In a groundbreaking development, a preliminary study suggests that the diabetes and weight loss drug semaglutide, known by its commercial names Ozempic and Wegovy, could potentially enable individuals recently diagnosed with Type 1 diabetes to significantly reduce or even eliminate their reliance on insulin injections.
The popularity of semaglutide, particularly for its weight loss effects, has surged over the past year. Officially approved for Type 2 diabetes treatment and weight loss, Ozempic and Wegovy have become household names.
The study, published as a research letter in the New England Journal of Medicine, scrutinized existing data from a mere 10 individuals recently diagnosed with Type 1 diabetes who commenced weekly semaglutide therapy. Astonishingly, three months into treatment, all participants were able to discontinue insulin use during meals. Within six months, seven out of the ten subjects no longer required insulin at all, according to the report.
While experts not associated with the study express excitement over these findings, they emphasize the need for further extensive research.
Dr. Paresh Dandona, the lead author and a professor of medicine at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences, expressed his surprise at the results, stating, “I was absolutely shocked that we could get rid of fast-acting insulin in three months and then basal insulin in seven out of 10 patients. It was almost like science fiction.”
Both Type 1 and Type 2 diabetes pose challenges in controlling blood sugar levels, albeit with different etiologies and treatment approaches. Type 1 diabetes results from an autoimmune response that targets and destroys pancreatic beta cells responsible for insulin production, necessitating insulin therapy. In contrast, Type 2 diabetes typically involves insufficient insulin production by beta cells and insulin resistance.
Semaglutide, in the context of Type 2 diabetes, functions by mimicking the action of a hormone called GLP-1, released post-meals to stimulate insulin secretion, subsequently lowering blood sugar levels. Dr. Dandona’s earlier experiment with liraglutide, a related GLP-1 mimic, exhibited insulin reduction effects, though less pronounced than those observed in the current study.
Dandona’s motivation to explore semaglutide’s potential in Type 1 diabetes stemmed from the realization that newly diagnosed patients still possess a considerable insulin reserve. The study assessed blood sugar levels as a marker of treatment efficacy, revealing a substantial drop in HbA1c levels over time.
Apart from the reduced insulin dependency, participants benefitted from stable blood sugar levels without significant fluctuations.
Researchers, focusing on recently diagnosed patients, are hopeful that semaglutide may not only help reduce insulin usage but also preserve beta cells. Such an outcome could revolutionize the treatment paradigm for Type 1 diabetes.
While this study holds promise, larger and longer-term investigations are crucial before recommending any changes to treatment protocols. Dr. Dandona has initiated collaborative efforts with diabetes investigators across multiple centers for future research, pending funding.
Notably, Novo Nordisk, the manufacturer of semaglutide, is not presently involved in Type 1 diabetes research related to semaglutide.
Experts have welcomed this study but caution that more extensive research is essential before altering treatment guidelines. Dr. Michael Natter, an endocrinologist at NYU Langone Health, expressed excitement while emphasizing the need for larger studies. As a person with Type 1 diabetes, he shared anecdotal evidence suggesting that semaglutide could indeed reduce insulin requirements and improve blood sugar control.
Dr. Vanita Aroda, director of diabetes clinical research at Brigham and Women’s Hospital in Boston, lauded the study’s focus on newly diagnosed patients as “brilliant” and called for further investigations to assess the potential benefits for Type 1 diabetes patients.
Dr. Utpal Pajvani, an associate professor of medicine at Columbia University’s Vagelos College of Physicians and Surgeons, found the research “very, very interesting” but underscored the need for external validation. He also pointed out limitations in the study, such as its retrospective nature and the possibility of Type 2 diabetes misclassification.
Despite these challenges, experts remain intrigued and optimistic about the potential impact of semaglutide on Type 1 diabetes treatment. Further research will be crucial to validate these promising initial findings.
