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Semaglutide (identified by its model identify Ozempic) has gained widespread consideration for its weight-loss advantages, however is formally authorised for managing kind 2 diabetes. Whereas there’s at present restricted knowledge on its dangers and advantages for these with kind 1 diabetes, new analysis presents promising insights.
A brand new examine reveals that semaglutide can enhance glucose ranges for individuals with kind 1 diabetes who use automated pumps, with out rising hypoglycemia. On this double-blinded randomized trial performed on the Centre for Revolutionary Medication of the Analysis Institute of the McGill College Well being Centre (The Institute), contributors utilizing semaglutide alongside automated insulin remedy had been in a position to preserve protected glucose ranges for longer intervals.
The outcomes of the examine had been lately revealed within the journal Nature Medication.
“The typical goal for patients with type 1 diabetes is to maintain a glycated hemoglobin (HbA1c) level of less than 7%, and to remain within the target glycemic range for 70% or more of the time, in order to reduce the risk of microvascular and macrovascular complications. However, studies suggest that almost half of all people using automatic insulin pumps fail to achieve this,” explains Dr. Michael Tsoukas, principal investigator of the examine, Investigator within the Metabolic Problems and Issues Program at The Institute and Affiliate Professor within the Division of Endocrinology, McGill College Well being Centre (MUHC). “Our study shows that the addition of semaglutide can help them better manage the disease.”
In kind 1 diabetes, the pancreas is unable to supply insulin, a hormone that regulates glucose ranges. Consequently, individuals with diabetes should repeatedly monitor their blood glucose ranges and supply their our bodies with the quantity of insulin they should keep away from problems.
Attaining this purpose will be facilitated by means of an automatic insulin supply (AID) system, generally often known as an insulin pump, which permits for the automated administration of insulin doses which are adjusted in actual time due to a glucose sensor and an algorithm that performs the mandatory calculations.
“Multiple innovations have improved automated insulin delivery systems, which constitute the most advanced therapy for type 1 diabetes. For that reason, the placebo intervention, which consisted of using the AID with a weekly injection of a placebo, represented the best commercially available treatment and therefore the ideal point of comparison,” says Ahmad Haidar, Ph.D., lead scientist of the examine, Scientist within the Metabolic Problems and Issues Program at The Institute and Affiliate Professor within the Division of Biomedical Engineering at McGill College.
The trial lasted a complete of 32 weeks and included 28 grownup contributors. Throughout the first 15 weeks, half of the contributors injected themselves with a weekly dose of semaglutide, and the opposite half with a placebo, whereas persevering with their very own insulin remedy (22 of the 28 had been utilizing an insulin pump firstly of the trial). The dose of semaglutide was steadily elevated as much as 1 mg or the utmost tolerated dose.
Over the past 4 weeks of the 15, contributors used a research-created automated insulin pump. After this intervention, contributors took a two-week break and switched teams, in order that those that had began on semaglutide took a placebo, and vice versa, for one more 15 weeks.
Advantages related to weight reduction and decrease insulin necessities
Within the scientific trial, semaglutide use led to decrease insulin necessities and elevated weight reduction. It confirmed better advantages in contributors with a better physique mass index, as they misplaced extra weight and achieved better glycemic advantages. This has essential implications, for the reason that prevalence of weight problems in individuals with kind 1 diabetes is rising and is related to the chance of heart problems and problems.
Whereas no diabetic ketoacidosis—a life-threatening complication of diabetes—or extreme hypoglycemia occurred throughout the trial, there have been two episodes of recurrent excessive ketone ranges with out excessive blood sugars or acidosis that occurred whereas contributors had been utilizing semaglutide. Excessive ketone ranges can happen in individuals with kind 1 diabetes when there’s not sufficient insulin for the physique to soak up sugar, so the physique breaks down fats as a substitute; at very excessive ranges, this will make blood acidic and trigger extreme sickness. Gastro-intestinal negative effects had been additionally related to semaglutide.
“We know that off-label use of semaglutide is rising in people with type 1 diabetes, despite a lack of information to guide patients and health care providers on the benefits and risks associated with it,” says Dr. Melissa-Rosina Pasqua, the examine’s first creator, endocrinologist on the MUHC and doctoral scholar at The Institute, who coordinated the examine.
“This study addresses a current treatment gap and is an important stepping stone in demonstrating the benefits of this drug, as well as the ongoing need to educate patients about the risks of high ketone levels.”
Extra data:
Melissa-Rosina Pasqua et al, Subcutaneous weekly semaglutide with automated insulin supply in kind 1 diabetes: a double-blind, randomized, crossover trial, Nature Medication (2025). DOI: 10.1038/s41591-024-03463-z
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Semaglutide can be helpful to individuals with kind 1 diabetes, scientific trial finds (2025, January 15)
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