Ozempic may help treat type 1 diabetes: Montreal McGill University Health Centre study

Although it is best known for treating type 2 diabetes, semaglutide — known by its brandname Ozempic — may also be effective in treating type 1 diabetes when used in combination with insulin therapy, a study conducted at the McGill University Health Centre shows.

In a randomized, double-blind trial conducted at the Centre for Innovative Medicine at the Research Institute of the MUHC, participants who took semaglutide in addition to automated insulin therapy were able to maintain safe glucose levels for longer periods of time.

“The medication can work synergistically (with the pump), one can help the other,” summarized first author and study coordinator Dr. Melissa-Rosina Pasqua, an endocrinologist at the MUHC and a doctoral student at the Institute.

Typically, it was explained in a press release, in order to reduce the risk of microvascular and macrovascular complications, patients with type 1 diabetes aim to maintain a glycated hemoglobin level below 7 per cent and to stay in the target glycemic range for at least 70 per cent of the time.

However, studies suggest that nearly half of people using automatic insulin pumps do not achieve this, hence the need to find new strategies to support them.

“In some studies, we see up to 53 per cent of patients whose blood sugar is not in the desired target,” said Dr. Pasqua. “Unfortunately, there are still patients who have hyperglycemia.”

If patients’ blood sugar is not in the target zone with insulin therapy, there is nothing more that can be done, explained the researcher. “We really lack options and treatments at the moment,” she admitted.

The study aimed to see if semaglutide could improve blood sugar levels in these patients.

These patients often wear an automated insulin delivery system, commonly called an insulin pump, to constantly monitor their blood sugar levels and provide their body with the amount of insulin it needs to avoid complications.

Twenty-eight adults took part in this 32-week clinical trial. For the first 15 weeks, half of the participants injected themselves with a weekly dose of semaglutide, and the other half took a placebo, while continuing their own insulin therapy (22 of the 28 participants were using an insulin pump at the start of the trial).

The dose of semaglutide was gradually increased to 1 mg or the maximum tolerated dose. Eventually, the roles were reversed, so that participants who had started taking semaglutide took a placebo, and vice versa, for another 15 weeks.

In the clinical trial, the use of semaglutide reduced insulin requirements and increased weight loss.

“We saw that there were fewer hyperglycemias and more time spent in the target zone (for blood sugar),” explained Dr. Pasqua. “We also saw, with Ozempic, that we needed less insulin to obtain this result, compared to the placebo.”

These results have important implications, because the prevalence of obesity in people with type 1 diabetes is increasing and is associated with the risk of cardiovascular disease and complications.

“There are many patients who have type 1 diabetes who have difficulty losing weight,” recalled Dr. Pasqua.

All the more so, she continued, since in the context of this study, the greatest improvement in blood sugar was measured in patients who lost the most weight. “The higher the body mass index at baseline, the greater the improvement compared to those with a normal BMI,” summarized Dr. Pasqua.

This study, she added, contributes to the scientific literature the solid data that was lacking to possibly revise the guidelines for the management of type 1 diabetes.

The conclusions of this study were published by the journal Nature Medicine.

–This report by La Presse Canadienne was translated by CityNews