Semaglutide, a medication widely recognized for its weight loss effects under the brand name Ozempic, is primarily approved for the treatment of type 2 diabetes. However, recent research has explored its potential for managing type 1 diabetes, a condition where the pancreas fails to produce insulin. The findings, published in Nature Medicine, indicate that semaglutide may offer significant benefits for individuals with type 1 diabetes using automated insulin pumps, improving glucose control without increasing the risk of hypoglycemia.
The study, led by Dr. Michael Tsoukas at the Centre for Innovative Medicine of McGill University Health Centre, aimed to assess whether semaglutide could help patients achieve better glycemic control when combined with automated insulin therapy. A double-blind, randomized trial involving 28 adult participants revealed promising results. Those who received semaglutide injections in addition to their usual insulin therapy maintained safer glucose levels for longer durations compared to those who received a placebo.
Dr. Tsoukas, who serves as the principal investigator of the study, explained, “The goal for type 1 diabetes management is to maintain a glycated hemoglobin (HbA1c) level of less than 7% while staying within the target glycemic range for over 70% of the time. However, almost half of insulin pump users struggle to meet these goals. Our study shows that adding semaglutide can help these patients manage their condition more effectively.”
Type 1 diabetes requires constant blood glucose monitoring, as the pancreas cannot produce insulin. Automated insulin delivery systems, or insulin pumps, offer a solution by adjusting insulin doses based on real-time glucose sensor readings. According to Ahmad Haidar, Ph.D., the lead scientist of the study, these pumps represent the most advanced form of diabetes therapy, and semaglutide showed additional benefits when used in conjunction with this technology.
The trial lasted for 32 weeks, with participants divided into two groups. Half received a weekly dose of semaglutide, while the other half received a placebo. The semaglutide dosage was gradually increased to 1 mg, or the maximum tolerated amount. After the first 15 weeks, participants switched groups for the remaining period. Throughout the study, participants continued using their insulin pumps.
In addition to improving glucose control, semaglutide use resulted in reduced insulin requirements and significant weight loss, particularly among individuals with higher body mass indexes (BMIs). These findings are crucial given the rising rates of obesity among individuals with type 1 diabetes, a condition that exacerbates the risk of cardiovascular complications.
While no cases of diabetic ketoacidosis (DKA), a severe diabetes complication, or major hypoglycemic episodes were observed, two participants experienced high ketone levels without high blood sugars. Ketone buildup can occur when the body doesn’t have enough insulin to absorb glucose, leading it to break down fat for energy. This condition can lead to dangerous health complications if left unchecked. Gastrointestinal side effects were also noted among participants using semaglutide.
Dr. Melissa-Rosina Pasqua, the study’s first author, emphasized the growing off-label use of semaglutide in type 1 diabetes treatment, despite limited guidance on its risks and benefits. “This study fills an important gap in current treatment knowledge and highlights the need for continued education for both patients and healthcare providers regarding the potential risks, such as elevated ketone levels,” said Dr. Pasqua.
While more research is needed to fully understand the long-term effects of semaglutide for type 1 diabetes, this study provides a promising step forward in the exploration of novel treatments for the condition.
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