GLP-1 drugs like semaglutide (Ozempic, Wegovy), dulaglutide (Trulicity), and tirzepatide (Mounjaro, Zepbound) are making headlines in kind 2 diabetes, however folks with kind 1 diabetes (T1D) are taking these drugs, too. No, these drugs aren’t FDA-approved for T1D, however nonetheless, many individuals are taking them off-label with the total approval of their docs.
The advantages of GLP-1 drugs for T1D at the moment are fairly apparent, and but many clinicians are nonetheless reluctant to make this remedy extra accessible to this inhabitants.
Right here’s a better take a look at why folks with T1D are utilizing GLP-1 medicine and why they maintain calling it a “game-changer.”
The Advantages of GLP-1 Medication for Kind 1 Diabetes
Listed here are a couple of the explanation why GLP-1 drugs like Ozempic can have such a huge impact 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 chubby 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 drugs assist your physique compensate for the misproduction of these different hormones.
- Insulin sensitivity: Many individuals with T1D wrestle to keep up insulin sensitivity which suggests you want an increasing number of insulin to do the identical job. This makes it more durable to succeed in or keep your A1C objectives. In truth, some clinicians are additionally diagnosing T1D sufferers with T2D due to that overlapping insulin resistance and weight wrestle. GLP-1s can considerably scale back your physique’s day by day insulin wants, making it simpler to handle blood glucose ranges.
GLP-1 drugs aren’t authorised for the remedy of kind 1 diabetes, and a few clinicians are nervous about them as a result of they improve an individual’s danger of hypoglycemia. Nevertheless, many individuals with T1D are arguing precisely the other: They imagine that drugs like Ozempic scale back your danger of hypoglycemia as a result of they will let you take much less insulin.
Hypoglycemia is a professional danger, and lowering your insulin doses is vital to beginning a GLP-1 remedy with T1D. If a GLP-1 will increase your insulin sensitivity, chances are you’ll want to cut back your insulin doses and ratios in a short time, ideally with the cooperation of your healthcare supplier.
Experiences in Our Group
During the last yr, I’ve heard from many folks with T1D utilizing GLP-1s like Ozempic or Mounjaro. Each time I speak about Ozempic on my Instagram, I hear from an increasing number of kind 1s who’re grateful for these drugs — and so they’ve shared their experiences with me by way of interviews and feedback:
After Simply Two Weeks, an Speedy Influence
Alexis has lived with T1D for over 40 years, recognized as an toddler at solely 18 months previous! She began taking Wegovy simply two weeks in the past, however the influence on her T1D was vital and fast.
“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 vary my basal insulin doses, significantly within the night.”
Wegovy is one other type of semaglutide, the identical drug as Ozempic, however is prescribed to folks for weight reduction as an alternative 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 acquired the copay down from $200/month to only $25/month.
“My insurance coverage firm stated 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 stated sure.”
Alexis has tried dropping pounds prior to now with out a lot success, maybe because of vital insulin resistance.
“My healthcare workforce stated I simply had an excessive amount of insulin on board which makes it a lot more durable to drop a few pounds,” stated 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 deliver it down.”
These “sticky highs” are gone because of Wegovy.
“I’m not having these cussed afternoon highs and I’ve already misplaced 5 kilos in two weeks,” stated Alexis. “I additionally really feel a lot extra glad 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 glad.”
The one negative 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 knowledgeable, has lived with T1D for over 37 years. Right this moment, he’s additionally prescribing GLP-1 and GIP/GLP-1 drugs like Ozempic and Mounjaro to his sufferers with T1D.
“Mounjaro has been a tremendous drug for me. I initially simply diminished my basal fee, however it turned 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 folks with T1D is the way it shuts down the over-production 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 evening. I’m additionally consuming much less, and my weight began trickling down. I’m not a heavy individual to start with, however it helped me lose somewhat further weight and get somewhat leaner. Lots of my sufferers describe that they’re ‘leaning out’ and shedding these further fats cells.”
Chris factors to the opposite advantages of those drugs that attain past diabetes and weight administration.
“Now we’re studying even an increasing number of about the advantages for cardiovascular and kidney safety. And on the neurology facet, too, with diminished dementia danger and the advantages for folks with sleep apnea. The advantages are pouring out from the literature.”
For folks 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 medicine, however it’s important to be actually, actually cautious to extend the dosages of those meds an excessive amount of or too rapidly. Begin low and gradual. In kind 1s, I don’t deliver sufferers as much as the best dose of those medicine. I additionally educate a number of my sufferers that these medicine work on each urge for food and thirst, so you must control your fluid consumption. Keep well-hydrated!”
Chris talked about the plateau impact, too.
“I’ve seen some sufferers expertise a plateau within the results after a few yr,” stated Chris. “That is anticipated, however I received’t maintain growing their dose. Keep on the comfy 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 the entire instruments to handle, and a few days are nonetheless actually laborious.”
“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 bolus for meals, and a lot insulin on board. The extra insulin you require, the more durable it’s to handle.”
Ozempic reduce her insulin wants down considerably, and now it feels safer and simpler to handle her blood sugar ranges.
“Now we have a very nice endocrinologist who has been so supportive of newer approaches to T1D administration,” stated 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 0.25mg beginning dose,” defined Kelly. “We’ve additionally labored with Integrative Diabetes Companies for further 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 scale 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 might be tough as a result of she’s so delicate to insulin, however needing much less insulin total means the whole lot is less complicated to handle.”
Kelly credit the T1D on-line neighborhood 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 check out this stuff,” stated Kelly. “Something you are able to do to make life somewhat extra regular and simpler to handle. All of this comes with the privilege and sources to get educated on this stuff and pay for this stuff on prime of standard diabetes administration instruments.”
Lastly Shedding Weight
“I took Ozempic for a couple of years,” says Melissa, who was recognized with T1D nearly 25 years in the past. “It was like a miracle remedy 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 weight-reduction plan and train alone. Unbeatable insulin resistance made all of it really feel not possible. The dimensions wouldn’t budge, actually, even when attempting her hardest to drop a few pounds, she’d solely achieve extra.
“I used to be lastly in a position to drop a few pounds due to Ozempic,” she recollects. “Earlier than, regardless of consuming very well, monitoring energy, and exercising commonly, I used to be at all times 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 turn out to be pregnant stand in the way in which for now.
My Expertise
I began taking Ozempic about 1.5 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 this moment, I take a teeny dose of 0.25mg — as prescribed by my physician. I’ve tried going as much as 0.5mg 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 lots!
It makes the whole lot 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 evening 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 further sugar from my liver. I even have considerably fewer lows whereas taking Ozempic as a result of it reduces my total insulin wants, particularly for meals, which suggests I typically 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 & 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 critiques of how a lot these drugs have helped them handle blood glucose ranges extra simply, enhance insulin sensitivity, and drop a few pounds.
These feedback have been edited barely for spelling or readability:
“My time in vary on Ozempic is 94-96 %! I’ve had three lows in six months!” – Lorin
“Ozempic has been the very best factor for my diabetes administration and my weight. Earlier than, I felt like I used to be at all times 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 90-95 %. Had a couple of negative effects the second day (nausea) however aside from that it’s been wonderful. My endo is basically supportive of those meds for kind 1s and I completely belief her.” – Chrsitina
“My want for Humalog is non-existent and my dose of Lantus has been reduce in half. I’m within the technique of titrating and haven’t had any negative effects.” – Dan (LADA)
“I’m a T1D and I’ve been on Trulicity for a few yr and it’s finished wonderful issues for my blood sugar! With the scarcity, I haven’t had it for 2 weeks and I’m utilizing rather more insulin. I’m hoping my doc can change me over to Ozempic quickly!” – Liza
“It actually makes such a world of a distinction!” – Maya
“I’ve been on Mounjaro for two 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. Typically 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 really 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 eternally. 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 residing my finest life in vary! Ozempic undoubtedly helped with my resistance. I stated for years I’m so resistant it helps me in so some ways.” – Nikki
“Cherished 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 laborious to get again up generally.” – Jules
“Ozempic is wonderful for blood sugar management. Makes me really feel like T1D is manageable now.” – Erika
“I’m on Mounjaro and it’s such a game-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 wonderful for my blood sugars as an individual with T1D.” – Grace
