Semaglutide can also be beneficial to people with type 1 diabetes, clinical trial finds

Semaglutide (identified by its model title Ozempic) has gained widespread consideration for its weight-loss advantages, however is formally permitted for managing sort 2 diabetes. Whereas there’s at present restricted information on its dangers and advantages for these with sort 1 diabetes, new analysis presents promising insights.

A brand new examine reveals that semaglutide can enhance glucose ranges for individuals with sort 1 diabetes who use automated pumps, with out growing hypoglycemia. On this double-blinded randomized trial carried out on the Centre for Progressive Drugs of the Analysis Institute of the McGill College Well being Centre (The Institute), individuals utilizing semaglutide alongside automated insulin remedy had been capable of keep protected glucose ranges for longer durations.

The outcomes of the examine had been just lately printed within the journal Nature Drugs.

“The everyday aim for sufferers with sort 1 diabetes is to take care of a glycated hemoglobin (HbA1c) stage of lower than 7%, and to stay inside the goal glycemic vary for 70% or extra of the time, with a purpose to cut back the danger of microvascular and macrovascular issues. Nonetheless, research counsel that nearly half of all individuals utilizing automated insulin pumps fail to realize 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 examine reveals that the addition of semaglutide will help them higher handle the illness.”

In sort 1 diabetes, the pancreas is unable to provide insulin, a hormone that regulates glucose ranges. Because of this, individuals with diabetes should constantly monitor their blood glucose ranges and supply their our bodies with the quantity of insulin they should keep away from issues.

Attaining this aim will be facilitated by means of an automatic insulin supply (AID) system, generally often called an insulin pump, which permits for the automated administration of insulin doses which can be adjusted in actual time due to a glucose sensor and an algorithm that performs the mandatory calculations.

“A number of improvements have improved automated insulin supply methods, which represent probably the most superior remedy for sort 1 diabetes. For that cause, the placebo intervention, which consisted of utilizing the AID with a weekly injection of a placebo, represented one of the best commercially out there therapy and subsequently the best level of comparability,” 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 individuals. In the course of the first 15 weeks, half of the individuals 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 in the beginning of the trial). The dose of semaglutide was regularly elevated as much as 1 mg or the utmost tolerated dose.

Over the past 4 weeks of the 15, individuals used a research-created automated insulin pump. After this intervention, individuals 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 medical trial, semaglutide use led to decrease insulin necessities and elevated weight reduction. It confirmed larger advantages in individuals with a better physique mass index, as they misplaced extra weight and achieved larger glycemic advantages. This has necessary implications, because the prevalence of weight problems in individuals with sort 1 diabetes is growing and is related to the danger of heart problems and issues.

Whereas no diabetic ketoacidosis—a life-threatening complication of diabetes—or extreme hypoglycemia occurred in the course of the trial, there have been two episodes of recurrent excessive ketone ranges with out excessive blood sugars or acidosis that occurred whereas individuals had been utilizing semaglutide. Excessive ketone ranges can happen in individuals with sort 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 could make blood acidic and trigger extreme sickness. Gastro-intestinal unwanted side effects had been additionally related to semaglutide.

“We all know that off-label use of semaglutide is rising in individuals with sort 1 diabetes, regardless of a lack of awareness to information sufferers and well being care suppliers on the advantages and dangers related to it,” says Dr. Melissa-Rosina Pasqua, the examine’s first writer, endocrinologist on the MUHC and doctoral pupil at The Institute, who coordinated the examine.

“This examine addresses a present therapy hole and is a crucial stepping stone in demonstrating the advantages of this drug, in addition to the continued want to coach sufferers in regards to the dangers of excessive ketone ranges.”