Semaglutide: drug found in weightloss jabs could ‘eliminate need for insulin injections’ for type 1 diabetes patients

A drug used in weight-loss jabs could drastically reduce or even eliminate the need for injected insulin, a small study suggests.

Treating newly diagnosed type 1 diabetes patients with semaglutide could possibly be the most dramatic change in treating type 1 diabetes since the discovery of insulin in 1921 - if the findings can be replicated in larger studies, experts say.

Patients in the study were treated first with a low dose of semaglutide, also sold under the brand names Ozempic, Wegovy and Rybelsus, while also taking meal-time (bolus) insulin and basal (background) insulin.

The semaglutide dose was increased while mealtime insulin was reduced in order to avoid hypoglycaemia – low blood sugar.

Paresh Dandona is a professor in the department of medicine, former chief of the division of endocrinology in the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo (UB), and senior author on the paper.

He said: “Our findings from this admittedly small study are, nevertheless, so promising for newly diagnosed type 1 diabetes patients that we are now absolutely focused on pursuing a larger study for a longer period of time.”

The US study, published in the New England Journal of Medicine, looked at 10 patients who were newly diagnosed with type 1 diabetes between 2020 and 2022.

They had been diagnosed with type 1 diabetes in the past three to six months - type 1 diabetes is less common than type 2 but is a chronic condition that tends to start in childhood and is not linked to age or weight.

The body is unable to produce the hormone insulin and so daily injections of it are required to regulate blood sugar levels.

The average HbA1c level (a person’s average blood sugar level over 90 days) at diagnosis was 11.7, far above the American Diabetes Association’s HbA1c recommendation of seven or below.

Within three months researchers were able to eliminate all of the mealtime insulin doses for all of the patients.

Dr Dandona added: “And within six months we were able to eliminate basal insulin in seven of the 10 patients. This was maintained until the end of the 12-month follow-up period.”

During that time, the patients’ mean HbA1c fell to 5.9 at six months and 5.7 at 12 months.

The most common side effects for patients were nausea and vomiting as well as appetite suppression.

This led a number of patients to experience weight loss, an outcome that Dr Dandona said is generally an advantage since 50% of patients with type 1 diabetes in the US are overweight or obese.

He continued: “As we proceeded with the study, we found that even the dose of basal insulin could be reduced or eliminated altogether in a majority of these patients.

“We were definitely surprised by our findings and also quite excited.

“If these findings are borne out in larger studies over extended follow-up periods, it could possibly be the most dramatic change in treating type 1 diabetes since the discovery of insulin in 1921.”