Over a year into Mounjaro treatment for Type 2 diabetes, the well of fresh topics is running a little dry. So once again, I do what I do best: talk about me. This week’s update is a tour through six back-to-back medical appointments, starring your faithful 78-year-old narrator, with occasional tangents, health system gripes, and—naturally—a slice of carrot cake.

For those new here, I’m a Type 2 diabetic who’s attained an HbA1c of 5.3% and lost 70 pounds with the help of Mounjaro (tirzepatide), some dietary discipline, and a steady commitment to strength training. I’ve cut my losartan dose in half and ditched metformin. But let’s be clear: Mounjaro isn’t fairy dust. You still have to eat like a grown-up and move your body like you mean it.

Last week, I told you about the precursors for the forthcoming blitz. Now, onto the week’s circus.

Monday Madness

I kicked off with a hernia evaluation. Turns out I’ve got bilateral inguinal hernias, likely congenital, not gym-induced. One of them is self-reducible, which is every bit as glamorous as it sounds. Surgery’s on hold pending CT scan results for some recent weight loss and general malaise. The surgeon was great, but his scheduler? Not so much—blissfully unaware of clinical notes or context. Also on Monday: knee rehab, the one appointment where I voluntarily sweat.

Tuesday: Scan Shuffle

The CT scan got the ol’ reschedule treatment thanks to a paperwork snafu about oral contrast. Apparently, getting some contrast bottles two hours early is harder than launching a SpaceX payload. So instead of the scan, I settled for a chest x-ray and a return trek through hospital hallways after leaving my sunglasses in the radiology room. Joy.

Wednesday: Laser Light Show

Time for a YAG laser zap to fix post-cataract cloudiness. In and out. No pain, no fuss. I did recommend the Fyodorov patient turntable to the doc, but he didn’t bite. (Too bad—it would improve throughput and provide carnival vibes.)

Thursday: A Breather

Only one follow-up appointment, which in this new medical lifestyle qualifies as a day off. Thursday is Lunch with Wifey day, so I indulged in a sandwich and a pile of fried breaded onion rings, which as you’ll soon see was not my only nutritional travesty of the week.

Friday: The Grand Contrast Caper

Finally got the CT scan—after a mere 40 minutes of waiting and a foot-up-the-ass inquiry at the front desk. After slugging two bottles of vintage 2025 contrast fluid, I was free to roam until scan time. I indulged in carrot cake (for science) and amused the skinny IV blonde with tales of banana dream cake—though her sense of humor remained unscanned.

CT Results: A Reluctant Relief

Good news: no malignancy. Just hernias and the usual 78-year-old relics of prior adiposity. Bad news: still feeling off, and Dr. DeLorean tends to tap out when medicine stops being linear. We’ll see what he offers at tomorrow’s follow-up—or if I’ll be referred to The Irascible Dr. Scrooge for further adventures in GI guesswork.

This week’s medical mayhem was facilitated by my trusty Tesla, which drove me to all the appointments. Full Self Driving is quite handy for these boring medical commutes, inspiring the question asked by some of my friends: If you conk out in the car, will it drive you to the hospital? We’ll see…

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Supplement Scam Alert

A brief sidebar on creatine, courtesy of influencer Thomas DeLauer. He tested various creatine gummies and found—surprise!—some contained no creatine. A smartphone app created by his partner SuppCo lets you scan barcodes to see how your supplements stack up. It’s possibly biased, definitely commercial, but potentially useful. I’ve installed it and turned off the spammy notifications.

I checked out my collection of supplements, which SuppCo calls my “supplement stack.” More vogue terminology bullshit, and I bet they say “based off of” in the office at SuppCo, but I digress. The vast preponderance of my “supplement stack” were rated “poor.” Harrumph!

Here is a link to SuppCo’s deep dive into creatine supplement testing.

As I type this, my Amazon Echo Show screen is flashing ads for creatine monohydrate gummies, triggering a directed-ad paranoia attack. Oy vey, what a world of dubiously modern bullshit we live in! Anyway, watch DeLauer’s video, with a Turkey-approved jaundiced eye, of course.

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This Week’s Mounjaro Numbers

• Weight: 176.2 lbs (up 2.6 lbs) — thanks, carrot cake.
• Average fasting glucose: 109 mg/dL — edging higher, time to tighten things up.
• Stelo overall average: 108 mg/dL — steady under the circumstances.

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Conclusion

So ends another thrilling episode of “As the Glucose Turns.” Six appointments, one carrot cake, and zero answers to the nagging malaise. Still, I didn’t die, didn’t need surgery (yet), and didn’t assault anyone in the waiting room—though I was tempted. The CT says I’m boringly normal, which is both comforting and confounding. Next week’s adventure hinges on whether Dr. DeLorean brings inspiration or inertia to the table. Stay tuned, my fellow metabolic misfits.

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For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

Your health-conscious Nittany Turkey is back atcha with another week of medical frivolity, pharmaceutical love/hate, and whatever else crosses my mind. I’ve just passed the one-year mark both taking Mounjaro and writing these updates, which center on that GLP-1 receptor agonist drugs and more specifically, tirzepatide, whose trade names are Mounjaro and Zepbound.

Via Mounjaro therapy combined with lifestyle changes in diet and exercise, this 78-year-old Type 2 diabetic has controlled his blood sugar, most recently scoring a 5.3% HbA1c, which deliciously makes my doctor jealous. “It’s lower than mine!” he exclaimed at our last encounter. Mounjaro has allowed me to eliminate metformin and halve my dose of losartan, a blood pressure control drug. Along with Mounjaro, I credit my amazingly supportive wife, my friends, you readers, and from time-to-time, my healthcare team (when I’m not bitching about them).

Nevertheless, along with the positive strides, there exists an omnipresent background reality of a near-octogenarian body that has seen better days. While I might be accused of over-sharing some personal health information, I know many of my readers either have endured similar health travails or will do so at some point. I hope that by providing TMI (too much information), I’ll help someone, somewhere. Plus, I love to write, and my expository efforts here provide a safety valve that helps me deal with the stress of living inside an unpredictable, old body.

Weight Loss: The Good, the Bad, and the Ugly

Over the year on Mounjaro, I have lost about 72 pounds of excess body weight. However, the most recent eight or ten of those pounds were unplanned and undesirable. I wanted to stop losing weight while concentrating on retaining or even building skeletal muscle. Thus, I had increased my caloric intake, especially the protein component, and I have been doing copious strength training workouts The plan was working well, with my weight hovering in the low 180-pound area until last weekend, when I suddenly dropped eight pounds, inspiring my latest visit to the fabled Dr. DeLorean (not his real name). I’ll talk about that visit, its sequels, and my busy week ahead in healthcare after our featured article.

In This Week’s Issue…

Rapid weight loss causes not only fat loss but also loss of muscle tissue. Coupled with sarcopenia, the muscle loss associated with aging, the results can be catastrophic for older adults. Heretofore, the remedy was strength training and increasing protein in the diet. This is a big problem for a couple of reasons. First of all, primary care physicians obsessing on the weight loss aspects seldom stress the crucial need to preserve muscle mass. Patients, too, become enthralled by decreasing numbers on the scale, in their euphoria not considering the possibility of collateral damage. When that realization arrives for some of them, it could be too late.

Although I have reservations about prescription drugs addressing all our body issues better than natural methods, I found the subject we’ll cover this week exceedingly interesting, especially for those of us who focus all our attention on weight loss. What if we could lose fat and gain muscle? Is that even possible. Well, saddle up and let’s take a ride through the monkey jungle to the confluence of the Trevogrumab and the Garetosmab, which define the fertile crescent of astounding pharmacological research.

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This Week’s Feature: Of Monkeys, Muscles, and Multinational Mischief

If you’ve been paying attention to the rapidly mutating landscape of weight-loss medications, you might’ve noticed that the latest shiny objects aren’t injectables, but injectable combos. And now, courtesy of Regeneron Pharmaceuticals, Inc., of Tarrytown, NY—who incidentally just pulled off a genetic database coup by acquiring the remnants of 23andMe—we’ve got a new pair of biologics in the spotlight: trevogrumab and garetosmab.

These two monoclonal antibodies are being studied in tandem with semaglutide (yes, that semaglutide, the generic name for Ozempic and Wegovy) to address the elephant in the examination room: muscle loss during rapid weight loss. As I have mentioned ad nauseam, it is a huge problem especially with GLP-1 drugs, where dieters lose weight fast but unfortunately lose a decent chunk of lean muscle in the process. So, Regeneron’s idea? Inject something that blocks muscle breakdown and perhaps even builds muscle, while semaglutide peels off the fat.

Monkey See, Monkey Gain

The inspiration comes from preclinical studies on obese monkeys, where combining semaglutide with trevogrumab and garetosmab not only reduced body fat but also increased skeletal muscle mass. Yes, you read that right—those lucky macaques lost weight and gained muscle, a metabolic unicorn if there ever was one. Try pulling that off at your local Planet Fitness!

So, what exactly are these mystery drugs?

• Trevogrumab is a monoclonal antibody that blocks myostatin, a protein that acts like a brake on muscle growth. Inhibiting it gives muscle tissue the green light to grow. Think of it as the anti-sarcopenia serum we’ve all been waiting for.

• Garetosmab targets activin A, another protein that suppresses muscle growth and promotes inflammation. Blocking both pathways theoretically amplifies anabolic signaling while dialing down the catabolic stress signals that GLP-1s may unintentionally stir up.

Together, this tag team may not only protect muscle mass during semaglutide-induced weight loss—but potentially reverse the muscle decline altogether.

Big Pharma’s Duality Dance

Now, before we break out the syringes and protein powder, remember: this is Regeneron. The company that gave us pricey eye injections and COVID monoclonals—both highly effective, mind you, but also wallet-vaporizing. So it’s no surprise that this muscle-preserving magic cocktail is currently sitting in Phase 2 clinical trials, with human results likely a year or two away. If Phase 3 goes smoothly (and that’s a big “if”), expect FDA filings around 2027 or 2028.

And pricing? Take a guess. If semaglutide alone can run $1,000+/month and a single monoclonal antibody like garetosmab (once studied for fibrodysplasia ossificans progressiva) is priced in the $300,000/year neighborhood—well, you do the dystopian math. Pairing two such drugs with a GLP-1 will likely result in a monthly bill much larger than your Social Security income and your Tom Selleck-approved reverse mortgage combined.

The Muscle Mass Mirage

Still, for a subset of patients—think elderly, frail, or cancer-cachexia cases—this combo therapy could be revolutionary. For the rest of us trying to keep our biceps from dissolving into batwings while on semaglutide or tirzepatide, it may be the ultimate carrot-and-stick routine… assuming your insurance company doesn’t laugh you out of the pharmacy.

Of course, for those of us who don’t mind some hard work, there’s always a cheaper alternative: lift weights, eat your protein, and maybe toss in some creatine. No prescription required.

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My Week on Mounjaro

So, as I mentioned above, I visited Dr. DeLorean on Tuesday with my tale of rapid weight loss and feelings of malaise. He did some blood draws: a CMP, CBC, and iron, as well as a urinalysis, and ordered an abdominal/pelvic CT scan and a chest X-ray, which I have scheduled for tomorrow. The blood results revealed an elevated white cell count, especially monocytes, so something is going on in there.

I still feel like crap, although I have been trying to keep up with strength training, much to the chagrin of my lovely wife. (But like she often exhorts to me, I’m not a princess). So, we await results of the imaging for more clarity on what ails me. From my point of view, my damn digestive tract is the root of all bodily evils, so I firmly believe that the answer will be found there. It might be bad or ugly, but it likely will not be good.

However, there was some good news in my lab report. The potassium spike noted on my May 17 blood work proved to be an anomalous blip. Potassium is back to normal.

Stacking It Up

I started physical therapy for my bum knee last Wednesday. I’m supposed to do that twice per week, but I scheduled only through today for a couple of reason. For one, this morning, I’m seeing a general surgeon to evaluate my inguinal hernia. My intent is to have it surgically repaired before it becomes a medical emergency. However, my schedule is a mess. The CT scan and Chest X-Ray results will bear heavily on my decision. I will not speculate on anything until I have digested them. As I mentioned above, I might or might not be able to schedule the six weeks of physical therapy I was prescribed, given the recovery time for hernia surgery, which will also impinge on my planned August road trip. So, albeit with a foreboding sense about the CT scan, I look forward to attaining more clarity as the week progresses.

I covered Monday and Tuesday, but the medical bullshit does not end there. On Wednesday morning, I will have YAG laser surgery on my left eye. Three-and-a-half years after cataract surgery, I have developed some cloudiness of the rear surface of the lens capsule, which is a common sequel. The YAG laser is a specialty tool that zaps the film and cleans up the visual field, not that all my floaters will go away or anything, but the cloudiness will be gone. For how long, no one knows.

Whew! About time I get to the numbers for the week, which are anticlimactic in comparison to the excitement of chasing around from medical facility to medical facility while waiting for results, which I’ll share with you in next week’s exciting update.

The Mounjaro Numbers, Already!

Given my unexplained weight loss, abetted by my appetite suppressing malaise, I have been eating opportunistically, not watching carbs. Thus, the glucose is a bit higher than I would like, although the weight keeps dropping.

Body weight: 173.6 lbs (78.9 kg) —  down another two pounds (0.9 kg) with no explanation
Average fasting glucose: 104 mg/dl (5.8 mmol/L) — would like it to return to the 90s
Average overall glucose (Stelo biosensor): 108 (6.0 mmol/L) — steady, all things considered.

Bonus Info: It Wasn’t the Coffee!

Remember Week 51, when I described a glucose spike I attributed to my morning coffee? Well, friends, I found the true reason for the spike, and it wasn’t the cuppa joe. Coffee does produce what can be described more accurately as a slight hump, but as it turns out, the spike was from the damn supplements I take in the morning before my coffee. Because of the Mounjaro Effect, I take a fiber supplement. I also take probiotic and magnesium supplements. I’ve been buying gummies without paying attention to the carbs. Well, friends, it turns out that all three supplements contain significant amounts of sugar and pack a combined 20g carb punch every morning. They were the culprit, not the coffee.

Conclusion: Of Science, Supps, and Sarcopenia

So there you have it—another week of GLP-1 rumination, medical spelunking, and simian steroidal envy. We began our odyssey deep in the metabolic jungle, where macaques on miracle meds defied the laws of thermodynamics and gained muscle while shedding fat. Meanwhile, back in the human world, I’m losing weight whether I want to or not, fighting off sarcopenia like it’s a rogue AI, and booking more appointments than a celebrity dermatologist during Oscar season.

This week brought a sobering reminder: weight loss without muscle preservation is a fool’s bargain, especially as we inch toward our eighth decade (with or without dignity). Whether future drugs like trevogrumab and garetosmab will be the golden ticket—or just another pricey detour on the road to “better living through chemistry”—remains to be seen. In the meantime, I’ll stick to my current stack: sweat, protein, creatine, and sarcasm.

Next week, we’ll parse scan results, ponder potential surgery, and maybe even exorcise that cloudy lens ghost with a well-placed YAG. Until then, stay skeptical, stay strong, and please—check the damn carb count on your gummies.

For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.

First Anniversary Edition!

Welcome to my weekly update, a place where you can take advantage of my firsthand experience with the Type 2 diabetes drug Mounjaro. Having been on Mounjaro therapy for a year now, I have enjoyed sharing lots of valuable information about GLP-1 receptor agonist drugs like Mounjaro (tirzepatide). Apart from Mounjaro, I also offer irreverent opinions about Big Pharma, the sad state of healthcare these days, and YouTube influencer disinformation sources.

I’m not a doctor, just a geriatric Mark Twain wannabe, so take any advice I offer with a grain of kosher salt. Do yourself a favor — do your own research. If you find this subject as intriguing as I do, you’ll be rewarded.

A Year on Mounjaro

You’ll note that I have ditched the old image of the moon rising over Mt. Kilimanjaro, which was a meaningless tribute to Facebook’s penchant for disallowing previous posts where I used an image of a Mounjaro injector. The crude and arbitrary Facebook spam detection bots condemned my posts accusing me of capitalizing on the popularity of GLP-1 drugs. The current image is suitably generic yet more relevant than the mooning mountains, so let’s see how that goes.

This 78-year-old Type 2 diabetic is in much better shape than when I initiated Mounjaro in June 2024. First at the 2.5 mg dose, I slowly amped it up to 5.0 mg and then 7.5 mg injected weekly, a dose I will likely not increase. Although the hunger suppression feature has faded, weight loss is no longer a goal. However, Mounjaro is still providing excellent glucose control. My HbA1c dropped from 7.4% to 5.3%, with fasting glucose now in the low 90s (except for a blip I write about below). I shed 70 pounds of blubber, facilitated by a low-carb dietary approach coupled with a stringent strength training program. My excellent progress on Mounjaro enabled me to de-prescribe metformin and cut my blood pressure medication in half.

I’ll remind you that this is not a damn “journey”, the trite characterization I avoid for good reason. It’s hard work, and slacking off was never an option. I try to impress that point on anyone who wishes to approach GLP-1 RA therapy.

Mounjaro is Not Magic

Given all the media coverage, the direct-to-consumer advertising by Big Pharma, and the inane YouTube, Instagram, and TikTok cheerleading channels dedicated to GLP-1 RAs, people might get the impression that these drugs are magic elixirs. I want to dispel the notion that they can sit on their asses eating doughnuts while losing hundreds of pounds and buying their way to a miracle cure for Type 2 diabetes and obesity. Without commitment to decent nutrition and punishing exercise, the only thing that will be permanently lighter will be their bank accounts. They might temporarily lose a few pounds and see some improvement in the numbers, but they’re not fixing what needs fixing—the behavior that landed them in the diabetic predicament. If they don’t intend to go all in, they might as well remain on the couch drinking beer and eating potato chips.

Adjusted Goals

Fortunately, my success story is not unique. Thousands of similar stories exist; all involve persistence and commitment. Let nothing here imply that my work is finished; I can never sit back and relax (with a donut or two). I will need to be especially careful once I discontinue Mounjaro.

Although my goals have shifted, the lifestyle changes must continue for the rest of my days. My current goal is to preserve or increase skeletal muscle mass, which would be difficult if I continue to lose weight. It is hard enough for an near octogenarian to avert sarcopenia, let alone build muscle. Therefore, I have adjusted my dietary protein and caloric intake upward, and I am increasing carbs. My secondary goal is to discontinue Mounjaro, with a target of year-end. Otherwise, I am in maintenance mode: preserved strength, continued excellent glucose control, and stable body weight.

Writing about one full year’s experience with Mounjaro has produced a treasure trove of compelling information for those embarking on GLP-1 RA therapy. I’ve covered much more than the drug and its side-effects, with subjects ranging from useful monitoring equipment to dietary revelations, from healthcare triumphs to shared laughs over the vagaries of the system and the odd characters comprising my healthcare team. If you have some spare time and a sense of curiosity about Mounjaro and its sister drugs, Ozempic, Wegovy, and Zepbound, please peruse my catalog of past updates.

Please note: This blog is not “monetized.” I write for the joy of writing, which is my only incentive.

In This Issue…

This week’s feature article materialized due to a surprise mid-week glucose spike. Because I routinely monitor my blood sugar, both through my Dexcom Stelo biosensor (a device like a continuous glucose monitor) and a traditional finger-stick Contour Next One glucometer, I can typically predict my glucose response curve. But last Tuesday’s sudden elevation defied explanation—until it didn’t. I quickly added two and two, got five, then did some digging to confirm my suspicions. Read about it below.

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The Circle of Strife: Steroids, Sugar, and Serendipity (Epilogue Edition)

This week brought an uninvited guest to my otherwise well-behaved glucose profile: a 40 mg triamcinolone injection. Wait, what? Delivered to my perpetually irascible left knee (the “good” one) by the sports med doc under ultrasound guidance, its design was to break the pain cycle so I could rehab it with relatively pain-free PT. While the knee appreciated the gesture, my blood sugar most certainly did not. Within hours, my Stelo biosensor (installed earlier that evening) threw up a reading of 170 mg/dL. Suspicious of a fresh sensor’s tendency to fabricate reality, I confirmed with a finger stick: 197 mg/dL. Being reasonably well controlled until now, that’s not a spike — that’s an erupting glucose volcano!

I recalled that corticosteroids (for example, Prednisone, taken by mouth) can increase blood glucose. However, the famous Dr. DeLorean (not his real name) once told me that cortisone injected in the knee would not produce that same glucose elevating effect. As my story unfolds, you’ll see that was bullshit. I lay out the facts below.

While local in intent, injected steroids often go global in effect. Their MO includes amping up hepatic gluconeogenesis and reducing insulin sensitivity — the metabolic equivalent of cutting the brake lines while greasing the brake pads just to be sure. Cutesy metaphors aside, impelled by the alarmingly unexpected spike alert from the Stelo, I sought countermeasures.

Enter the ghost of therapies past: metformin, which I’d discontinued last November after Mounjaro had taken the glucose control reins.

Metformin to the Rescue

It turns out that not only could metformin have blunted the steroid-induced glucose surge, but a recent Australian study also links it to reduced knee pain in diabetic and obese patients. (See JAMA graphic on the right). In other words, the drug I had stopped might have eliminated the need for the injection that caused the glucose spike it could have treated. Metabolic karma! Who knew?

Conveniently, due to clerical ineptitude from the fabled Dr. DeLorean’s office, my old metformin script was never canceled. A fresh bottle had recently arrived on my doorstep courtesy of my much vilified, revenue-hungry PBM. So I took action: 500 mg that night, 500 mg the next morning, and 500 mg that evening for good measure. Encouraged by more reasonable glucose measurements, I stopped after that, as I did not want to press my luck with metformin-induced diarrhea.

Normogluteability Restoration Protocol

I dubbed this my normogluteability restoration protocol, my latest pseudo-medical neologism. (Bullshit, by any other name, would smell as sweet…). As my research predicted, by Friday morning, I was approaching my version of normal. Glucose excursions had returned to their pre-steroid baselines: my usual morning coffee bump settled around 140 mg/dL, and postprandial readings remained tame. Stelo and Contour Next One readings agreed. Time and metformin were the victors in this metabolic tug-o-war.

So, for anyone following along in these grand Mounjaro chronicles: yes, steroid injections can spike your glucose, even if they’re aimed at your knee and not your pancreas. And yes, metformin can serve as a short-term countermeasure, even after months off-duty. And finally, yes, the American healthcare system will still ship you drugs you’re not taking, occasionally serendipitously.

I sent an informative description of my research to my sports med doc via her Almighty Patient Portal (see Week 50). Although I prefaced my comments with “no reply is necessary”, I am hoping that these revelations will remind her to brief other diabetic patients about the potential glucose spike after steroid injections. Of course, her typical patients are NBA players for the local team, so she probably doesn’t see many diabetic old farts like me.

Next week: either back to smooth sailing, or another installment of “As the Beta Cells Turn.” For now, if you’re curious about the mechanism by which injected corticosteroids can affect blood glucose, read the next section. It is a detailed, technical description of the process. Afterwards, we’ll wrap up the week with a look at my slightly wild numbers.

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My Week on Mounjaro

Above, I referred to my Tuesday knee evaluation. My “good” knee has been giving me pain when climbing or descending stairs, but not while walking, even for long distances. I decided to see the sports med doc about it. After viewing MRI results from last year and Tuesday’s fresh X-rays, she gave me some options, which included my ultimate choice: a steroid injection to provide short-term relief, breaking the pain cycle, plus a course of physical therapy. Another alternative is the hyaluronic acid injection which lasts longer for some people, but doesn’t work as well for others. I rejected that path for now. And, of course, I’ve been trying to avoid knee replacement surgery at all cost.

On Wednesday morning, I donated a pint of my finest B- borscht for anyone who needs the rare type. I figured that the increased glucose would give them a hyperglycemic energy boost to accelerate fixing whatever necessitated the transfusion. Pre-donation qualification by the blood bank revealed that my iron isn’t in bad shape, so it is responding to the Feosol Complete supplementation. I’m pleased to report that my hemoglobin clocked in at 14.0 g/dL.

I had a decent deadlift day on Thursday, followed by a Korean lunch. However, I felt a little off for Friday’s gym session. The exercise physiologist, who had last seen me a week before, noted that I looked like I had lost weight. As you’ll see below, I had indeed shed several pounds. My lack of energy continued on Saturday, so I skipped the home workout, but inspired by Jenny’s deadlifts, I resumed upper body work on Sunday. Nevertheless, my energy deficit, coupled with an unexplained weight loss, remains troubling. Something ain’t right!

The Mounjaro Numbers, Already!

My temporary glucose excursion resulting from the steroid injection, albeit somewhat muted by metformin, is evident in the readings below.

Body weight: 175.6 lbs (79.8 kg) — down 4.6 lbs (2.1 kg) an alarming loss with no explanation
Average fasting glucose: 110 mg/dl (6.1 mmol/L) — out of range the morning after the shot
Average overall glucose (Stelo biosensor): 123 (6.8 mmol/L) — elevated, due to temporary effects of corticosteroid.

Starting a New Year on Mounjaro

This week should be relaxing. I hope to shake whatever is sapping my energy and I hope to not lose any more weight, to avoid freaking Jenny out. (She is worried that I will soon weigh less than she does, but I digress). I’ll be seeing my favorite PT (physical torturer) for the knee rehab evaluation on Wednesday morning, the only quasi-medical appointment for the week, leading into next week’s healthcare triple-header of a hernia evaluation on Monday, a renal ultrasound on Tuesday and a YAG laser eye-zap on Wednesday. (Throw in the YAG laser follow-up appointment on Thursday and we’ve got every day covered except Friday the Thirteenth).

Reflections at the One-Year Mark

So here we are — one full year of Mounjaro therapy in the rear-view mirror, and it’s been anything but dull. I’ve been poked, prodded, scanned, injected, monitored, and data-logged like a diabetic lab rat with a Fitbit. But through it all, the numbers don’t lie: HbA1c, weight, blood pressure, glucose variability — all dramatically improved. That’s not the magic of a weekly injection. That’s the product of a disciplined, occasionally deranged, commitment to better health.

Still, this week’s detour via steroid-induced glucose chaos was a helpful reminder: diabetes doesn’t sleep, and pharmacologic surprises lurk behind every well-intentioned procedure. It also reminded me that old tools (like metformin) can still have a role to play, even when your primary therapy is humming along nicely. The moral? Stay flexible, stay curious, and keep a few metabolic tricks up your sleeve.

Looking Ahead

As I embark on Year Two, my goals are shifting — not because I’m done, but because diabetes management evolves. I’m focused now on preserving muscle, maintaining metabolic stability, and gradually weaning off Mounjaro. If that proves feasible, great. If not, it won’t be for lack of effort. Either way, I’ll keep showing up at the gym, eating like a man who reads nutrition labels for fun, and poking my fingers when the Stelo gets suspicious.

Thanks for sticking around through 52 weeks of sarcasm, science, and blood sugar psychodrama. If you’ve learned anything from my misadventures, great. If not, at least I hope you were entertained. Stay tuned for Week 53 — who knows what body part will rebel next?

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For an annotated catalog of all my Mounjaro updates, please visit my Mounjaro Update Catalog page.