Popular weight loss drug may help people with Type 1 diabetes cut back on insulin, small study suggests

Treatment with the diabetes and weight loss drug semaglutide may allow people newly diagnosed with Type 1 diabetes to dramatically cut back or even completely stop insulin injections, a very small study published Wednesday suggests.

The drug — known more commonly as Ozempic or Wegovy — has soared in popularity in the past year, largely because of its effects on weight loss. Officially, Ozempic is approved to treat Type 2 diabetes, while Wegovy is approved for weight loss.

In the report — published as a research letter in the New England Journal of Medicine — researchers analyzed previously collected data from 10 people with Type 1 diabetes who had started taking semaglutide weekly. Three months into the treatment, all were able to stop taking insulin with meals. Within six months, seven out of the 10 were able to stop taking insulin altogether, according to the report.

Experts not involved with the study called the results exciting, but stressed that much more research is needed.

The findings surprised even the study authors.

“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,” the lead author, Dr. Paresh Dandona, said, referring to two types of insulin, one fast-acting and used to blunt blood sugar spikes after eating, and the other more long-acting, meant to keep blood sugar steady throughout the day.

“It was almost like science fiction,” said Dandona, a professor of medicine at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences in New York.

People with Type 1 and Type 2 diabetes both have trouble controlling blood sugar levels. But the causes of the conditions — and how they are treated — are different.

Type 1 diabetes is an autoimmune disease. In Type 1 diabetes, the body mistakenly attacks and destroys beta cells in the pancreas that produce insulin. Insulin is a molecule that tells the body to move sugar from the blood into cells, where it can be used for energy. People with Type 1 diabetes must therefore take insulin, because their bodies cannot make it.

In Type 2 diabetes, the beta cells in the pancreas are not attacked, but they do not produce enough insulin. In addition, the body doesn’t respond well to the insulin that is produced, a condition known as insulin resistance. Drugs for Type 2 diabetes work in different ways, including lowering blood sugar, increasing insulin sensitivity and increasing insulin production.

How could semaglutide help?

Semaglutide helps with Type 2 diabetes by mimicking a hormone in the body called GLP-1, which is released in the digestive system after eating and prompts the body to make more insulin, which in turn lowers blood sugar.

In 2011, Dandona had tried treating patients with Type 1 diabetes with a related but less effective medication, liraglutide. That medication, which also mimics GLP-1, reduced the amount of insulin patients needed but not as dramatically as what he described in the new report.

When semaglutide came on the market, he was intrigued. Around that time, he said, he also learned that when people were diagnosed with Type 1 diabetes, they still had 50% of their insulin reserve intact.

“I thought why not try treating patients newly diagnosed with Type 1 diabetes and see what happens” he said.

To see whether the semaglutide was working, Dandona looked at patients’ blood sugar levels; lower levels would suggest it was having an effect. At diagnosis, the average HbA1c level (a measure of a person’s average blood sugar level over 90 days) was 11.7, far above the recommended 7 or below. Six months later, the patients’ HbA1c levels had dropped to 5.9, on average, and at 12 months, it had fallen to an average of 5.7.

Another big advantage for the patients was that their blood sugar levels did not fluctuate, but rather remained level.