthoscopic hypotension, or presyncope upon standing. Every time I stand up, damn near, it feels like I’m going to pass out.
And I’ve got idiots on the internet telling me I’m cheating and I’m weak.
If you’ve ever bullied someone on a GLP-1 drug, or talked trash about their use, please shut the fuck up. It’s all loud enough, nobody cares what you think unless there’s a Dr. prefixing your name. Even then we’re tired.