GLP-1 medicines like semaglutide (Ozempic, Wegovy), dulaglutide (Trulicity), and tirzepatide (Mounjaro, Zepbound) are making headlines in kind 2 diabetes, however individuals with kind 1 diabetes (T1D) are taking these medicines, too. No, these medicines are usually not permitted by the U.S. Meals and Drug Administration (FDA) for T1D, however nonetheless many individuals are taking them off-label with the total approval of their medical doctors.
The advantages of GLP-1 medicines for T1D are actually fairly apparent, and but many clinicians are nonetheless reluctant to make this medicine extra accessible to this inhabitants.
Right here’s a more in-depth have a look at why individuals with T1D are utilizing GLP-1 medication and why they maintain calling it a “recreation changer.”
The Advantages of GLP-1 Medication for Sort 1 Diabetes
Listed here are a couple of explanation why GLP-1 medicines like Ozempic can have such a big effect on T1D well being and blood sugar administration:
- Weight reduction: Weight problems could be very prevalent in T1D. In truth, 62 % of adults with T1D are obese or overweight. Managing your weight with T1D isn’t simple since you’re taking injections of insulin, a hormone that shops extra glucose as physique fats!
- Hormonal well being: In kind 1 diabetes, your physique additionally doesn’t correctly regulate the manufacturing of 5 different hormones that handle your urge for food, liver glucose manufacturing, satiety, insulin sensitivity, and extra! GLP-1 medicines assist your physique compensate for the misproduction of these different hormones.
- Insulin sensitivity: Many individuals with T1D battle to keep up insulin sensitivity, which implies you want increasingly more insulin to do the identical job. This makes it more durable to achieve or keep your A1C objectives. In truth, some clinicians are additionally diagnosing T1D sufferers with T2D due to that overlapping insulin resistance and weight battle. GLP-1s can considerably cut back your physique’s day by day insulin wants, making it simpler to handle blood glucose ranges.
GLP-1 medicines are usually not permitted for the therapy of kind 1 diabetes, and a few clinicians are nervous about them as a result of they enhance an individual’s danger of hypoglycemia. Nonetheless, many individuals with T1D are arguing precisely the other: They imagine that medicines like Ozempic cut back your danger of hypoglycemia as a result of they will let you take much less insulin.
Hypoglycemia is a legit danger, and lowering your insulin doses is crucial to beginning a GLP-1 medicine with T1D. If a GLP-1 will increase your insulin sensitivity, it’s possible you’ll want to scale back your insulin doses and ratios in a short time, ideally with the cooperation of your healthcare supplier.
Experiences in Our Neighborhood
Over the past yr, I’ve heard from many individuals with T1D utilizing GLP-1s like Ozempic or Mounjaro. Each time I discuss Ozempic on my Instagram, I hear from increasingly more kind 1s who’re grateful for these medicines — and so they’ve shared their experiences with me by interviews and feedback:
After Simply Two Weeks, an Speedy Affect
Alexis has lived with T1D for over 40 years, identified at solely 18 months previous! She began taking Wegovy simply two weeks in the past, however the influence on her T1D was important and instant.
“My common blood sugar is down from 165 mg/dL to 140 mg/dL. I’ve had some lows, too, however I simply want to alter my basal insulin doses, significantly within the night.”
Wegovy is one other type of semaglutide, the identical drug as Ozempic, however is prescribed to individuals for weight reduction as a substitute of diabetes. Alexis’ BMI is over 27, so her physician knew that her insurance coverage was extra more likely to approve Wegovy for weight reduction. With a coupon from Novo Nordisk, Alexis obtained the copay down from $200/month to simply $25/month.
“My insurance coverage firm mentioned they wouldn’t prescribe Ozempic for my kind 1 diabetes as a result of it doesn’t work for T1D,” laughed Alexis. “When my physician prescribed Wegovy for weight reduction, they mentioned sure.”
Alexis has tried dropping pounds up to now with out a lot success, maybe attributable to important insulin resistance.
“My healthcare workforce mentioned I simply had an excessive amount of insulin on board which makes it a lot more durable to drop extra pounds,” mentioned Alexis. “I additionally by no means felt full after consuming. And I had very sticky highs each afternoon that wouldn’t budge. Up round 250 mg/dL for 5 hours, nothing would carry it down.”
These “sticky highs” are gone due to Wegovy.
“I’m not having these cussed afternoon highs, and I’ve already misplaced 5 kilos in two weeks,” mentioned Alexis. “I additionally really feel a lot extra happy after consuming. On Wegovy, I can eat a traditional quantity of meals and really feel full. And I can have a small snack between meals and really feel happy.”
The one unwanted side effects she’s skilled are gentle nausea within the morning on an empty abdomen and if she waits too lengthy between meals.
“My blood sugar has been a lot simpler to handle. … I’m so impressed.”
Why a Nurse Practitioner With T1D Selected Mounjaro
Chris Szoke, a nurse practitioner and diabetes skilled, has lived with T1D for over 37 years. Right now, he’s additionally prescribing GLP-1 and GIP/GLP-1 medicines like Ozempic and Mounjaro to his sufferers with T1D.
“Mounjaro has been a tremendous drug for me. I initially simply decreased my basal fee, however it grew to become obvious to me inside a month that I needed to make a number of severe changes in all my insulin doses as a result of I used to be that rather more delicate.”
Chris feels probably the most highly effective facet of this drug for individuals with T1D is the way it shuts down the overproduction of sugar within the liver.
“The primary impact of the drug that’s so interesting to me is the overproduction of glucose from the liver. Personally, I discover the most important advantages there at night time. I’m additionally consuming much less, and my weight began trickling down. I’m not a heavy particular person to start with, however it helped me lose slightly additional weight and get slightly leaner. Loads of my sufferers describe that they’re ‘leaning out’ and dropping these additional fats cells.”
Chris factors to the opposite advantages of those medicines that attain past diabetes and weight administration.
“Now we’re studying even increasingly more about the advantages for cardiovascular and kidney safety. And on the neurology aspect, too, with decreased dementia danger and the advantages for individuals with sleep apnea. The advantages are pouring out from the literature.”
For individuals with T1D, he firmly believes that dosages ought to begin low and be titrated up very slowly, hardly ever ever reaching the total “therapeutic” dosage that may be given to an individual with T2D or weight problems.
“As kind 1s taking insulin, we undoubtedly run the danger of hypoglycemia on these medication, however you need to be actually, actually cautious to extend the dosages of those meds an excessive amount of or too rapidly. Begin low and sluggish. In kind 1s, I don’t carry sufferers as much as the best dose of those medication. I additionally train numerous my sufferers that these medication work on each urge for food and thirst, so it is advisable to regulate your fluid consumption. Keep effectively hydrated!”
Chris talked about the plateau impact, too.
“I’ve seen some sufferers expertise a plateau within the results after a few yr,” mentioned Chris. “That is anticipated, however I received’t maintain rising their dose. Keep on the snug dose and encourage these different way of life habits to assist keep the advantages. In kind 1, I don’t imagine we should always maintain pushing the dosage up.”
A Teen Utilizing Ozempic
“My daughter makes use of a pump, inhaled insulin, and Ozempic,” defined mother, Kelly, about her 15-year-old daughter with T1D. “We wish her to have all the instruments to handle, and a few days are nonetheless actually exhausting.”
“We reached this level in her early teenagers that there was sufficient insulin resistance inflicting noticeable weight achieve regardless of a really nutritious diet and really energetic way of life.”
“I wished to assist her keep away from these physique picture and consuming dysfunction dangers that include taking insulin plus the insane quantity of insulin she wanted simply to right highs and boluses for meals, and a lot insulin on board. The extra insulin you require, the more durable it’s to handle.”
Ozempic minimize her insulin wants down considerably, and now it feels safer and simpler to handle her blood sugar ranges.
“We now have a very nice endocrinologist who has been so supportive of newer approaches to T1D administration,” mentioned Kelly, together with looping and inhaled insulin.
Getting Ozempic was simple, as a result of the endocrinologist documented her insulin resistance clearly and conveyed it effectively within the prescription particulars.
“She began at a really low dose, simply 10 clicks, which isn’t at the same time as a lot because the 0.25 [milligram] mg beginning dose,” defined Kelly. “We’ve additionally labored with Integrative Diabetes Providers for additional teaching on utilizing it.”
Kelly’s daughter took her first injection in mid-March. Her insulin wants dropped about 20 % nearly instantly and have continued to lower since then. Now she’s solely taking about 50 % as a lot insulin as she used to.
“We’ve had a couple of moments the place we rapidly needed to cut back insulin doses due to lows,” defined Kelly. “You want that consciousness of adjusting insulin doses rapidly as issues evolve. And the times proper after her menstrual cycle begins will be tough as a result of she’s so delicate to insulin, however needing much less insulin general means every little thing is less complicated to handle.”
Kelly credit the T1D on-line group for serving to her study insulin, weight administration, and insulin resistance challenges.
“You don’t study this from the physician, however we’re grateful our endo is so supportive once we come to him and take a look at these items,” mentioned Kelly. “Something you are able to do to make life slightly extra regular and simpler to handle. All of this comes with the privilege and sources to get educated on these items and pay for these items on high of normal diabetes administration instruments.”
Lastly Shedding Weight
“I took Ozempic for a couple of years,” says Melissa, who was identified with T1D nearly 25 years in the past. “It was like a miracle treatment for me!”
For Melissa, Ozempic eradicated excessive fluctuations in her blood sugar ranges and that fixed feeling of starvation.
She’d struggled to handle her weight with eating regimen and train alone. Unbeatable insulin resistance made all of it really feel not possible. The dimensions wouldn’t budge, in actual fact, even when attempting her hardest to drop extra pounds, she’d solely achieve extra.
“I used to be lastly capable of drop extra pounds due to Ozempic,” she recollects. “Earlier than, regardless of consuming very well, monitoring energy, and exercising frequently, I used to be all the time steadily gaining weight.”
Sadly, Melissa needed to go off Ozempic whereas planning for being pregnant, as a result of it hasn’t been studied for its security to a rising fetus.
“I haven’t had success on getting pregnant thus far, and I’ve gained the load again, together with blood sugar fluctuations like earlier than.”
Annoyed and feeling defeated, Melissa needs to return on Ozempic however is aware of her intentions to develop into pregnant stand in the way in which for now.
My Expertise
I began taking Ozempic about 1 1/2 years in the past. I needed to go off of it for a couple of months once I misplaced insurance coverage protection — and that’s once I actually got here to understand how a lot it was doing for me.
Right now, I take a teeny dose of 0.25 mg — as prescribed by my physician. I’ve tried going as much as 0.5 mg, however I simply skilled abdomen ache that I don’t expertise on the decrease dose. Since I’m not utilizing Ozempic for weight reduction, that smaller dose appears to be a lot!
It makes every little thing about T1D simpler, with one caveat: Once I eat a slow-digesting meal earlier than mattress, I have a tendency to want a bolus in the midst of the night time to stop spiking.
In any other case, that tiny dose of Ozempic makes it simpler to remain in vary, keep my weight, really feel satiated when consuming, and suppress that additional sugar from my liver. I even have considerably fewer lows whereas taking Ozempic as a result of it reduces my general insulin wants, particularly for meals, which implies I usually have much less insulin on board.
By combining a low dose of Ozempic with my day by day habits round train and consuming principally entire meals, it simply makes life with T1D a lot simpler.
Different T1Ds Share: Ozempic and T1D Feedback From Instagram
Each time I submit about Ozempic on Instagram, I obtain dozens of feedback from different T1Ds who’re taking semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), or dulaglutide (Trulicity). The overwhelming majority of those feedback are glowing evaluations of how a lot these medicines have helped them handle blood glucose ranges extra simply, enhance insulin sensitivity, and drop extra pounds.
These feedback have been edited barely for spelling or readability:
“My time in vary on Ozempic is 94 to 96 %! I’ve had three lows in six months!” – Lorin
“Ozempic has been one of the best factor for my diabetes administration and my weight. Earlier than, I felt like I used to be all the time preventing in opposition to a brick wall.” – Jessica
“I’m on day 4 of the bottom dose of Mounjaro, and I’m loving it. My TIR went from 75 % to 90 to 95 %. Had a couple of unwanted side effects the second day (nausea), however aside from that it’s been superb. My endo is basically supportive of those meds for kind 1s and I completely belief her.” – Christina
“My want for Humalog is nonexistent, and my dose of Lantus has been minimize in half. I’m within the technique of titrating and haven’t had any unwanted side effects.” – Dan (LADA)
“I’m a T1D, and I’ve been on Trulicity for a few yr and it’s accomplished superb issues for my blood sugar! With the scarcity, I haven’t had it for 2 weeks and I’m utilizing way more insulin. I’m hoping my doc can change me over to Ozempic quickly!” – Liza
“It really makes such a world of a distinction!” – Maya
“I’ve been on Mounjaro for 2 weeks now. Lowest dose and I’m loving how good my sugar vary has been! I’m utilizing an Omnipod so I needed to set all my basal charges a lot decrease, however it’s been nice!” – Heidi
“It’s a tremendous drug. Generally I nearly really feel prefer it’s curing my kind 1 diabetes [because it’s so much easier to manage].” – Dana
“I’ve been doing this for nearly a month now. I discover the day after the shot I’ve 500 lows! This half has been tough, however it’s getting simpler. I like the urge for food suppression and all my garments are feeling so a lot better. My frozen shoulder appears to have dissipated! If this retains working so effectively for me, I’ll proceed ceaselessly. I’m additionally solely taking half of the beginning dose, and it’s working so effectively.” – Natalie
“It’s soooo useful, and I used to take 130 models a day by way of my Tandem pump. Now I take 30 to 35 models by way of my pump, and I’ve misplaced and stored off 55 kilos. I’m dwelling my finest life in vary! Ozempic undoubtedly helped with my resistance. I mentioned for years I’m so resistant, it helps me in so some ways.” – Nikki
“Beloved being on it, however my insurance coverage doesn’t cowl it anymore. I undoubtedly noticed enhancements with my sugars.” – Elle
“I attempted it however wasn’t given any recommendation on managing my insulin doses so I’d go loopy low and it was so exhausting to get again up generally.” – Jules
“Ozempic is superb for blood sugar management. Makes me really feel like T1D is manageable now.” – Erika
“I’m on Mounjaro, and it’s such a recreation changer.” – Fernanda
“My first endocrinologist wouldn’t put me on Ozempic, however then my new and present endo let me go on it. It has been superb for my blood sugars as an individual with T1D.” – Grace
