High blood sugar (hyperglycemia) is one of the possible side effects of Itovebi treatment.
A more complete overview of Itovebi side effects, including tips that may help, can be found at Side Effects & Tips.
This page can help you understand why blood sugar levels may rise with Itovebi treatment, how blood sugar levels are monitored, and what you and your healthcare provider (HCP) can do to help manage them.
What is hyperglycemia?
Hyperglycemia is a higher-than-normal amount of sugar in the blood. It is also called high blood glucose, or high blood sugar.
- High blood sugar is common with Itovebi and may be severe or fatal
- Untreated severe hyperglycemia can lead to a condition called diabetic ketoacidosis that can happen in people treated with Itovebi
- Diabetic ketoacidosis is a serious condition that requires treatment in a hospital and that can lead to death
- Your healthcare provider will monitor your blood sugar levels before you start and during treatment with Itovebi. Tell your healthcare provider right away if you develop symptoms of high blood sugar, including excessive thirst, urinating more often, blurred vision, confusion, difficulty breathing, or increased appetite with weight loss
Be proactive in monitoring and managing your blood glucose levels.
Why is hyperglycemia common with Itovebi treatment?
High blood sugar is not a sign that something has gone wrong with your treatment. It happens because of how Itovebi works in your body.
Normally, a hormone called insulin helps control your blood sugar, letting it move from your bloodstream into your cells (like in your muscles and fat) to be used for energy or stored. Insulin also tells your liver not to make too much sugar.
Itovebi can block these normal insulin signals. This means sugar might not move into your cells as easily, and your liver might produce more sugar, leading to higher blood sugar levels. It's important to work with your HCP to manage high blood sugar levels to help you stay on treatment.
How is glucose monitored in patients on Itovebi?
Your HCP may monitor your fasting blood glucose in their office or clinic, or may ask you to self-monitor and report your fasting glucose levels at home.
“Fasting” means not eating or drinking anything except water for at least 8 hours (usually overnight) before your blood glucose measurement.
Monitoring will be required more frequently in the first 4 weeks of treatment. If your HCP suggests you monitor at home, ask them to recommend a glucose monitoring method for you.
Review the discussion guide for glucose monitoring to prepare for a conversation with your HCP.
Download the Blood Glucose Tracking Worksheet to keep track of your fasting blood glucose levels. Share the worksheet with your HCP at your appointments.
Monitoring schedule
Fasting glucose level
| Once | before starting Itovebi |
| Week 1 | every 3 days |
| Weeks 2-4 | once a week |
| Weeks 5-12 | once every 2 weeks |
| After Week 12 | once every 4 weeks and when your doctor feels it's needed |
Hemoglobin A1C
| Once | before starting Itovebi |
| Once | every 3 months and when your doctor feels it's needed |
If you have a history of Type 2 diabetes, your blood sugar level monitoring may be more frequent.
How can you and your care team manage hyperglycemia?
Consume low glycemic index (GI) foods
Foods such as leafy greens, whole grains (quinoa and oats), lentils, nuts, berries, and sweet potatoes cause slower, steadier rises in blood sugar. Avoid or limit things like white bread, white rice, white potatoes, sugary drinks, and ultraprocessed snacks.
Balance your meals with macronutrients
Structure meals with lean protein (chicken, tofu, fish, eggs), healthy fats (avocado, olive oil, seeds), and fiber-rich carbs (veggies, legumes, whole grains). Protein and fat slow the absorption of carbs and reduce blood sugar spikes.
Eat meals at consistent times
Consistency helps avoid blood sugar spikes and crashes. In addition to your 3 meals a day, you might also include 1–2 small snacks spaced evenly.
Stay well-hydrated during treatment with Itovebi
Drink water regularly. Dehydration can make blood sugar more difficult to control.
Exercise aerobically
Regular brisk walking, cycling, swimming, or even dancing can enhance insulin sensitivity and help glucose uptake by your muscles. Aim for around 150 minutes per week (30 minutes a day/5 days a week).
Train to be stronger
Strength training builds muscle, which improves glucose metabolism. Consider bodyweight exercises, weightlifting, or resistance bands 2–3 times a week.
Move around after meals
It reduces after-meal spikes in sugar levels. Consider a light 10–15 minute walk after your meal.
Manage stress
Stress hormones, such as cortisol, can increase blood sugar levels. Deep breathing, meditation, yoga, hobbies, or therapy may help.
Don’t skimp on sleep
Poor sleep hygiene can impair insulin sensitivity. Try to get 7–9 hours of consistent, quality sleep per night.
In a clinical study of Itovebi, among the people who developed hyperglycemia, about half experienced it within the first 7 days.†
†The time to first onset of hyperglycemia ranged from 2 to 955 days.
SPEAK WITH A NURSE EDUCATOR
Receive one-on-one information sessions about Itovebi at no cost*
*Nurse Educators are representatives of Genentech and do not give medical advice. Please contact your healthcare provider if you experience side effects or need medical advice. A Nurse Educator can help with additional support and tips.
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