GLP-1 medicines like semaglutide (Ozempic, Wegovy), dulaglutide (Trulicity), and tirzepatide (Mounjaro, Zepbound) are making headlines in sort 2 diabetes, however individuals with sort 1 diabetes (T1D) are taking these medicines, too. No, these medicines 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 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 preserve calling it a “game-changer.”
The Advantages of GLP-1 Medicine for Type 1 Diabetes
Listed here are just a few the 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 p.c of adults with T1D are chubby or overweight. Managing your weight with T1D isn’t straightforward since you’re taking injections of insulin, a hormone that shops extra glucose as physique fats!
- Hormonal well being: In sort 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 wrestle to take care of insulin sensitivity which implies you want increasingly 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 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 medicines aren’t permitted for the therapy of sort 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 consider that medicines like Ozempic scale back your danger of hypoglycemia as a result of they mean you can take much less insulin.
Hypoglycemia is a professional danger, and decreasing your insulin doses is vital to beginning a GLP-1 medicine with T1D. If a GLP-1 will increase your insulin sensitivity, you might want to cut back your insulin doses and ratios in a short time, ideally with the cooperation of your healthcare supplier.
Experiences in Our Neighborhood
During the last 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 sort 1s who’re grateful for these medicines — they usually’ve shared their experiences with me by interviews and feedback:
After Simply Two Weeks, an Fast 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 impression on her T1D was vital and speedy.
“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 an alternative of diabetes. Alexis’ BMI is over 27, so her physician knew that her insurance coverage was extra prone 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 sort 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 shedding weight previously with out a lot success, maybe attributable to vital insulin resistance.
“My healthcare crew stated I simply had an excessive amount of insulin on board which makes it a lot more durable to drop extra 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 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,” 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 unintended effects she’s skilled are mild 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. At the moment, 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 diminished my basal charge, but it surely turned obvious to me inside a month that I needed to make a number of critical 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 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 night time. I’m additionally consuming much less, and my weight began trickling down. I’m not a heavy individual to start with, but it surely helped me lose a bit additional weight and get a bit leaner. Loads of my sufferers describe that they’re ‘leaning out’ and shedding 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 about the advantages for cardiovascular and kidney safety. And on the neurology facet, too, with diminished 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 is likely to be given to an individual with T2D or weight problems.
“As sort 1s taking insulin, we undoubtedly run the chance 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 shortly. Begin low and gradual. In sort 1s, I don’t carry sufferers as much as the very best dose of those medication. I additionally educate lots of my sufferers that these medication work on each urge for food and thirst, so you should 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 gained’t preserve growing their dose. Keep on the snug dose and encourage these different way of life habits to assist keep the advantages. In sort 1, I don’t consider we should always preserve 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 would like her to have the entire instruments to handle, and a few days are nonetheless actually onerous.”
“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 lively 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 minimize her insulin wants down considerably, and now it feels safer and simpler to handle her blood sugar ranges.
“We’ve got a extremely nice endocrinologist who has been so supportive of newer approaches to T1D administration,” stated Kelly, together with looping and inhaled insulin.
Getting Ozempic was straightforward, 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 whilst a lot because the 0.25mg beginning dose,” defined Kelly. “We’ve additionally labored with Integrative Diabetes Companies for additional teaching on utilizing it.”
Kelly’s daughter took her first injection in mid-March. Her insulin wants dropped about 20 p.c nearly instantly, and have continued to lower since then. Now she’s solely taking about 50 p.c as a lot insulin as she used to.
“We’ve had just a few moments the place we shortly needed to scale back insulin doses due to lows,” defined Kelly. “You want that consciousness of adjusting insulin doses shortly 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 all the things is simpler 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 after we come to him and check out these items,” stated Kelly. “Something you are able to do to make life a bit extra regular and simpler to handle. All of this comes with the privilege and assets to get educated on these items and pay for these items on prime of normal diabetes administration instruments.”
Lastly Dropping Weight
“I took Ozempic for just a few 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 eating regimen and train alone. Unbeatable insulin resistance made all of it really feel unimaginable. The size wouldn’t budge, actually, even when making an attempt her hardest to drop extra pounds, she’d solely achieve extra.
“I used to be lastly in a position to drop extra pounds due to Ozempic,” she remembers. “Earlier than, regardless of consuming rather well, monitoring energy, and exercising often, 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 up to now, and I’ve gained the load again, together with blood sugar fluctuations like earlier than.”
Annoyed and feeling defeated, Melissa desires 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 just a few 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.
At the 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 all the things 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 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 complete 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 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 94-96 p.c! 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 towards 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 p.c to 90-95 p.c. Had just a few unintended effects the second day (nausea) however apart from that it’s been superb. My endo is actually supportive of those meds for sort 1s and I completely belief her.” – Chrsitina
“My want for Humalog is non-existent and my dose of Lantus has been minimize in half. I’m within the technique of titrating and haven’t had any unintended effects.” – Dan (LADA)
“I’m a T1D and I’ve been on Trulicity for a few yr and it’s executed superb 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 but it surely’s been nice!” – Heidi
“It’s a tremendous drug. Typically I nearly really feel prefer it’s curing my sort 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 but it surely’s getting simpler. I really like the urge for food suppression and all my garments are feeling so significantly 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 saved off 55 kilos. I’m residing my greatest 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 onerous to get again up typically.” – 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 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 superb for my blood sugars as an individual with T1D.” – Grace
