Is Vyepti Raising My Blood Sugar?

I am one of the lucky people to have found a combination therapy regimen that manages my chronic migraine well enough to live life on my terms.

What have I noticed since taking Vyepti?

I currently use an anti-CGRP (calcitonin gene-related peptide) medicine called Vyepti® (eptinezumab). I’ve also used Ajovy® (fremanezumab) and Emgality® (galcanezumab) combined with Nurtec® (rimegepant). These are the newest migraine preventives.

As part of my routine with treating chronic migraine, I continually track how my body reacts to those treatments. Since beginning Vyepti, I have noticed a trend in my bloodwork. My blood glucose levels have been ticking up despite:

• Eating less
• Cutting my sugar intake
• Being able to exercise more regularly

When I was taking Ajovy and Emgality, this trend was absent. So I began to research what CGRP does in our bodies. I read through several studies and found that CGRP is throughout our bodies. It affects different areas, including the:¹

• Nervous system
• Cardiovascular (heart and blood vessel) system
• Endocrine system
• Thyroid
• Pancreas

I’ve been fighting to manage debilitating migraine disease actively for the past 12 years. I know my body reacts differently to different medicines. This is the main reason I track my migraine disease across a wide swath. It helps me notice the subtle changes my body has during treatment.

How CGRP antagonists impact the body

CGRP has many benefits for your body. The CGRP antagonists prevent the available CGRP in our bodies from doing its typical job. In the case of migraine prevention, that’s a benefit for me. Still, if these drugs prevent CGRP from allowing my body to metabolize glucose or affect my insulin resistance normally, it is a risk I must carefully weigh. There has been very little study into the effect anti-CGRP drugs have on blood sugar. According to a study conducted on mice, some anti-CGRPs may increase the risk of developing type 2 diabetes.²

Apparently, human and mouse insulin behave similarly. I have spoken to my headache specialist. And I will follow up with my primary care doctor after my next round of bloodwork.

Is Vyepti affecting my blood sugar?

The risk versus reward levels are important to me when managing multiple health conditions. The trend for my glucose levels since starting a 300-milligram dose of Vyepti has shown my A1c levels go from 5.6 up to 6.0. And my fasting glucose levels have increased from 91 to 148 milligrams per deciliter. As I said earlier, this is despite lifestyle changes aimed at improving those levels.

There was no such trend while I was taking Ajovy or Emgality. I took these for far longer than Vyepti. At this point, I’m left wondering if the way my body uses Vyepti is indeed affecting my insulin resistance and raising my blood glucose. This is another hurdle to jump along my migraine journey, and I’m not going to let it get the best of me.

What's my next move?

Using a new medicine always poses risks. This is true even when the drug has been approved by the U.S. Food and Drug Administration (FDA). I have filed my concern with the government site for reporting medication reactions. If the "side effect" of using Vyepti is my developing type 2 diabetes, that is something I will have to reconcile within myself and with the help of my treating doctors.

It pains me to have to treat 1 condition caused by another. The benefits and risks may sometimes balance each other, but not always. One option to explore may be using the lower strength of Vyepti combined with Botox® (onabotulinumtoxinA) and Nurtec. I will start that regimen next month and will keep you informed.

Has anyone else had to balance the risks and rewards as part of their therapy regimens? Let’s discuss this in the comments.